Information From Your Health Care Provider

VARICOSE VEINS

Basic information

description

Varicose veins are veins, usually in the legs and ankles, which become permanently enlarged and often twisted. Varicose veins typically involve the superficial veins (those close to the skin). The disorder is more common in adults and occurs in women more than men.

FREQUENT SIGNS & SYMPTOMS

Enlarged, bulging, ropelike, bluish veins that are visible under the skin. They appear most often in the back of the calf or on the inside of the leg from the ankle to the groin.
Vague discomfort and aching, or pain in the legs, especially after standing.
Fatigue.

causes

The veins of the legs contain one-way valves every few inches to help blood return against gravity to the heart. Varicose veins can develop when valves leak and the blood pressure in the veins prevents blood from draining properly. Blood pools in the veins causing them to stretch, bulge, and be visible.

risk increases with

Increasing age and females.
Family history of varicose veins.
Prolonged sitting or standing (as with certain jobs).
Pregnancy.
History of blood clots.
Overweight, high blood pressure, straining (as with constipation), prior leg surgery or injury, and being less active physically may increase risks.
Congenital (being born with) abnormal veins.

PREVENTIVE MEASURES

None specific. Risks may be reduced.
Exercise regularly, especially by walking, swimming, or bicycling to keep circulation healthy.
Don't sit or stand for long periods. Move around.
Maintain a healthy weight.
May wear compression hose if you are at high risk.
Elevate your legs when possible.

expected outcomes

Self-care steps may help symptoms. Medical treatment has a high success rate.

possible complications

Ulcers (deep sores) in the legs or ankles.
Phlebitis (inflammation) in a vein or thrombophlebitis (small blood clot in a vein).
Large varicose veins may bleed easily if bumped or scratched.
Complications may occur with treatment.
Varicose veins may return after treatment.

diagnosis & treatment

general measures

Your health care provider will do a physical exam of the affected veins and ask about your symptoms. Medical tests may include ultrasound and other studies.
Simple treatment methods may be recommended:
- Take frequent rest periods with legs elevated.
- Use lightweight, elastic compression hosiery. It is best to put them on before getting out of bed.
- Avoid tight clothing around waist, legs, or groin.
- Avoid long periods of sitting or standing. Take breaks and walk around.
- Wear comfortable shoes and avoid high heels.
- Cross legs at ankles and not at the knees.
Surgery and other treatment methods may be done for pain, recurrent phlebitis (inflamed veins), skin changes, or for cosmetic reasons.
Veins can be sealed off by using sclerotherapy (injections), laser, intense-pulsed light therapy, or radio-frequency ablation. Veins can also be removed with surgery. Your health care provider will discuss your options, the risks, and benefits of each one with you.
Spider veins (idiopathic telangiectases) are small superficial veins. They may be treated with a laser or with injections.

medications

A chemical may be injected (sclerotherapy) into small varicose veins to make them collapse and disappear over time. Other veins will take over blood flow.
Drugs for pain may be prescribed following surgery.

activity

Walking and being active after any treatment is important to help promote healing.
Compression hose will usually need to be worn for a period of time after any form of treatment.