Varicose veins are tortuous, enlarged veins. Any vein may become varicose, but the veins most commonly affected are those in the legs and feet. That’s because standing and walking upright increases the pressure in the veins of the lower body. This is due to gravity and hence only human beings suffer from varicose veins (being able to stand).

For most people, varicose veins and spider veins — a common, milder variant of varicose veins — are simply a cosmetic concern. For other people, varicose veins can cause aching pain and discomfort. Occasionally, varicose veins can lead to more-serious problems like skin ulceration.

Symptoms :

  • Veins that are dark purple or blue in color
  • Veins that appear twisted and bulging
  • An achy or heavy feeling in your legs
  • Burning, throbbing, muscle cramping and swelling in your lower legs
  • Itching around one or more of your veins
  • Skin ulcers near your ankle, which can mean you have a serious form of vascular disease
  • Spider veins are similar to varicose veins, but they’re smaller. Spider veins are found closer to the skin’s surface and are often red or blue. Spider veins vary in size and often look like a spider’s web.

Causes :

Arteries carry blood from your heart to the rest of your tissues. Veins return blood from the rest of your body to your heart, so the blood can be recirculated. To return blood to your heart, the veins in your legs must work against gravity. Muscle contractions in your lower legs act as pumps, and elastic vein walls help blood return to your heart. Tiny valves in your veins open as blood flows toward your heart then close to stop blood from flowing backward.

  • Age :

    • As you get older, your veins can lose elasticity causing them to stretch. The valves in your veins may become weak, allowing blood that should be moving toward your heart to flow backward. Blood pools in your veins, and your veins enlarge and become varicose. The veins appear blue because they contain deoxygenated blood, which is in the process of being recirculated through the lungs.

  • Pregnancy :

    • Some pregnant women develop varicose veins. Pregnancy increases the volume of blood in your body, but decreases the flow of blood from your legs to your pelvis. This circulatory change is designed to support the growing fetus, but it can produce an unfortunate side effect — enlarged veins in the legs. Varicose veins may surface for the first time or may worsen during late pregnancy, when the uterus exerts greater pressure on the veins in the legs. Changes in the hormones during pregnancy also may play a role. Varicose veins that develop during pregnancy generally improve without medical treatment within three months after delivery.

  • Family history :

    • If other family members had varicose veins, there’s a greater chance you will too.

  • Obesity :

    • Being overweight puts added pressure on your veins.

  • Posture :

    • Standing or sitting for long periods of time. Your blood doesn’t flow as well if you’re in the same position for long periods.

Complications :

Ulcers : Extremely painful ulcers may form on the skin near varicose veins, particularly near the ankles. Ulcers are caused by long-term fluid buildup in these tissues, caused by increased pressure of blood within affected veins. A discolored spot on the skin usually begins before an ulcer forms.
Blood clots : Occasionally, veins deep within the legs become enlarged. In such cases, the affected leg may swell considerably. Any sudden leg swelling warrants urgent medical attention because it may indicate a blood clot — a condition known medically as thrombophlebitis.

Tests and diagnosis :

To diagnose varicose veins, your doctor will do a physical exam, including looking at your legs while you’re standing to check for swelling. Your doctor may also ask you to describe any pain and aching in your legs.

You may also need an ultrasound test to see if the valves in your veins are functioning normally or if there’s any evidence of a blood clot.

Treatments and drugs :

Self-care — such as exercising, losing weight, not wearing tight clothes, elevating your legs, and avoiding long periods of standing or sitting — can ease pain and prevent varicose veins from getting worse.

Compression stockings :
Wearing compression stockings is often the first approach to try before moving on to other treatments. Compression stockings are worn all day. They steadily squeeze your legs, helping veins and leg muscles move blood more efficiently. The amount of compression varies by type and brand.

Additional treatments for more-severe varicose veins
If you don’t respond to self-care, compression stockings, or if your condition is more severe, you may need one of these varicose vein treatments:

Sclerotherapy :

In this procedure, a solution is injected into small- and medium-sized varicose veins. This scars and closes those veins. In a few weeks, treated varicose veins should fade. Although the same vein may need to be injected more than once, sclerotherapy is effective if done correctly. Sclerotherapy doesn’t require anesthesia and can be done in on an out-patient basis.

Laser / Radiofrequency ablation:

In these treatments, a thin tube (catheter)is inserted into an enlarged vein and the tip of the catheter is heated. As the catheter is pulled out, the heat destroys the vein by causing it to collapse and seal shut. This procedure is usually done for larger varicose veins. It can be done on an out-patient basis, although a day of hospitalization is required for comfortable recovery.

Vein stripping :

This procedure involves removing a long vein through small incisions. This is a surgical procedure and requires at-least a day or two of hospitalization for complete recovery. Removing the vein won’t adversely affect circulation in your leg because veins deeper in the leg take care of the larger volumes of blood.
Varicose veins that develop during pregnancy generally improve without medical treatment within three to 12 months after delivery.

When it comes to treatment options for varicose veins, it pays to be a cautious health consumer. Advertisements claiming “unique,” “permanent” or “painless” methods to remove varicose veins may be appealing, but they may not actually measure up to those claims. Before having any procedure, ask your doctor about any health risks and possible side effects.

You may want to inquire about treatment costs, as well. Many insurance policies don’t cover the expense of elective cosmetic surgery for varicose veins. However, in many cases if you have signs or symptoms, such as swelling and bleeding, insurance may cover the treatment.

Current treatments for varicose veins and spider veins are effective. However, it’s possible that varicose veins can recur.