Varicose veins are enlarged veins that can be blue, red, or flesh-colored. They often look like cords and appear twisted and bulging. They can be swollen and raised above the surface of the skin. Varicose veins are often found on the thighs, backs of the calves, or the inside of the leg.
Varicose veins are diagnosed based on a physical exam. We will look at your legs while you are in a sitting position with your legs dangling. You will be asked about your family history of varicose veins and any symptoms you’re having.
During your initial visit, we will determine if a Doppler Duplex Ultrasound Scan will be necessary. The ultrasound 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. This is the first step to tailoring a treatment plan that is right for you.
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 the people 50 years and older.
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 backward 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.
Many factors increase a person's chances of developing varicose or spider veins. These include:
- Increasing age. As you get older, the valves in your veins may weaken and not work as well.
- Medical history. Being born with weak vein valves increases your risk. Having family members with vein problems also increases your risk. About half of all people who have varicose veins have a family member who has them too.
- Hormonal changes. These occur during puberty, pregnancy, and menopause. Taking birth control pills and other medicines containing estrogen and progesterone also may contribute to the forming of varicose or spider veins.
- Pregnancy. During pregnancy, there is a huge increase in the amount of blood in the body. This can cause veins to enlarge. The growing uterus also puts pressure on the veins. Varicose veins usually improve within three months after delivery. More varicose veins and spider veins usually appear with each additional pregnancy.
- Obesity. Being overweight or obese can put extra pressure on your veins. This can lead to varicose veins.
- Lack of movement. Sitting or standing for a long time may force your veins to work harder to pump blood to your heart. This may be a bigger problem if you sit with your legs bent or crossed.
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, 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.
Yes. Heredity is a primary factor in over 80% of varicose vein cases. Other contributing factors may include pregnancy, obesity, hormone therapy, standing or sitting for long periods of time and injury.
Yes. Although women are affected at a higher percentage than men, men can also be troubled with varicose veins and their associated symptoms (and benefit from treatment).
Spider veins are dilated vessels that form just under the skin and result in red, blue or purple clusters of veins visible on the skin's surface. Besides the appearance of the veins, other symptoms may include skin redness; a firm, tender, and warm vein; and for some patients, pain, and swelling.
Spider veins can be caused by pregnancy, heredity, weight gain, and standing or sitting for long periods of time. These are the same things that cause varicose veins.
Not necessarily. Some of your visible veins may be larger size reticular or even varicose veins. Each of our patients receives a screening ultrasound prior to treatment so that we can determine exactly what venous problems exist and develop an appropriate treatment plan. You may call our office to schedule a consultation to learn if you have spider veins and the right treatment for you.
Spider veins don't actually increase during the winter but at the beginning of summer, our tans have faded so the spider veins may be more obvious. Once we get into our summer clothes and begin wearing shorts, capris, or swimsuits, we become more aware of them. Many women are not comfortable with the cosmetic appearance of their spider veins and will continue to wear long pants in the summer.
Most varicose and spider veins appear in the legs due to the pressure of body weight, force of gravity, and the task of carrying blood from the bottom of the body up to the heart. Compared with other veins in the body, leg veins have the toughest job of carrying blood back to the heart. They endure the most pressure. This pressure can be stronger than the one-way valves in the veins.
The first step in finding the right treatment for damaged veins is finding its source. A Doppler Duplex Ultrasound Scan provides a visual window, revealing the diseased, refluxing veins beneath the skin's surface. With this diagnostic capability, we can pinpoint the exact cause of varicose veins and customize a treatment plan for each individual patient - and each damaged vein. Because the problem is dealt with at its source, the treatments are quicker, more effective and less painful than traditional methods, such as vein stripping. The ultrasound scan is especially important if you have had previous vein treatment.
No, we usually recommend that you wait 3 months after delivery.
Not all varicose and spider veins can be prevented, but there are some steps you can take to reduce your chances of getting new varicose and spider veins. These same things can help ease discomfort from the ones you already have:
- Exercise regularly to improve your leg strength, circulation, and vein strength. Focus on exercises that work your legs, such as walking or running.
- Control your weight to avoid placing too much pressure on your legs.
- Elevate your legs when resting as much as possible.
- Don’t stand or sit for long periods of time. If you must stand for a long time, shift your weight from one leg to the other every few minutes. If you must sit for long periods of time, stand up and move around or take a short walk every 30 minutes.
- Avoid wearing high heels for long periods of time. Lower-heeled shoes can help tone your calf muscles to help blood move through your veins.
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 stay active and maintain a healthy lifestyle and weight.
Healing time from vein procedures can vary from person to person, but it's important to set the expectation that complete healing may take a year or more. While some individuals may experience significant improvement within six months of the procedure, others may require more time to recover fully. It's also important to note that if you're experiencing swelling in your legs, it's common for this to take about a year to improve. Therefore, it's essential to be patient and to follow our recommendations for post-procedure care to ensure a successful recovery.
