Varicose Veins
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Varicose Veins

Varicose Veins Varicose Veins

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Varicose veins are swollen, twisted vein that lie just under the skin and usually occur in the legs.

This health topic focuses on varicose veins in the legs, but sometimes varicose veins form in other parts of the body. Hemorrhoids, for example, are a type of varicose vein that develops in the rectum. Telangiectasia, often called spider veins, is another type of vein problem that affects smaller blood vessels.

 

What are the symptoms?

A posterior view of the external female lower legs. Easily seen and identified with a label are varicose veins coursing down the legs.
Medical Animation Copyright © 2022 Nucleus Medical Media, All rights reserved.

Symptoms of varicose veins include:

  • Bulging, bluish vein or veins
  • Swelling in the legs
  • Aching pain in the legs
  • A feeling of heaviness in the legs and feet
  • Itching around the vein or veins
  • Skin color changes around the vein or veins
  • Nighttime leg cramps

Sometimes varicose veins can limit your activities. Your symptoms may get worse when you sit or are on your feet for long periods, and they may get better when you lie down or put your feet up.

How are varicose veins diagnosed?

To diagnose varicose veins, your doctor will do a physical exam and ask about your symptoms, family history, activity levels, and lifestyle.

Your doctor may do an imaging test, such as an ultrasound or X-ray, to see how healthy your leg veins are.

What causes varicose veins?

Varicose veins are a common condition caused by weak or damaged vein walls and valves. Veins have one-way valves inside them that open and close to keep blood flowing toward the heart. Weak or damaged valves or walls in the veins can cause blood to pool and even flow backwards. This is called reflux. The veins may grow larger and become distorted, resulting in varicose veins. Visit How the Heart Works to learn more about blood flow to and from the heart.

Varicose veins may form whenever blood pressure increases inside your veins. This can happen because of pregnancy, constipation, a tumor, or overweight and obesity. You may also be at a higher risk for varicose veins if you are older, sit or stand for long periods, have an inactive lifestyle, or have a family history of varicose veins or deep vein thrombosis, a type of venous thromboembolism.

How are varicose veins treated?

 Depending on how serious your symptoms and varicose veins are, your doctor may recommend a combination of treatments or no treatment at all. There is also a chance that new varicose veins may form even after treatment, or you may need to be treated more than once.

The goals of treatment are to relieve symptoms, improve appearance, and prevent serious complications such as skin ulcers or sores, deep vein thrombosis, skin color changes, and bleeding.

Call 9-1-1 if you see any bleeding from varicose veins. This is a medical emergency. 

If you are pregnant, your doctor may recommend compression therapy and pain medicine to relieve symptoms of varicose veins, such as pain or heaviness in the legs.

Lifestyle changes

Your doctor may recommend adopting lifestyle changes to help relieve symptoms or prevent varicose veins from getting worse. These may include:

  • Aiming for a healthy weight. This will improve blood flow and ease the pressure on your veins.
  • Being physically active to help blood move through your veins. Strenuous or vigorous exercise might make varicose veins worse. Before starting any exercise program, ask your doctor about what level of physical activity is right for you.
  • Avoiding standing or sitting for long periods. When sitting, elevate your feet so your legs are raised above the level of your heart.

Procedures

Your doctor may do an ultrasound or other exams to see how well your veins are working. Most procedures for varicose veins do not require a long recovery.

  • Endovenous ablation to close off a varicose vein: Your doctor uses lasers or radiofrequency energy to heat the inside of the vein and close it off. This procedure is usually done in a doctor’s office with ultrasound to guide the treatment. Your doctor numbs the area around the vein so you do not feel pain during the procedure. Bruising, pain, and changes in skin color are common after endovenous ablation. More serious complications, including numbness, venous thromboembolism, and skin burns, are rare.
  • Sclerotherapy to close off a varicose vein: Your doctor injects liquid or foam chemicals into the vein to seal it closed. Sclerotherapy is done in your doctor’s office with ultrasound guidance. Liquid sclerotherapy is often used for spider veins. Complications of foam sclerotherapy may include skin color changes and, rarely, venous thromboembolism, nerve damage, serious allergic reaction, or stroke. Some people may have temporary vision problems, headaches, or confused mental states.
  • Surgery to remove severe varicose veins: Your doctor may make small cuts to remove smaller varicose veins near the skin’s surface. For larger, deeper veins, your doctor may use tools to tie off and remove them in a procedure called vein ligation or stripping. Surgery can often be done on an outpatient basis, but you may need medicine to help you sleep during the procedure. Because surgery may involve more pain and a longer recovery time, this option is usually only for people who are not eligible for endovenous ablation or sclerotherapy. Surgery complications may include infection, nerve damage, bruising, pain, and changes in skin color. Severe complications are rare.

Several procedures are available for treating varicose veins and spider veins. 

 

 

Research for your health

The NHLBI is committed to advancing science and translating discoveries into clinical practice to promote the prevention and treatment of heart and vascular diseases, including varicose veins. Learn about NHLBI efforts to improve health through heart and vascular disease research and scientific discovery, including studies in our Vascular Interventions/Innovations and Therapeutic Advances (VITA) Program.

Compression therapy

Your doctor may recommend compression therapy as a treatment alone or after a procedure to remove or close off varicose veins. Compression therapy involves special elastic stockings or compression bandages that put gentle pressure on the legs to help prevent swelling.

For some people, especially those who have to sit or stand for long periods, compression may help relieve pain, swelling, and other symptoms, such as a feeling of heaviness in the legs. If you are pregnant, your doctor may recommend compression hose.

Compression therapy only relieves symptoms. Most doctors now recommend procedures to correct the reflux problem that is causing your varicose veins.

After you have a procedure to remove or close off your varicose veins, your doctor will probably recommend compression stockings for at least a week. Compression stockings may also help heal leg ulcers or sores that are a complication of varicose veins. Because vein problems are long term, your doctor may suggest that you continue to wear compression stockings.

Some people find that compression stockings cause discomfort, itching, skin irritation, or swelling.

Medicines

Your doctor may recommend medicine to help relieve the pain of varicose veins. Diosmiplex is the only available medicine approved for varicose veins. This plant-based medicine may help with some varicose vein symptoms and complications, including swelling, ulcers, and changes in skin and tissues of the legs.

It may take several weeks before you notice any improvement. Side effects may include gastrointestinal problems and rashes, but these are usually minor.

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