A varicose vein is an enlarged, swollen, and twisted vein that appears under the skin. Varicose veins are often blue or purple in color, and can cause pain, itching, or bleeding. They are usually not a serious health problem, but they can affect your appearance and quality of life. The condition can sometimes cause complications such as ulcers, blood clots, or skin infections in some cases.
Vascular valves that control blood flow are damaged or weak in varicose veins. Blood normally flows from the legs to the heart against gravity via these valves, which open and close. As a result of faulty valves, blood can pool in veins, stretching or twisting them.
Some factors that can increase the risk of developing varicose veins are:
Age: As you get older, your veins lose elasticity and your valves become less effective.
Gender: Women are more likely to develop varicose veins than men, due to hormonal changes that can affect the vein walls. Pregnancy, menopause, and birth control pills can also increase the risk.
Family history: If you have relatives with varicose veins, you are more likely to inherit them.
Lifestyle: Standing or sitting for long periods of time, especially with crossed legs, can reduce blood circulation and increase pressure in the veins. Wearing tight clothing or shoes can also restrict blood flow.
Weight: Being overweight or obese can put extra strain on the veins and valves.
Health conditions: Some diseases or disorders that affect the blood vessels, such as chronic venous insufficiency, deep vein thrombosis, or phlebitis, can increase the risk of varicose veins.
Varicose veins may not cause any symptoms, except for their appearance. However, some people may experience:
A feeling of heaviness, aching, or cramping in the legs
Burning, throbbing, or tingling sensations in the legs
Swelling, inflammation, or redness in the legs or ankles
Itching or dryness around the veins
Bleeding from the veins or skin ulcers near the veins
Changes in skin color or texture around the veins
The symptoms of varicose veins may worsen after standing or sitting for a long time, or during warm weather.
During an examination of your legs, your health care provider will ask about your symptoms and medical history. Some tests may be performed to check your veins and blood flow, such as:
An ultrasound is a non-invasive technique used to create images of veins and blood flow. It can detect blockages, clots, or reflux (backward flow).
A venogram involves injecting dye into the veins and taking X-rays to show how blood flows. It can identify any abnormalities or damage in the veins.
Treatment of varicose veins depends on the severity of the condition, your symptoms, and your preferences. Some treatment options are:
Self-care: This involves making some lifestyle changes to improve blood circulation and reduce the symptoms of varicose veins. These include:
Exercising regularly to strengthen the leg muscles and veins
Elevating the legs when resting or sleeping to reduce swelling and pressure
Avoiding standing or sitting for long periods of time, and moving the legs frequently
Wearing loose-fitting clothing and comfortable shoes that do not constrict the veins
Wearing compression stockings that apply gentle pressure to the legs and help the blood flow
Maintaining a healthy weight and diet to prevent obesity and constipation
Avoiding smoking and excessive alcohol consumption to improve blood vessel health
Medications: Your health care provider may prescribe some medications to treat the underlying cause or complication of varicose veins, such as:
Anti-inflammatory drugs to reduce pain and swelling
Anticoagulants to prevent or treat blood clots
Antibiotics to prevent or treat skin infections
Diuretics to reduce fluid retention and edema
A minimally invasive or surgical procedure may be recommended if self-care and medications do not relieve symptoms or improve the appearance of varicose veins. These include:
Sclerotherapy: This involves injecting a chemical solution into the vein that causes it to scar and close. The blood then reroutes to other veins, and the treated vein fades away over time.
Laser therapy: This involves applying strong bursts of light onto the vein that heat up and damage the vein wall, causing it to collapse and seal. The blood then reroutes to other veins, and the treated vein disappears over time.
Radiofrequency ablation: This involves inserting a thin tube (catheter) into the vein and delivering radiofrequency energy that heats up and destroys the vein wall, causing it to collapse and seal. The blood then reroutes to other veins, and the treated vein shrinks over time.
Endovenous laser ablation: This involves inserting a thin tube (catheter) into the vein and delivering laser energy that heats up and destroys the vein wall, causing it to collapse and seal. The blood then reroutes to other veins, and the treated vein shrinks over time.
Vein stripping: This involves making small incisions in the skin and removing the vein through them. The blood then reroutes to other veins, and the removed vein is discarded.
Phlebectomy: This involves making tiny punctures in the skin and removing small segments of the vein through them. The blood then reroutes to other veins, and the removed vein segments are discarded.
If you have a genetic predisposition or suffer from a health condition that affects your veins, it may not be possible to prevent varicose veins completely. By following some of the self-care measures mentioned above, you can reduce the risk of developing or worsening varicose veins, including:
Elevating the legs
Avoiding prolonged standing or sitting
Wearing compression stockings
Maintaining a healthy weight and diet
Avoiding smoking and excessive alcohol consumption
If you have any concerns or questions about varicose veins, you should consult your health care provider for advice and treatment options.