• Varicose Veins

    Definition

    Varicose veins are enlarged and swollen veins. They can occur anywhere in the body, but are particularly common in the surface veins in the legs.
    Varicose Veins
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    Causes

    Veins have one way valves to channel blood back to the heart. Varicose veins develop when the valves of the veins become damaged. This causes blood to pool in the veins, enlarging them and often making the veins just beneath the skin visible.

    Risk Factors

    Varicose veins are more common in women who are of childbearing age and older. Other factors that increase your chance of getting varicose veins include:
    • Family members with varicose veins
    • Hormonal changes, as with puberty, pregnancy, or menopause
    • Pressure on the veins of the pelvis, as with pregnancy
    • Obesity
    • Job that requires you to sit or stand for long periods of time without much movement
    • Smoking

    Symptoms

    Varicose veins may cause:
    • Enlarged, twisted, and swollen veins that are visible through the skin
    • Achy, tired, heavy feeling in the area of the varicose veins or generally in the legs, especially after standing
    • Leg cramps
    • Burning or throbbing pain in the legs
    • Itching
    • Swollen legs
    In severe cases, varicose veins may cause skin changes. These changes occur under the area of the varicose veins and include:
    • Rashes
    • Discoloration
    • Sores that are difficult to heal

    Diagnosis

    You will be asked about your symptoms and medical history. A physical exam will be done. Varicose veins can be easily seen. An ultrasound exam of your legs may also be done.

    Treatment

    Talk with your doctor about the best treatment plan for you. Options may include one or more of the following:

    Lifestyle Changes

    Conservative treatment is tried first to relieve symptoms. Steps may include:
    • Avoid standing for long periods of time.
    • Rest with your legs elevated.
    • Flex legs occasionally when standing or sitting for long periods.
    • Wear compression stockings. Wearing these may help improve circulation in the leg veins.

    Procedures

    Veins that are causing more severe symptoms may need further treatment such as:
    • Laser or light source therapy—laser or light source energy used to seal, collapse, and dissolve varicose veins
    • Sclerotherapy—injects the varicose veins with a chemical to shrink the veins
    • Radiofrequency ablation—collapses and seals varicose veins using radiofrequency energy
    • Surgery—banding and removing varicose veins—only for severe cases
    • Endovenous mechanochemical ablation—closing varicose veins with a rotating wire and chemical agent
    • Adhesive sealing—sealing the affected veins that are close to the skin using an adhesive agent

    Prevention

    Varicose veins can't be completely prevented, especially if they run in your family. The following recommendations may help:
    • Maintain a healthy weight.
    • Exercise regularly.
    • Try to avoid standing or sitting for long periods of time.
    • Try to avoid crossing your legs for long periods of time while sitting.
    • Keep your legs elevated when resting.
    • Consider wearing support hose.

    RESOURCES

    American College of Phlebology http://www.phlebology.org

    American Society of Plastic Surgeons http://www.plasticsurgery.org

    CANADIAN RESOURCES

    Canadian Society for Aesthetic Plastic Surgery http://www.csaps.ca

    Canadian Society for Vascular Surgery http://canadianvascular.ca

    References

    Varicose veins and spider veins fact sheet. US Office on Women's Health. Available at: http://womenshealth.gov/publications/our-publications/fact-sheet/varicose-spider-veins.html. Updated July 16, 2012. Accessed June 13, 2016.

    3/16/2015 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T116699/Varicose-veins : US Food and Drug Administration. FDA approves closure system to permanently treat varicose veins. Available at: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm435082.htm. Published February 20, 2015. Accessed June 13, 2016.

    6/13/2017 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T116699/Varicose-veins : Endovenous mechanochemical ablation for varicose veins. National Institute for Health and Care Excellence website. Available at: https://www.nice.org.uk/guidance/ipg557. Published May 2016. Accessed June 13, 2017.

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