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Varicose veins are swollen, twisted blood vessels that appear just beneath the surface of the skin. These are blue or purple bulges that are commonly found in the legs, feet, and ankles. This occurs due to standing and walking which raise the pressure in the veins of the lower body. In most cases, varicose veins are not considered dangerous.
Varicose and spider veins are two distinct types of venous conditions that exhibit dissimilar appearances. Spider veins are characterized by small streaks of red or purple color on the skin’s surface and may be found in the vicinity of varicose veins. Varicose veins, on the other hand, are visibly larger and thicker than spider veins. Although both conditions are usually considered cosmetic issues, some individuals may experience additional symptoms.
Varicose veins can cause agonizing pain and discomfort. Severe varicose veins can cause serious health complications such as blood clots. Most varicose vein symptoms can be treated at home. Injections, laser therapy, or surgery are other treatment options.
Symptoms
Varicose veins are usually visible. They are twisted, blue or purple veins immediately seen beneath the skin’s surface and often resemble cords on the legs.
Varicose veins can be uncomfortable. Common symptoms include:
- Aching or heavy sensation in the legs. Leg muscles may feel fatigued, heavy, or sluggish, especially after strenuous activity.
- Burning, throbbing, muscular cramps, and swelling in the lower leg, ankles, and feet.
- Increased pain after prolonged sitting or standing.
- Itching, which may occur near varicose veins.
- Skin color changes, specifically brown discolorations if left untreated.
While varicose veins are typically not a cause for concern, it is advisable to seek medical attention if self-care measures have been ineffective, or if they have become bothersome. Consulting a doctor for an examination and treatment may be necessary if the veins or skin exhibit signs of bleeding, discoloration, swelling, or sensitivity to the touch.
Causes
Arteries are vessels that transport blood from the heart to the rest of the body. Veins transport blood from other parts of the body to the heart. Ideally, the veins in the legs must battle against gravity to return blood to the heart.
Varicose veins develop when the walls of the veins deteriorate. Lower leg muscle contractions operate as pumps, and elastic vein walls aid in blood return to the heart. As the vein’s blood pressure rises, the weaker walls allow it to expand. The valves that keep blood flowing in one direction in the veins are unable to function properly as the vein stretches. Slowly flowing blood backs up or pools in the vein, leading it to expand, bulge, and twist.
Vein walls and valves can become weak due to a variety of factors such as hormones, aging, excessive weight gain, extremely tight clothing, and prolonged standing which puts pressure on the veins.
Risk factors
Various factors can increase an individual’s susceptibility to varicose veins, including:
- Family history: This condition can be inherited. If other members of the family have varicose veins, the likelihood of getting it is higher.
- Age: As the person gets older, the vein walls and valves stop working as they used to. Veins lose flexibility and become rigid. The valves in the veins that assist control blood flow wear down. Because of this wear, the valves eventually allow some blood to flow back into the veins, where it gathers.
- Gender: Female hormones can cause vein walls to stretch. Varicose veins are more common in women who are on the birth control pill, or going through menopause because to changes in hormone levels.
- Pregnancy: Varicose veins are common in pregnant women due to the rise of the blood volume in the body. It can cause vein enlargement in the legs.
- Obesity: Excess weight puts strain on veins.
- Lifestyle: Standing or sitting for long periods of time reduces circulation. Movement promotes blood flow. Constriction of clothing, such as girdles or jeans with tight waistbands, can reduce blood flow.
Diagnosis
The diagnosis of varicose veins typically involves a physical examination, as the veins are visible and located near the skin’s surface. During the examination, a doctor can assess the veins by feeling them while the patient is sitting or standing. The doctor may also check for swelling and inquire about any associated symptoms to confirm the diagnosis.
Imaging test: Doppler ultrasound is a noninvasive imaging test that employs sound waves to examine blood flow through vein valves. The procedure is done by moving a small hand-held device, called transducer, roughly the size of a bar of soap across the skin over the body area being evaluated. The transducer sends images of the legs’ veins to a monitor, which displays the results. This test can detect blood clots as well as how well the valves are performing. This is known to be an effective way of diagnosing varicose veins.
Treatment
Although there is no cure for varicose veins, several treatments are available help to lessen their appearance and alleviate discomfort. Common treatments include self-care techniques, compression stockings, surgery, and other special procedures. Surgical treatment for varicose veins is frequently performed as an outpatient surgery, which means patients usually go home the same day.
- Self-care: Self-care measures such as exercise, elevating the legs while sitting or lying down, and using compression stockings can help relieve varicose vein pain and possibly prevent from worsening. It is beneficial to raise the legs above the waist multiple times during the day to promote blood flow and lower vein pressure.
- Compression stockings: These stockings or socks compress the veins and relieve pain. The pressure prevents veins from stretching and improves blood flow. The amount of compression differs based on the type and brand. If varicose veins are causing symptoms, prescription-strength stockings may be prescribed. Wearing compression stockings all day is a common first step in managing varicose veins.
- Surgeries or other procedures: Surgery and other treatment procedures are often recommended if self-care and compression stockings are ineffective in managing the symptoms. These treatments are also possible for those who want to have their varicose veins removed for cosmetic reasons.
- Sclerotherapy. This procedure uses a solution that induces the vein walls to bind to one another. The solution or foam is injected into the varicose veins. In some cases, the same vein will need to be injected more than once. The vein eventually transforms into scar tissue. The repaired varicose veins should diminish in a few weeks.
- Laser treatment: In this treatment, no cuts or needles are necessary. The laser procedure delivers powerful pulses of light to the vein, causing it to diminish and disappear over time.
- Ambulatory phlebectomy: This treatment usually incurs minimal scarring. It is an outpatient surgery where only the punctured areas of the leg are numbed. In this procedure, smaller varicose veins are removed through a series of micro skin punctures.
- Catheter-based procedures using radiofrequency or laser energy: It is a minimally invasive treatment generally recommended for larger varicose veins. During the procedure, a catheter is inserted into an enlarged vein and uses radiofrequency or laser radiation to heat the catheter’s tip. The heat causes the vein to compress, and seal shut. Closing varicose veins helps healthy veins to reopen and resume normal blood flow.
- High ligation and vein stripping: This is a surgical procedure used to eliminate varicose veins in the legs. This involves tying up the problem vein (ligation) to prevent blood from pooling. To prevent varicose veins from reappearing, the surgeon may remove (strip) the vein. The healthy veins take over after varicose vein stripping and ligation to help restore normal blood flow.
