Varicose Veins

Did you know that over 25 million people suffer from symptomatic varicose veins in the United States? Varicose veins are often mistakenly thought to be only a cosmetic condition when, in fact, they are usually a symptom of a more serious condition, called Venous Reflux Disease or Venous Insufficiency. This is a condition that progressively damages the valves of the vein and can cause long term complications, while also cosmetically disfiguring the leg.

Varicose veins

Varicose veins, also called vein or venous disease, is a condition of the veins in the leg in which the veins become swollen, giving a bumpy and twisted appearance. Varicose veins can cause pain, leg swelling and long term damage.

Varicose veins happen when the veins in the legs do not work properly. Normally, the veins in the legs carry blood from the legs back to the heart. The veins have tiny valves inside them to help keep blood moving in only one direction (toward the heart). The valves open to let blood flow to the heart, and close to keep it from flowing back down the leg. Vein disease can happen when the valves are damaged or do not work well (this is called Venous Insufficiency). This causes blood to collect in the veins of the legs. Blood is especially likely to collect in the legs when people sit or stand for a long time without walking.

Symptoms of vein disease

For many people, there are few, if any, symptoms. However, if you have any of these symptoms, you should consult your doctor.

  • Leg pain, or the leg feeling tired, achy, or heavy; this often progresses throughout the day and with prolonged standing.
  • Swollen veins – “Varicose veins” are larger leg veins (just under the skin) that are swollen and twisted, have a “squishy” and bumpy appearance.
  • “Spider veins” are small leg veins that are swollen and often have a purple appearance.
  • Swelling in the lower legs or ankles – People can have swelling at the end of the day or all the time.
  • Skin color changes – The skin can turn red or red-brown. Skin color changes often happen first around the ankle.
  • Open sores, also called “venous ulcers” – These are usually at the ankle and can be painful and ooze.

What causes vein disease?

Veins have one-way valves, preventing your blood from flowing backwards. When these valves fail, your blood collects in your vein rather than continuing to your heart. Varicose veins often affect the legs because they are the farthest from the heart and gravity makes it harder for the blood to flow upward. Causes of varicose veins include:

  • Age.
  • A blood clot in a leg vein (called a DVT-- deep vein thrombosis); this can have long term effects even after the blood clot has resolved.
  • Leg injury.
  • Being pregnant more than once – This causes a change in hormone levels that can weaken vein walls; also the pressure of the baby in the uterus on the veins in the pelvis can cause varicose veins.
  • Weight gain.
  • Family genetics as vein disease does tend to run in families.

How are varicose veins diagnosed?

Your doctor or nurse will do an exam to look at your legs. He or she might also do a test called an ultrasound. An ultrasound is a test in which a ultrasound technician presses a plastic wand against your leg, creating an image of the inside using sound waves. They look specifically at the valves in the veins to determine if there is Venous Insufficiency (poorly functioning valves); this test can also see if any of the veins in the legs are blocked.

Learn more about our screenings and diagnostic tests.

Vein Ablation Treatments

Vein ablation treatments are treatments designed to destroy superficial veins with abnormal valve function. These treatments are usually reserved for people with symptoms that cannot be managed with lifestyle changes. Veins are destroyed in one of three ways and have specific post-surgical care needs.

Compression stockings

Compression stockings are generally recommended following these ablation procedures. Compression stockings gently compress the legs, which may improve blood flow in the veins by preventing backward flow through the veins of the legs.

**It is important to note that while compression stockings can help to reduce the symptoms of vein disease (swelling, aching, tired feeling in legs), they do not fix the underlying vein disease (venous insufficiency).

Effective compression stockings apply the greatest amount of pressure at the ankle and gradually decrease the pressure up the leg. These stockings are available with varying degrees of compression.

  • Stockings with small amounts of compression can be purchased at pharmacies and surgical supply stores without a prescription.
  • People with moderate to severe disease, those on their feet a lot, and those with ulcers usually require prescription stockings. A healthcare provider may take measurements for stockings, or may write a prescription for stockings and then have a surgical supply or specialty store take the necessary measurements.

Stockings are available in several heights, including knee-high, thigh-high, and pantyhose. Knee-high stockings are sufficient for most patients. Some stockings can cause skin irritation or pain, although proper measurement and fitting of the stockings can reduce the risk of discomfort.

Managing symptoms of vein disease

To reduce swelling, you can:

  • Walk around, and try not to sit or stand in one place for a long time.
  • Elevate your legs while resting, 3 or 4 times a day, for 30 minutes each time. Your legs need to be above your heart level to allow gravity to work, and allowing the excess fluid to drain out of your legs.
  • Do exercises to point your toes and feet down and up a few times each day. Using your muscles help to push the blood out of your legs back to your heart.
  • Your doctor may recommend Compression Stockings to help with your symptoms.

To treat dry or itchy skin, you can use an unscented moisturizing cream. Ask your doctor or nurse before using any other type of cream or ointment, because some creams and ointments can cause a rash.

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