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What Is It?
Varicose veins result from a chronic dilatation of the veins, a condition called "varicosity." Instead of flowing from one valve to the next, the blood begins to pool in the vein, increasing venous pressure and causing the vein to bulge and twist.
Your body has two types of blood vessels: arteries carry oxygen- and nutrient-rich red blood from your heart to your muscles and organs, while veins return the "used" bluish blood back to your heart. The deep veins located beneath the muscles carry about 90 percent of the blood traveling from your legs back to your chest. The other 10 percent flows through veins located closer to the surface, often visible, and less well supported.
While your leg muscles help your veins pump the blood upward, the real workhorse is an intricate system of one-way valves that prevent the blood from draining back down the leg under the force of gravity. In many people, women in particular, these valves stop working as well as they should, putting additional pressure on the wall of the vein.
Varicose veins results from a chronic dilatation of the veins, a condition called "varicosity." When the vein walls are pushed apart, the valves no longer seal properly, making it difficult for the muscles to push the blood upward. Instead of flowing from one valve to the next, the blood begins to pool in the vein, increasing venous pressure and causing the vein to bulge and twist. The result is varicose veins.
In some people, varicose veins are simply a cosmetic concern. In others, the condition leads to pain and more serious problems. And in some cases, varicose veins can signal a higher risk for other conditions involving the circulatory system. When inflamed or clotted, they become hard and tender to the touch. Increasing pressure may cause itchy skin and aching in the affected limb.
If you suffer from varicose veins, you are not alone. According to the American College of Phlebology, up to 50 percent of American women have varicose veins or a related venous disorder. Spider veins, also referred to as telangiectasia or broken capillaries, are formed by the dilation of a small group of blood vessels located close to the surface of the skin and are most commonly found on the legs and face. They look like red or purple sunbursts or branched or web patterns and only rarely cause pain. Varicose veins differ from spider veins in that they are:
Varicose veins aren't just a cosmetic concern. They can pose a health risk. Sometimes they are associated with:
Certain people seem to be more predisposed to varicose veins than others, including:
In addition, several factors can lead to varicose veins in people who are predisposed to them, including:
In addition to hormonal changes, pregnancy causes both an increased volume of blood and increased pressure from the abdomen, which in turn causes veins to enlarge. The good news is varicose veins due to pregnancy often improve within three months after delivery. However, with successive pregnancies, these abnormal veins are more likely to enlarge further.
Many cases of varicose veins are clearly visible, with the knotted, twisted or bulging darkened veins showing beneath the skin of the thigh and lower legs. And, your legs may be swollen. If you have varicose veins, you may also experience pain in the legs, especially after standing or sitting still for a long time. Some women describe the pain as feelings of fatigue, heaviness, aching, burning, throbbing, cramping or restlessness.
Severe varicose veins can make your skin itchy or lead to a skin condition similar to eczema or even ulcers on your lower legs. Keep in mind that not all leg discomfort is caused by varicose veins. Any persistent or severe symptoms warrant a visit to your health care professional.
Vein disorders are not always visible. If you can't see any symptoms, or, to help determine the cause and severity of the problem, your health care professional may conduct a noninvasive ultrasound or other vascular test.
Be sure to call your health care professional if swelling becomes incapacitating or if the skin over your varicose veins becomes flaky, ulcerated, discolored or prone to bleeding. In addition, if you have redness, warmth and burning pain in the area of a vein, call your health care professional, because this can be a sign of phlebitis or a blood clot.
Because varicose and spider veins are congested with blood, they really aren't doing their job anymore. Fortunately, there are usually plenty of other, healthy veins to take over. So most of these unwanted veins simply aren't necessary and can be removed. But while invasive treatment is an option, don't rush to the operating room. There are simpler things you can try first, including:
If these conservative methods don't work to your satisfaction, you should discuss with your health care professional the possibility of trying one or more corrective measures, such as:
In addition, if you develop small painful ulcers at the injection site, inform your health care professional immediately.
Although sclerotherapy works well for spider veins, studies show that it is not as effective as surgery for treating varicose veins and that recurrence rates are high.
Surgery
Surgery is generally used to treat large varicose veins and has been shown to be effective, with most patients reporting satisfaction with their procedure. Surgery for varicose veins can be performed using local, spinal or general anesthesia. Most patients return home the same day as the procedure. Surgical options include:
Unfortunately, no treatment can prevent veins from becoming varicose. Varicose veins sometimes recur after any form of treatment, but it's not the same vein coming back; it's a different vein becoming affected.
Before undergoing any procedure for varicose or spider veins, be sure to tell your health care professional if you've ever had blood clots in your lungs or legs.
Health care professionals who specialize in the treatment of varicose veins include:
Unfortunately, some treatment centers specializing in varicose veins have been caught by the Federal Trade Commission making unfair promises to patients. Keep in mind that no treatment for varicose veins is ever 100 percent effective, and there is never a 100 percent guarantee that other veins in your legs won't become varicose.
Some companies distribute herbs or over-the-counter diet supplements with claims they prevent or cure varicose veins. While some of these supplements claim to have been shown in testing to improve circulation or impact veins in other ways, keep in mind that herbs and supplements are not regulated, and there is no guarantee of quality, safety or efficacy. Also remember that there is no 100 percent cure for or prevention of varicose veins. And keep in mind that it's important to discuss cost of treatments and out-of-pocket expenses because your health insurance may not cover the cost of the procedure.
You can't help being a woman, having been born into a family that suffers from varicose veins or even getting older. But there are a few things you can do to head off varicose veins or keep them from becoming more prominent, swollen and distorted, such as:
Review the following Questions to Ask about varicose veins so you're prepared to discuss this important health issue with your health care professional.
Both your leg muscles and valves within your veins work to get the used blood from your legs back up to your heart. When the valves stop working as well as they should—which can be caused by heredity, abdominal pressure, increased pressure from prolonged standing, obesity, hormonal changes, aging and a number of other factors—the blood pools in the vein, stagnating there and causing the vein to bulge or twist.
Although they can be painful and unsightly, in most cases, superficial or visible varicose veins don't lead to further complications. If you are concerned, your health care professional can conduct some painless tests to determine the severity of the problem and ascertain if any of the deeper veins are affected.
Probably not. If only surface veins are affected, the condition is usually harmless. You would probably be feeling more pain or other symptoms if deeper veins were abnormal, which can lead to more serious problems. However, you may want to talk to your health care professional about these concerns.
Leg pain can be caused by a number of factors or conditions. If the pain seems to be brought on by standing or sitting for prolonged periods, you could have varicose veins. But if you have no visible symptoms, the only way to determine the cause of your pain is to have some tests done by your health care professional.
Varicose veins due to pregnancy often improve within three months after delivery. However, with successive pregnancies, these abnormal veins are more likely to remain.
The best idea is probably to get a referral from your health care professional or from a friend or family member who has been successfully treated. The types of health care professionals best suited to treating varicose veins are most likely vascular or general surgeons, dermatologists and phlebologists.
Once the vein is removed, it's gone forever. However, you very well could develop varicosity in other veins.
Keep in mind that no medical treatment is ever 100 percent risk-free and cannot be 100 percent guaranteed. While it's true that once a varicose vein is removed surgically, it will not reappear, that doesn't mean you will forever be free of varicose veins. Other veins can develop problems. Remember that surgery is a rather drastic measure. The less drastic corrective measures such as sclerotherapy or laser treatments are by no means 100 percent effective 100 percent of the time. And none of the corrective measures can be guaranteed to be totally pain-free.
For information and support on Varicose Veins, please see the recommended organizations, books and Spanish-language resources listed below.
American Academy of Dermatology
Website: https://www.aad.org
Address: P.O. Box 4014
Schaumburg, IL 60618
Hotline: 1-866-503-SKIN (7546)
Phone: 847-240-1280
Email: mrc@aad.org
American Society for Dermatologic Surgery
Website: https://www.asds.net
Address: 5550 Meadowbrook Dr., Suite 120
Rolling Meadows, IL 60008
Phone: 847-956-0900
Society of Interventional Radiology
Website: https://www.sirweb.org
Address: 3975 Fair Ridge Drive, Suite 400 North
Fairfax, VA 22033
Hotline: 1-800-488-7284
Phone: 703-691-1805
Email: info@sirweb.org
Books
Beautiful Again: Restoring Your Image and Enhancing Body Changes
by Jan Willis
Spanish-language resources
Medline Plus: Varicose Veins
Website: https://www.nlm.nih.gov/medlineplus/spanish/varicoseveins.html
Address: US National Library of Medicine
8600 Rockville Pike
Bethesda, MD 20894
Email: custserv@nlm.nih.gov
HealthyWomen content is for informational purposes only. Please consult your healthcare provider for medical advice, diagnosis or treatment.