Definition and Overview

Varicose veins are veins that are swollen, twisted and enlarged. They usually appear on the surface of the skin with bluish or dark purple color. Varicose veins are most common in the legs or calves and lower body extremities, mainly because standing and walking put extra strain in the veins on the lower body.

Varicose veins are usually not serious as a condition, but in some instances they may be indicative of a more serious health problem such as blockage in the deeper veins, a condition known as deep vein thrombosis. This condition is quite common, affecting at least 3 in every 10 adults. Varicose veins tend to appear in women more than in men.

Causes and Risk Factors

Varicose veins are attributed to weakened valves and veins in the affected area. Inside the veins are small one-way valves that allow blood to flow through, yet close to prevent backflow. Sometimes, these valves weaken due to overstretching or loss of elasticity, causing blood to leak and flow backwards. This can lead to blood accumulation in the veins, causing them to be swollen and enlarged.

The exact cause as for this malfunction in the veins is yet to be fully elucidated. Some people tend to develop varicose veins for no apparent or distinct reason. However, there seems to be certain risk factors that increase one’s likelihood of developing varicose veins. These risk factors include the following:

  • Gender: women are more likely to be affected than men, the reason for which is purported to be linked to female hormones

  • Genetics: the risk of developing varicose veins seems to be hereditary

  • Age: aging can cause veins to lose elasticity

  • Weight: being overweight can cause extra pressure on the veins, prompting the valves to work harder, thereby making them prone to leaking

  • Occupation: people with occupations that require them to stand for a long period are at a higher risk of developing this condition

  • Pregnancy: pregnancy prompts the body to increase blood production to support the developing baby; this increased blood flow and hormonal changes make pregnant women prone to varicose veins (symptoms significantly improve after childbirth)

In some cases, development of varicose veins can be attributed to other medical conditions such as tumor in the pelvis, a previous blood clot or stroke, or abnormal behavior of blood vessels.

Symptoms of Varicose Veins

Symptoms of varicose veins can range from mild to serious. They usually develop as dark blue or purple, swollen vein lines under the skin. Along with these, minor symptoms such as the following may be observed:

  • aching, tiredness, and burning sensation as well as heaviness in the legs, which may worsen with long periods of standing or sitting
  • swelling in the feet and/or ankles
  • itching sensation in the affected veins
  • discomfort in the lower extremities
  • muscle cramps in the legs indicative of poor circulation

Serious symptoms can include swelling in the legs, extreme calf pain, inflammation with color changes in the skin, or open sores which may bleed if trauma is incurred.

When to See a Doctor for Varicose Veins

Varicose veins that don’t cause any pain or discomfort usually don't require medical attention. However, it may be necessary to talk to your doctor if you experience the following:

  • discomfort and pain in the veins
  • soreness or irritation on the skin where the varicose veins are located
  • extreme pain in the legs that disrupt your sleep

Moreover, if you think your varicose veins are significantly affecting the aesthetic appearance of your legs, you may see a doctor for some treatment solutions.

Diagnosis and Treatment Methods

During the consultation, your GP will diagnose varicose veins based on their appearance. Physical examination of the affected area will be performed to check for signs and severity. You will also be asked to describe any pain or discomfort, or state situations where the condition has worsened.

Your GP may recommend you to a vascular doctor or specialist if your varicose veins are causing more pain than normal, or if the symptoms indicate a more serious condition that needs further testing and analysis. In these cases, a test called the duplex ultrasound scan will be performed. High-frequency sound waves will be applied to the legs to produce a visual representation of the veins in the area. Results from this test can determine and locate damage in the valves, which may be causing the varicose veins.

Treatment is not always required for varicose veins, as they are mostly cosmetic problems more than medical ones. However, there are now various treatment options available to cure varicose veins. The choice of treatment will depend on the size or severity of the varicose veins, the symptoms involved, and the affected area. Treatment can range from home remedies to invasive surgery.

For mild cases of varicose veins, treatment may be sought my simply elevating the legs while sitting or sleeping to decrease pressure in the veins. Compression dressings with single or multi-layered systems as well as compression stocking may be recommended.

For serious cases of varicose veins, the doctor may suggest more invasive treatment, which may be one of the following:

  • Sclerotherapy – involves the injection of a chemical solution that irritates the vascular lining, causing swelling and blood clot while permanently destroying the vessel.

  • Ablation – this procedure involves the destruction of the damaged or abnormal veins through laser or radiofrequency techniques.

  • Surgery – surgical means such as phlebectomy or vein stripping can permanently remove varicose veins.

Preventing Varicose Veins

There is little evidence linked to effective solutions for preventing varicose veins. However, there are some noteworthy ways for easing symptoms of existing varicose veins. As a rule, it is best to avoid standing or sitting still for long periods. Should these be necessary, take regular breaks and end the night by raising the legs to ease the pressure on the legs. An active lifestyle with adequate exercise will also significantly prevent aggravation of varicose veins.

References:

  • Cole, Gary W. and Nabili, Siamak (2014). “Varicose Veins”

  • National Health Service. “Varicose Veins” Available: http://www.nhs.uk/Conditions/Varicose-veins/Pages/Whatarevaricoseveins.aspx Bhimji, Shabir MD (2014). “Varicose Veins”

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