Varicose Veins

Varicose veins are damaged superficial veins that have become stretched, enlarged, and/or twisted. They can develop virtually anywhere in the body, but they develop most commonly in the legs. They can often be seen on the legs, just below the surface of the skin, and they may give affected areas a lumpy appearance.

What Are Veins and Arteries?

The circulatory system has two main types of vessels for carrying blood to and from all of the body's cells, tissues, and organs. Arteries carry oxygenrich blood from the heart to the organs, and veins return oxygen-poor blood to the heart. Both arteries and veins are vessels, or tubes, through which blood flows, but they are dissimilar in many ways. Arteries have much thicker walls than veins of comparable size. Both arteries and veins have rings of smooth muscle surrounding them, but arteries have thicker rings. Arteries have many more elastic fibers than veins and have the property of elasticity. Veins are relatively inelastic. In addition, blood pressure in the veins is much lower than it is in the arteries. Veins do have valves, which help to keep blood from pooling in the veins. When these valves start to break down, as often happens in older or inactive people, the veins sometimes dilate * or collapse and become varices * , or varicose. The result is varicose veins. Although varicose veins can be painful, most are relatively benign * .

Where Do Varicose Veins Occur?

Varicose veins occur very often in the area behind the knee joint and in the calf area. The veins look bluish and may become swollen, which may give the affected area a lumpy appearance. About 23 percent of adults in the United States have varicose veins. Women are twice as likely as men to have varicose veins and are particularly prone to developing them during pregnancy. In addition, varicose veins tend to run in families.

What Is the Treatment for Varicose Veins?

Many people with varicose veins have no symptoms, but some people feel pain in their legs, especially when they stand for long periods. People with varicose veins will sometimes seek treatment for cosmetic reasons.

Conservative treatment

In mild cases, doctors usually suggest that their patients exercise to improve circulation and that they wear support hose or stockings to promote circulation in the legs and the return of blood to the heart. Doctors also typically tell people with varicose veins to sit with their feet up as often as possible and to avoid standing for prolonged periods.

Interventional treatment

Medical intervention can be divided into two classes: surgical and nonsurgical. Varicose veins can be removed surgically via a process known as vein stripping. This process takes about 30 minutes and is often quite successful. Vein stripping is commonly used to improve the appearance of the legs. There are also less invasive treatments including sclerotherapy, endovenous (en-doe-VEEN-us) laser therapy ablation, and radiofrequency ablation.

Sclerotherapy is the injection of a chemical irritant into a vein to sclerose, or harden it. The chemical substance irritates the lining of the vein, causing it to swell and the blood to clot. The vein loses its function entirely. Most of the vein tissue turns into scar tissue. Blood flow shifts to nearby healthy veins. Endovenous laser ablation therapy is a treatment for varicose veins in which a laser source is inserted into the affected vein, and laser light is emitted that strikes the interior of the vein. This causes the vein to contract, and the laser source is then withdrawn. An alternative treatment is radiofrequency ablation, which is similar to endovenous laser therapy but uses electromagnetic radiation of the radiofrequency range instead of laser light to close the vein.

Can Varicose Veins Be Prevented?

Varicose veins cannot be prevented from forming; however, one can take measures to prevent existing veins from getting worse and delay new veins from forming. One should avoid sitting or standing for long periods without taking a break. Keeping legs raised above the level of the heart when sitting can also help. Regular exercise and avoidance of wearing high heels for a long time are also recommended.




Leg with varicose veins.





Leg with varicose veins.
John E Heintz Jr/Shutterstock.com.

See also Vascular Diseases: Overview

Resources

Books and Articles

Weiss, Robert. “Varicose Veins and Spider Veins.” Medscape, November 17, 2014. http://emedicine.medscape.com/article/1085530-overview (accessed November 11, 2015).

Websites

MedlinePlus. “Varicose Veins.” U.S. National Library of Medicine. https://www.nlm.nih.gov/medlineplus/varicoseveins.html (accessed November 11, 2015).

NHS Choices. “Varicose Veins.” National Health Service. (accessed November 11, 2015).

University of Maryland Medical Center. “Varicose Veins.” https://umm.edu/health/medical/altmed/condition/varicose-veins (accessed November 11, 2015).

Organizations

American College of Phlebology. 101 Callan Ave., Suite 210, San Leandro, CA 94577. Telephone: 510-346-6800. Website: http://www.phlebology.org (accessed November 11, 2015).

National Heart, Lung, and Blood Institute. PO Box 30105, Bethesda, MD 20824-0105. Telephone: 301-592-8573. Website: http://www.nhlbi.nih.gov (accessed November 11, 2015).

* dilate (DY-late) means to become enlarged or stretched beyond the usual boundaries.

* varices (VAR-uh-seez) (varix, singular) are veins, arteries, or lymph vessels that have become stretched or enlarged.

* benign (beh-NINE) refers to a condition that is not cancerous or serious and will probably improve, go away, or not get worse.

  This information is not a tool for self-diagnosis or a substitute for professional care.