Varicose veins
Varicose veins are swollen, twisted, and enlarged veins that you can see under the skin. They are often red or blue in color. They most often appear in the legs, but can occur in other parts of the body.
Varicose veins - Animation
From the outside, your veins look like nothing more than a few faint blue lines under your skin. But inside your body, they work hard to transport blood from your organs to your heart. Sometimes, blood can get stuck in your veins and make them swell up so they really stick out. These swollen veins are called varicose veins. And if you have them, you may be putting a lot of effort into covering them up. Veins have valves in them that prevent blood from flowing the wrong way. They're kind of like the valves in your bathroom plumbing that prevent hot water in the water heater from backing up into the cold water supply. The valves inside your veins make sure that your blood keeps flowing in the right direction, toward your heart. But if those valves aren't working correctly, blood can back up and get stuck inside a vein. As the blood collects, the vein swells. So, what causes the valves in the veins to malfunction? Well, you may have been born with defective valves. Or, you might be putting on extra pressure on the veins in your legs if you stand for long periods of time, or you're pregnant. When you have varicose veins, you, and your doctor, should be able to tell just by looking at them. They look like raised, thick blue or purple veins. Varicose veins can also make your legs ache and your ankles swell. So, how are varicose veins treated? Well, first, your doctor will recommend rest and support for your varicose veins. Avoid standing for long periods of time, and prop up your feet on a pillow or box whenever you sit. Wearing elastic support hose can also help. If you're in a lot of pain from your varicose veins, or their appearance really bothers you, your doctor may recommend a treatment such as lasers to minimize the veins. Or, you may have a type of surgery called vein stripping. During this procedure, the surgeon threads a thin, plastic wire into each varicose vein and then pulls the vein out. At first, varicose veins are more of a cosmetic problem than a health issue. But over time, they can get worse. Some people develop sores, inflammation from phlebitis, clots, or their varicose vein breaks. Talk to your doctor if you have varicose veins, especially if they hurt or they don't improve from wearing support hose or staying off your feet. Call your doctor right away if you have intense pain, swelling, fever, or a sore on your leg.
Causes
Normally, one-way valves in your leg veins keep blood moving up toward the heart. When the valves do not work properly, they allow blood to back up into the vein. The vein swells from the blood that collects there, which causes varicose veins over time.
Varicose veins are common, and affect more women than men. They do not cause problems for most people. However, if the flow of blood through veins becomes poor enough, problems such as leg swelling and pain, blood clots, and skin changes may be present.
Risk factors include:
- Older age
- Being female (hormonal changes from puberty, pregnancy, and menopause can lead to varicose veins, and taking birth control pills or hormone replacement can increase your risk)
- Being born with defective valves in the veins
- Obesity
- Pregnancy
- History of blood clots in your legs
- Standing or sitting for long periods of time
- Family history of varicose veins
Symptoms
Symptoms of varicose veins include:
- Fullness, heaviness, aching, and sometimes pain in the legs
Pain in the legs
Leg pain is a common problem. It can be due to a cramp, injury, or other cause.
Read Article Now Book Mark Article - Visible, swollen veins
- Very small veins that you can see on the surface of the skin, called spider veins.
- Thigh or calf cramps (often at night)
- Mild swelling of feet or ankles
Swelling of feet or ankles
Painless swelling of the feet and ankles is a common problem, especially among older people. Abnormal buildup of fluid in the ankles, feet, and legs ...
Read Article Now Book Mark Article - Itching near the varicose veins
- Restless leg symptoms
If flow of blood through the veins becomes poor enough, symptoms may include:
- Leg swelling
- Leg or calf pain after sitting or standing for long periods
- Skin color changes of the legs or ankles
- Dry, irritated, scaly skin that can crack easily
- Skin sores (ulcers) that do not heal easily
- Thickening and hardening of the skin in the legs and ankles (this can happen over time)
Exams and Tests
Your health care provider will examine your legs to look for swelling, changes in skin color, or sores. Your provider also may:
- Check blood flow in the veins
- Check for other problems with the legs (such as a blood clot)
Varicose veins
Varicose veins are enlarged, twisted, painful superficial veins resulting from poorly functioning valves. Varicose veins usually occur in the veins of the legs, although it may occur elsewhere. It is a common condition, affecting mostly women.
Treatment
Your provider may suggest that you take the following self-care steps to help manage varicose veins:
Manage varicose veins
Blood flows slowly from the veins in your legs back to your heart. Due to gravity, blood tends to pool in your legs, primarily when you stand. As a...
Read Article Now Book Mark Article- Wear compression stockings to decrease swelling. These stockings gently squeeze your legs to move blood up toward your heart.
Compression stockings
You wear compression stockings to improve blood flow in the veins of your legs. Compression stockings gently squeeze your legs to move blood up your...
Read Article Now Book Mark Article - DO NOT sit or stand for long periods. Even moving your legs slightly helps keep the blood flowing.
- Raise your legs above your heart 3 or 4 times a day for 15 minutes at a time.
- Care for wounds if you have any open sores or infections. Your provider can show you how.
- Lose weight if you are overweight.
- Get more exercise. This can help you keep off weight and help move blood up your legs. Walking or swimming are good options.
- If you have dry or cracked skin on your legs, moisturizing may help. However, some skin care treatments can make the problem worse. Talk to your provider before using any lotions, creams, or antibiotic ointments. Your provider can recommend lotions that can help.
If only a small number of varicose veins are present, the following procedures may be used:
- Sclerotherapy. Salt water or a chemical solution is injected into the vein. The vein hardens and disappears.
Sclerotherapy
Varicose veins are swollen, tortuous, and sometimes painful veins that have filled with blood that does not drain out in a normal fashion.
Read Article Now Book Mark Article - Phlebectomy. Small surgical cuts are made in the leg near the damaged vein. The vein is removed through one of the cuts.
- If the varicose veins are larger, longer, or more widespread on the leg, your provider will suggest a procedure using such a laser or radiofrequency, which can be done in the provider's office or clinic.
Laser or radiofrequency
Varicose veins are swollen, tortuous, and sometimes painful veins that have filled with blood that does not drain out in a normal fashion.
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Outlook (Prognosis)
Varicose veins tend to get worse over time. Taking self-care steps can help relieve achiness and pain, keep varicose veins from getting worse, and prevent more serious problems.
When to Contact a Medical Professional
Contact your provider if:
- Varicose veins are painful.
- They get worse or do not improve with self-care, such as by wearing compression stockings or avoiding standing or sitting for too long.
- You have a sudden increase in pain or swelling, fever, redness of the leg, or leg sores.
- You develop leg sores that do not heal.
Reviewed By
Neil Grossman, MD, Saint Vincent Radiological Associates, Framingham, MA. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Iafrati MD. Varicose veins: surgical treatment. In: Sidawy AN, Perler BA, eds. Rutherford's Vascular Surgery and Endovascular Therapy. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 154.
Pascarella L, Marston W. Venous disease. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. St Louis, MO: Elsevier; 2022:chap 65.
Sadek M, Kabnick LS. Varicose veins: endovenous ablation and sclerotherapy. In: Sidawy AN, Perler BA, eds. Rutherford's Vascular Surgery and Endovascular Therapy. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 155.