Varicose veins are gnarled, enlarged veins. Any vein may become varicose, but the veins most commonly affected are those in your legs and feet. That’s because standing and walking upright increases the pressure in the veins of your lower body.For many people, varicose veins and spider veins — a common, mild variation of varicose veins — are simply a cosmetic concern. For other people, varicose veins can cause aching pain and discomfort. Sometimes varicose veins lead to more-serious problems.
The National Institutes of Health estimates that 60% of all men and women suffer from some of vein disorder. A quarter of varicose vein sufferers are men, although Dr.Robert A. Weiss, MD, assistant professor of dermatology at the Johns Hopkins School of Medicine in Baltimore notes that it is almost always women who seek help for spider veins.Spider veins, the more delicate red or blue tracings that can pop up on the skin’s surface like kinky spider webs, are a minor form of varicose veins and can precede development of the more unsightly variation or cause cosmetic concerns of their own. Sun exposure can make spider veins worse by breaking down collagen under the skin.
- Varicose veins may not cause any pain. Signs you may have with varicose veins include:
- Veins that are dark purple or blue in color
- Veins that appear twisted and bulging; often like cords on your legs
- When painful signs and symptoms occur, they may include:
- An achy or heavy feeling in your legs
- Burning, throbbing, muscle cramping and swelling in your lower legs
- Worsened pain after sitting or standing for a long time
- Itching around one or more of your veins
- Bleeding from varicose veins
Causes of varicose veins can include:
Age. As you get older, your veins can lose elasticity, causing them to stretch. The valves in your veins may become weak, allowing blood that should be moving toward your heart to flow backward. Blood pools in your veins, and your veins enlarge and become varicose. The veins appear blue because they contain deoxygenated blood, which is in the process of being recirculated through the lungs.
Pregnancy. Some pregnant women develop varicose veins. Pregnancy increases the volume of blood in your body, but decreases the flow of blood from your legs to your pelvis. This circulatory change is designed to support the growing fetus, but it can produce an unfortunate side effect — enlarged veins in your legs. Varicose veins may surface for the first time or may worsen during late pregnancy, when your uterus exerts greater pressure on the veins in your legs. Changes in your hormones during pregnancy also may play a role. Varicose veins that develop during pregnancy generally improve without medical treatment three to 12 months after delivery.
How Are Varicose Veins Treated?
Varicose veins are treated with lifestyle changes and medical procedures. The goals of treatment are to relieve symptoms, prevent complications, and improve appearance.
Avoid standing or sitting for long periods without taking a break. When sitting, avoid crossing your legs. Keep your legs raised when sitting, resting, or sleeping. When you can, raise your legs above the level of your heart.Do physical activities to get your legs moving and improve muscle tone. This helps blood move through your veins.If you’re overweight or obese, try to lose weight. This will improve blood flow and ease the pressure on your veins.Avoid wearing tight clothes, especially those that are tight around your waist, groin (upper thighs), and legs. Tight clothes can make varicose veins worse.Avoid wearing high heels for long periods. Lower heeled shoes can help tone your calf muscles. Toned muscles help blood move through the veins.
Wearing compression stockings all day is often the first approach to try before moving on to other treatments. They steadily squeeze your legs, helping veins and leg muscles move blood more efficiently. The amount of compression varies by type and brand. You can buy compression stockings at most pharmacies and medical supply stores. Prices vary. Prescription-strength stockings also are available.
Medical procedures are done either to remove varicose veins or to close them. Removing or closing varicose veins usually doesn’t cause problems with blood flow because the blood starts moving through other veins.You may be treated with one or more of the procedures described below. Common side effects right after most of these procedures include bruising, swelling, skin discoloration, and slight pain.The side effects are most severe with vein stripping and ligation (li-GA-shun). Rarely, this procedure can cause severe pain, infections, blood clots, and scarring.
Sclerotherapy (SKLER-o-ther-ah-pe) uses a liquid chemical to close off a varicose vein. The chemical is injected into the vein to cause irritation and scarring inside the vein. The irritation and scarring cause the vein to close off, and it fades away.This procedure often is used to treat smaller varicose veins and spider veins. It can be done in your doctor’s office, while you stand. You may need several treatments to completely close off a vein.Treatments typically are done every 4 to 6 weeks. Following treatments, your legs will be wrapped in elastic bandaging to help with healing and decrease swelling.
Microsclerotherapy (MI-kro-SKLER-o-ther-ah-pe) is used to treat spider veins and other very small varicose veins. A small amount of liquid chemical is injected into a vein using a very fine needle. The chemical scars the inner lining of the vein, causing it to close off.
Laser surgeries. Doctors are using new technology in laser treatments to close off smaller varicose veins and spider veins. Laser surgery works by sending strong bursts of light onto the vein, which makes the vein slowly fade and disappear. No incisions or needles are used.
Catheter-assisted procedures using radiofrequency or laser energy. In one of these treatments, your doctor inserts a thin tube (catheter) into an enlarged vein and heats the tip of the catheter using either radiofrequency or laser energy. As the catheter is pulled out, the heat destroys the vein by causing it to collapse and seal shut. This procedure is the preferred treatment for larger varicose veins.
Endovenous Ablation Therapy
Endovenous ablation (ab-LA-shun) therapy uses lasers or radio waves to create heat to close off a varicose vein. Your doctor makes a tiny cut in your skin near the varicose vein. He or she then inserts a small tube called a catheter into the vein. A device at the tip of the tube heats up the inside of the vein and closes it off. You’ll be awake during this procedure, but your doctor will numb the area around the vein. You usually can go home the same day as the procedure.
Endoscopic Vein Surgery
For endoscopic (en-do-SKOP-ik) vein surgery, your doctor will make a small cut in your skin near a varicose vein. He or she then uses a tiny camera at the end of a thin tube to move through the vein. A surgical device at the end of the camera is used to close the vein. Endoscopic vein surgery usually is used only in severe cases when varicose veins are causing skin ulcers (sores). After the procedure, you usually can return to your normal activities within a few weeks.
For ambulatory phlebectomy (fle-BEK-to-me), your doctor will make small cuts in your skin to remove small varicose veins. This procedure usually is done to remove the varicose veins closest to the surface of your skin. You’ll be awake during the procedure, but your doctor will numb the area around the vein. Usually, you can go home the same day that the procedure is done.
Vein Stripping and Ligation
Vein stripping and ligation typically is done only for severe cases of varicose veins. The procedure involves tying shut and removing the veins through small cuts in your skin. You’ll be given medicine to temporarily put you to sleep so you don’t feel any pain during the procedure. Vein stripping and ligation usually is done as an outpatient procedure. The recovery time from the procedure is about 1 to 4 weeks.
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