What are varicose veins?

Varicose veins are twisted, enlarged veins near the surface of the skin. They are most common in the legs and ankles. They usually aren’t serious, but they can sometimes lead to other problems.

What causes varicose veins?

Varicose veins are caused by weakened valves and veins in your legs. Normally, one-way valves in your veins keep blood flowing from your legs up toward your heart. When these valves do not work as they should, blood collects in your legs, and pressure builds up. The veins become weak, large, and twisted.

Varicose veins often run in families. Aging also increases your risk.

Being overweight or pregnant or having a job where you must stand for long periods of time increases pressure on leg veins. This can lead to varicose veins.

What are the symptoms?

Varicose veins look dark blue, swollen, and twisted under the skin. Some people do not have any symptoms. Mild symptoms may include:

More severe symptoms or complications include:

• A buildup of fluid and swelling in the leg.
• Significant swelling and calf pain after sitting or standing for a long time.
• Skin color changes (stasis pigmentation) around the ankles and lower legs.
• Dry, stretched, swollen, itching, or scaling skin.
• Superficial thrombophlebitis (when a blood clot and inflammation develop in a small vein near the surface of the skin).
• Open sores (ulcerations).
• Bleeding and/or bruising after a minor injury.

Symptoms of varicose veins may become more severe a few days before and during a woman’s menstrual period.

More severe symptoms or complications include:

• A buildup of fluid and swelling in the leg.
• Significant swelling and calf pain after sitting or standing for a long time.
• Skin color changes (stasis pigmentation) around the ankles and lower legs.
• Dry, stretched, swollen, itching, or scaling skin.
• Superficial thrombophlebitis (when a blood clot and inflammation develop in a small vein near the surface of the skin).
• Open sores (ulcerations).
• Bleeding and/or bruising after a minor injury.

Symptoms of varicose veins may become more severe a few days before and during a woman’s menstrual period.

Treatments:

• Laser treatment. Laser energy is used to scar and destroy varicose veins. This is called ablation.
  • Simple laser therapy is done on small veins close to the skin, such as spider veins. The laser is used outside of your skin.
  • Endovenous laser therapy uses a laser fiber inserted into the vein. Laser ablation inside the vein makes the vein close up.
• Ligation and stripping. Incisions are made over the varicose veins, and the vein is tied off (ligated) and removed (stripped).
• Phlebectomy. Several tiny cuts are made in the skin through which the varicose vein is removed.
• Radiofrequency treatment. Radiofrequency energy (instead of laser energy) is used inside a vein to scar and close it off. It can be used to close off a large varicose vein in the leg.
• Sclerotherapy. A chemical (sclerosant) is injected into a varicose vein to damage and scar the inside lining of the vein, causing the vein to close. This usually works best for small veins.

Treatment may be needed to remove the damaged veins, treat complications, or correct an underlying problem that is causing the varicose veins. The size of your varicose veins affects your treatment options. Generally, larger varicose veins are treated with ligation and stripping, laser treatment, or radiofrequency treatment. In some cases, a combination of treatments may work best. Smaller varicose veins and spider veins are usually treated with sclerotherapy or laser therapy on your skin.

Some people may want to improve how their legs look, even though their varicose veins are not causing other problems. In these cases, a procedure or surgery may be appropriate-as long as there are no other health problems that make these treatments risky.

All treatment methods-including all types of surgery, sclerotherapy, laser, and radiofrequency ablation-can scar or discolor the skin.

Treatment can be more difficult for deep veins that are damaged or for perforating veins, which connect the deep and superficial veins. These veins may be treated with surgery, radiofrequency ablation, or sclerotherapy, or a combination of these treatments.