Varicose veins, which appear as unsightly bulges, usually on the legs, may be a medical, as well as cosmetic, problem. Varicose veins affect both men and women. According to the The National Institutes of Health, a quarter of patients who suffer from this condition are men. More women seek help for this disorder than men not only because more women suffer from them, but because in our culture women expose their legs more frequently to public view. Regardless of gender, however, varicose veins can be a serious problem requiring medical intervention.
Varicose veins are the result of diseased veins with weakened walls and valves. These weaknesses in the veins may be congenital or may occur as a result of precipitating events or lifestyle habits. When veins are not functioning properly, they fail to return blood to the heart efficiently, and the blood begins to pool. This condition is known as venous insufficiency. When damaged valves are unable to keep blood moving in the proper direction, a backflow results; this condition is referred to as venous reflux.
Risks Factors for Varicose Veins
Risk factors for developing varicose veins are varied and some are gender-related. These risk factors include:
- Oral contraceptives
- Congenital weakness in veins
- Family history of the vascular disease
Many people are at greater risk because of their occupations or habits. Individuals whose work requires that they sit or stand for prolonged periods, teachers for example, are more likely to develop varicose veins. The same is true of those who spend a great deal of time in sedentary travel, whether as a driver or passenger.
Symptoms of Varicose Veins
Patients with varicose veins do not always experience pain from this condition, although some may develop aching, throbbing, cramping and other symptoms that may indicate a need for medical attention. The symptoms of varicose veins may include:
- Large swollen veins
- Swelling, usually of the feet, ankle or leg
- Pain, aching, throbbing or cramping in the legs
- Heaviness in the legs
- Itching in the lower leg or ankle
- Discoloration of skin
Although varicose veins are most frequently found in the legs, they can also occur in other areas, such as the pelvis, vagina, uterus, esophagus or anus.
Treatment of Varicose Veins
There are many treatment options available for the treatment of varicose veins, depending on the severity of the individual case. These treatment possibilities may include:
When varicose veins are mild, they may be successfully treated by the patient at home. Home treatment may include getting plenty of exercise, avoiding long periods of sitting or standing and elevating the legs when at rest.
The compression of these garments may provide symptomatic relief and slow disease progression. Compression stockings alone, however, will not remove varicose veins.
In this procedure a liquid called a sclerosant is injected into the affected vein to cause it to close and stop carrying blood. Sclerotherapy does not require an anesthetic, and is performed in about one hour with little or no discomfort.
Surgical Stripping of Veins
Surgical stripping has been the traditional varicose vein treatment. It is usually performed under general or spinal anesthesia in the hospital. Incisions are made along the course of the vein and the vein is stripped out in pieces. The surgical incisions are closed by stitches. Recovery time after surgical stripping may be 2 to 3 weeks.
Endovenous Laser Treatment (EVLT)
During EVLT, a laser fiber is threaded along the course of the diseased vein and the fiber is pulled out slowly, resulting in closure of the vein. This is an outpatient procedure done with topical or local anesthesia, and takes about 45 minutes with minimal downtime. Immediately after the procedure, the patient can drive home, return to work, and resume a normal routine.
Endovenous Radiofrequency Ablation
During radiofrequency ablation, a small incision is made through which a catheter is inserted into the targeted vein. Once precisely placed, the catheter delivers radiofrequency energy to the wall of the vein, causing the vein to collapse and seal so that blood can no longer travel through it. After the radiofrequency procedure, patients may experience mild bruising and swelling in the treated area, but are usually able to return to your regular activities shortly after treatment.
Complications of Varicose Veins
In patients of either gender, the biggest risk of having varicose veins is that the patient may develop a clot, or deep vein thrombosis (DVT), that may travel to another part of the body. This is referred to as an embolism and is a life-threatening condition. If the clot travels to the lungs, it is called a pulmonary embolism. If it travels to the brain, it may result in a stroke, and if it travels to the heart it may precipitate a heart attack.
When a clot occurs in a milder way, it is called phlebitis or superficial thrombophlebitis. While less serious than DVT, phlebitis must be medically treated to assure that the condition doesn't worsen. Usually remedies include resting with the affected leg elevated, taking anticoagulants or clot-dissolving medications. In the most serious cases, surgical removal of the vein may be necessary.
Prevention of Varicose Veins
While some individuals may develop varicose veins regardless of maintaining a healthy lifestyle, there are steps that can be taken to lower one's risk. These preventative measures include maintaining a healthy weight, exercising regularly, taking frequent breaks from sitting or standing, and elevating the legs while at rest.
- National Institutes of Health
- American College of Phlebology
- Society for Vascular Surgery
- National Heart, Lung and Blood Institute
- Centers for Disease Control and Prevention
- Eunice Kennedy Shriver
National Institute of Child Health and Human Development
- U.S. Department of Health & Human Services
- U.S. National Library of Medicine