Varicose veins are abnormally and irregularly swollen veins (the blood vessels that return blood to the heart from the body tissues).
The most common form of varicose veins progresses downward in either or both of two large veins near the surface of the leg.
Varicose veins are one of the most common problems of blood vessels. About 15 percent of all American adults eventually develop varicose veins. The condition occurs four times more often in women than in men. Most people with varicose veins are between ages 30 and 60.
Varicose veins develop slowly, but once they start they progress. They do not get better on their own.
Pregnancy is not the cause, but varicose veins can develop or worsen during pregnancy. This is due to increased pressure from the uterus on the pelvic and leg veins, increased blood volume and changing hormones.
Weakened vein walls - As you age, the walls of your veins may lose their elasticity. This weakening of the walls cause them to balloon-out (stretch).
Valve failure - As your veins become stretched, valves in your veins fail. Normally, these valves help keep blood flowing from your legs and arms back to your heart, but if vein walls are weakened and stretched, they spread apart. The valves can no longer keep blood flowing upward against gravity. As a result, blood may stagnate in your veins.
Vein damage - Damage may occur due to injury, blood clot or inflammation. If there is trouble in your deep veins, you usually have pain and swelling in your leg as well. Swollen surface veins can be a symptom of damage to your deep vein.
Varicose veins on the surface of your legs are not associated with dangerous blood clots that can travel to your heart or lungs and cause an obstruction (embolism). Any clot that forms near the surface will generally be small. There may be inflammation, but the clot does not seriously threaten your health.
Signs and symptoms of varicose veins are easy to recognize. Typically, they include:
- Aching - Your leg may ache and feel heavy and congested if you sit or stand for lengthy periods.
- Disfigurement - Veins may bulge or appear twisted for a portion or entire length of your leg, or there may only be a slight outline of bluish veins. If varicose veins are severe, the skin covering your leg may become swollen, dry and irritated. After several years, a brownish discoloration (stasis pigmentation) may develop in your lower leg.
- Itching - Your skin becomes dry and irritated over the vein.
- Inflammation of a vein - A section of the vein can become engorged with blood and swollen, firm, red and tender after prolonged periods of sitting and standing. This common condition is called phlebitis.
- Bleeding - Although uncommon, varicose veins can be injured by a nick or cut because they are large, near the surface of the skin and often covered by thin skin.
- Ulcers - These are open sores. Usually they appear near the ankle, where swelling may also be apparent.
For people with mild varicose veins, the first step is to compress the leg veins by means of support stockings. This simple measure serves to squeeze the blood out of the engorged vein, reducing their size. Some brands of hose provide greater support around the ankles and lower legs (where varicose veins tend to be the longest and the most painful). These stockings may extend to the upper thigh and groin, but for many people, the advantage of providing pressure on the entire leg is offset by the discomfort and expense of these compressive stockings.
When this conservative approach is not adequate, sclerotherapy can be considered. Safe and effective, this type of treatment involves injecting a chemical into the dilated vein, causing it to become sealed off. The procedure can be performed in a doctor's office and does not require admission to the hospital. One limitation of sclerotherapy is that it is most effective on smaller veins alone, particularly when the varicosities arise below knee. Although such treatment has been used for larger veins originating in the thighs, recurrences are more common at this site. As a result, doctors tend to combine sclerotherapy with surgery or use multiple applications when varicose veins are more extensive.
If the varicose veins are not treated, what are the chances of developing phlebitis or a clot?
Do you recommend sclerotherapy?
Are there any side effects to the sclerotherapy?
What is the procedure of surgical removal of the veins?
What are the risks of surgery?
Will there be scars everywhere? If so, will the scars fade or disappear?