What Are Varicose Veins?

Varicose (VAR-i-kos) veins are swollen, twisted veins that you can see just under the surface of the skin and may bulge above the surface of the skin. They may be blue, red, or flesh-colored in appearance. These veins usually occur in the thighs, backs of the calves, or the inside of the leg, but they also can form in other parts of the body.

Nearly 25% of women and 18% of men suffer daily from discomfort associated with varicose veins (chronic venous insufficiency). Varicose veins often cause leg pain, cramping, pelvic pain, unsightly bulging and leg swelling. Patients will often describe their legs as feeling tired and achy.

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Causes Of Varicose Veins And Spider Veins

Varicose veins can be caused by weak or damaged valves in the veins. The heart pumps blood filled with oxygen and nutrients to the whole body through the arteries. Veins then carry the blood from the body back to the heart. As your leg muscles squeeze, they push blood back to the heart from your lower body against the flow of gravity. Veins have valves that act as one-way flaps to prevent blood from flowing backwards as it moves up your legs. If the valves become weak, blood can leak back into the veins and collect there. (This problem is called venous insufficiency.) When backed-up blood makes the veins bigger, they can become varicose.

A number of factors predispose a person to varicose veins. These include:

  • Heredity
  • Occupations that involve a lot of standing, such as nurses, hair stylists, teachers, factory workers and hospitality staff
  • Obesity 
  • Hormonal influences of pregnancy, puberty, and menopause 
  • The use of birth control pills 
  • Postmenopausal hormonal replacement
  • A history of blood clots 
  • Conditions that cause increased pressure in the abdomen, such as tumors, constipation, and externally worn garments like girdles

Other reported causes include trauma or injury to the skin, previous vein surgery, and exposure to ultraviolet rays.


How common are abnormal leg veins?

About 50 to 55 percent of women and 40 to 45 percent of men in the United States suffer from some type of vein problem. Varicose veins affect half of people 50 years and older.

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What are the signs of varicose veins?

Varicose veins can often be seen on the skin. Some other common symptoms of varicose veins in the legs include:

  • Aching pain that may get worse after sitting or standing for a long time
  • Throbbing or cramping
  • Heaviness
  • Swelling
  • Rash that’s itchy or irritated
  • Darkening of the skin (in severe cases)
  • Restless legs

Are varicose veins and spider veins dangerous?

Spider veins rarely are a serious health problem, but they can cause uncomfortable feelings in the legs. If there are symptoms from spider veins, most often they will be itching or burning. Less often, spider veins can be a sign of blood backup deeper inside that you can’t see on the skin. If so, you could have the same symptoms you would have with varicose veins.

Varicose veins may not cause any problems, or they may cause aching pain, throbbing, and discomfort. In some cases, varicose veins can lead to more serious health problems. These include:

  • Sores or skin ulcers due to chronic (long-term) backing up of blood. These sores or ulcers are painful and hard to heal. Sometimes they cannot heal until the backward blood flow in the vein is repaired.
  • Bleeding. The skin over the veins becomes thin and easily injured. When an injury occurs, there can be significant blood loss.
  • Superficial thrombophlebitis (throm-bo-fli-BYT-uhs), which is a blood clot that forms in a vein just below the skin. Symptoms include skin redness; a firm, tender, warm vein; and sometimes pain and swelling.
  • Deep vein thrombosis, which is a blood clot in a deeper vein. It can cause a “pulling” feeling in the calf, pain, warmth, redness, and swelling. However, sometimes it causes no significant symptoms. If the blood clot travels to the lungs, it can be fatal.

How are varicose veins diagnosed?

Your doctor may diagnose your varicose veins based on a physical exam. Your doctor will look at your legs while you’re standing or sitting with your legs dangling. He or she may ask you about your symptoms, including any pain you’re having. Sometimes, you may have other tests to find out the extent of the problem and to rule out other disorders.

You might have an ultrasound, which is used to see the veins’ structure, check the blood flow in your veins, and look for blood clots. This test uses sound waves to create pictures of structures in your body.

Although less likely, you might have a venogram. This test can be used to get a more detailed look at blood flow through your veins.

If you seek help for your varicose veins, there are several types of doctors you can see, including:

  • A phlebologist, which is a vein specialist
  • A vascular medicine doctor, who focuses on the blood system
  • A vascular surgeon, who can perform surgery and do other procedures
  • An interventional radiologist, who specializes in using imaging tools to see inside the body and do treatments with little or no cutting
  • A dermatologist, who specializes in skin conditions

Each of these specialists do some or all of the procedures for treating varicose veins. You might start out by asking your regular doctor which specialist he or she recommends. You also might check with your insurance plan to see if it would pay for a particular provider or procedure.

 


Should I see a doctor about varicose veins?

You should see a doctor about varicose veins if:

  • The vein has become swollen, red, or very tender or warm to the touch
  • There are sores or a rash on the leg or near the ankle
  • The skin on the ankle and calf becomes thick and changes color
  • One of the varicose veins begins to bleed
  • Your leg symptoms are interfering with daily activities
  • The appearance of the veins is causing you distress

If you’re having pain, even if it’s just a dull ache, don’t hesitate to get help. Also, even if you don’t need to see a doctor about your varicose veins, you should take steps to keep them from getting worse.

Can varicose and spider veins return even after treatment?

Current treatments for varicose veins and spider veins have very high success rates compared to traditional surgical treatments. Over a period of years, however, more abnormal veins can develop because there is no cure for weak vein valves. Ultrasound can be used to keep track of how badly the valves are leaking (venous insufficiency). Ongoing treatment can help keep this problem under control.

The single most important thing you can do to slow down the development of new varicose veins is to wear gradient compression support stockings as much as possible during the day.

 


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