Varicose Veins - The Definitive Guide to Treatments and More

Varicose veins are a very common condition in the United States and affect approximately 30-50 percent of adults.

For many men and women, varicose veins and spider veins (these are the smaller and more common variation of varicose veins) makes them feel less attractive, and are a cosmetic concern. However, for others, varicose veins cause aching pain and discomfort.

As with many other health related issues, self-help measures contribute to prevention; compression stockings and changing certain aspects in one's lifestyle. To get rid of varicose veins your doctor can remove them through a number of medical treatments.

What are Varicose Veins?

Varicose veins are the blue or purplish enlarged veins you typically see bulging out of one's leg. The word "varicose" is derived from the Latin root word "varix," which is translated in English as "twisted." Any vein in your body may become varicose; however, varicose veins most often appear in the legs. Varicose veins occur in the legs and lower extremities because standing and walking increases the pressure in the veins in the lower half of your body.

In healthy veins, tiny valves open as blood flows toward your heart and then close to stop blood from flowing backward. In varicose veins, the valves are weakened or damaged allowing blood to flow backward causing swelling and the veins to become damaged.

This condition may lead to serious problems such as Thrombosis (blood clots) or venous stasis ulcers (slow or non-healing sores). Moreover, varicose veins may also indicate that the individual is at higher risk of other disorders of the circulatory system.

Varicose Vein Treatment Options

Varicose veins are treated with a combination of lifestyle changes and medical intervention.

Lifestyle changes

Losing weight, eating a balanced diet and engaging in regular exercise can alleviate varicose veins and associated discomfort of pain. If you sit for prolonged periods of time, taking activity breaks will help rev up your circulation.

Doctors usually recommended compression stockings for patients with varicose veins. Full length pantyhose offers the mildest support. Compression garments offer the next level support, and are available in above or below the knee socks or full length compression hose. Your doctor may recommend a prescription level supporting garment, which can usually be purchased from a medical supply store or pharmacy.

Non-Invasive Treatments

If a combination of self-management and compression garments are not sufficient to manage your symptoms, or if you would like to remove them for cosmetic reasons, there are a number of procedures your doctor can use to remove varicose veins:

  • Sclerotherapy: One of the most commonly used procedures to remove small varicose veins and spider veins. In this non-surgical procedure your doctor injects a liquid chemical into the vein, which causes irritation and scarring, causing the body to close off the vein and reabsorb it into the body. Sclerotherapy can be done in your doctor’s office and usually does not require anesthesia.
  • Endovenous Ablation: Uses laser or radio waves to burn (cauterize) and close off problem veins. This procedure is minimally invasive and most effective on small to medium sized veins. Veins that have been closed off are reabsorbed into the body.
  • Ambulatory Phlebectomy: This procedure uses tiny punctures or incisions to remove small portions of the vein, one section at a time. No stitches and little recovery time are expected. The incisions are so small no stitches are required.
  • Vein Ligation & Stripping: Older methods of treating veins, ligation includes making small incisions over the problem vein and tying off the vein in order to cut off blood flow, which in turn causes the vein to become less visible. Vein stripping involves tying off of the upper end of a problem vein and then removing the vein. Long veins are often removed this way.

Although current treatments for varicose veins and spider veins are highly successful, it is possible for varicose veins to recur.

Screening and Diagnosis by a Physician

Prior to making a diagnosis, your doctor will take a complete patient history, taking special note of family history, and any previous injury or illness which may affect your circulation. Be sure to bring a list of your current and past medications to your appointment, as well as a list of questions or concerns you might have. Your doctor will perform a thorough physical exam, which will include examining your legs while standing to check for edema. Varicose vein symptoms will be noted. If indicated, your doctor may order a duplex ultrasound to examine blood flow in your legs or identify a blood clot in your veins.

Use the information and resources on this site to become educated about varicose veins, and choose a qualified physician who specializes in varicose vein and spider vein treatment.

Symptoms of Varicose Veins

A number of people do not experience any discomfort with varicose veins, however, some people do. Here are some uncomfortable symptoms common with varicose veins:

  • Dark blue or purple veins
  • Twisted, thickened veins
  • Achiness or heaviness in the legs
  • Veins feel like they are burning, throbbing or itchy
  • Swelling in the lower legs
  • Pain is worse after sitting or standing for long periods of time
  • Skin ulcers on the leg and ankle. Skin ulcers can indicate severe vascular disease, and may require immediate attention.

Risk Factors for Varicose Veins

  • Standing for long periods of time: Blood doesn't flow as well if you're in the same position for long periods of time because your muscles are not contracting to push the blood back to the heart.
  • Obesity: Extra weight puts more pressure on your veins.
  • Age: As you age, normal wear and tear weakens vein walls and venous valves which regulates blood flow.
  • Sex: Women are more likely than men to develop varicose veins and spider veins. This is attributed to hormonal changes during pregnancy, PMS and menopause. The female hormone estrogen may relax vein walls, and hormone replacement therapy and birth control pills may also increase your risk of varicose veins.
  • Genetics: You are more likely to have varicose veins if close family members have them.
  • Injury or Trauma to the leg

Pregnancy and Varicose Veins

Pregnant women sometimes complain of developing varicose veins for good reason. Varicose veins may appear for the first time during pregnancy. While pregnancy increases the volume of blood in a woman’s body, it decreases the flow of blood from the legs to the pelvis. This change in circulation is designed to support a growing baby, but it can also lead to enlarged veins in the legs. Hormonal changes during pregnancy also contribute to the development of varicose veins. Varicose veins may worsen in late pregnancy because the uterus exerts greater pressure on the veins in your legs. Many women experience relief from varicose veins within 3 months of delivery without treatment.

Prevention of Varicose Veins

There's no way to completely prevent varicose veins. But improving your circulation and muscle tone can reduce your risk of developing varicose veins or getting additional ones. Traditional, common-sense approaches include:

  • Exercise. Get your legs moving. Walking is a great way to encourage blood circulation in your legs. Your doctor can recommend an appropriate activity level for you.
  • Watch your weight, and your diet. Shedding excess pounds takes unnecessary pressure off your veins. What you eat makes a difference, too. Follow a low-salt, high-fiber diet to prevent the swelling that may result from water retention and constipation.
  • Watch what you wear. Avoid high heels. Low-heeled shoes work calf muscles more, which is better for your veins. Don't wear tight clothes around your waist, legs or groin. Tight panty-leg girdles, for instance, can restrict circulation.
  • Elevate your legs. To improve venous circulation, take several short breaks daily to elevate your legs above the level of your heart. For example, lie down with your legs resting on three or four pillows.
  • Avoid long periods of sitting or standing. Make a point of changing your position frequently to encourage blood flow. Try to move around at least every 30 minutes.
  • Don't sit with your legs crossed. This position can aggravate circulation problems.

Alternative Medicine and Varicose Veins

Some alternative medicine experts have noted that horse chestnut seed extract may be an effective treatment poor venous circulation, especially for symptoms such as varicose veins characteristic of chronic venous insufficiency ( a chronic condition in which leg veins have problems returning blood to the heart.) The herb may help improve swelling and discomfort caused by varicose veins. Make sure you talk with your doctor before trying horse chestnut seed extract or any other herb or dietary supplement.

Related Medical Conditions

Hemorrhoids

You may be surprised to learn that hemorrhoids are actually varicose veins located in and around the anus. This condition is very common in the United States. By age 50, about half of adults have had to deal with the itching, bleeding and pain that often signal the presence of hemorrhoids.

Hemorrhoids, also known as “piles”, are swollen veins in your anus and rectum. The causes include straining during a bowel movement or the increased pressure during pregnancy.

Effective medications and procedures are readily available to treat hemorrhoids. Fortunately, most people can get relief from hemorrhoids by changing their lifestyle.

Leg Ulcers

In advanced stages of venous disease, painful ulcers may form on the skin near varicose veins, particularly near the ankles. When venous circulation is compromised, blood can stand still or pool in the veins (venous stasis) which increases pressure within affected veins, causing skin breakage and venous ulcers to form. It is important to see a physician immediately if you suspect you've developed an ulcer.

Sudden Swelling of the Leg

If you have considerable swelling in the leg (caused by the enlarging of veins deep within the legs) you must see a doctor immediately. Sudden leg swelling requires urgent medical attention because it could indicate thrombophlebitis, a condition where a blood clot block your vein, leading to inflammation and other potentially serious problems.

Always Be a Cautious Consumer

Before undergoing any procedure, ask your doctor about any health risks and possible side effects.

Some insurance companies will cover varicose vein treatment if you display signs or symptoms such as swelling and bleeding. Most insurance companies do not cover primarily cosmetic procedures. Check with your insurance company to clarify coverage requirements. For more information, click here for health insurance coverage information. Talk to your doctor’s office about cost of treatment, and check whether your insurance company will reimburse your treatment costs. You may also consider the merits of getting a second opinion when having your vein issues diagnosed.

Updated: December 30, 2015

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