What Are Varicose Veins?

Understanding Varicose Veins - the Basics

Varicose veins usually announce themselves as bulging, bluish cords running just beneath the surface of your skin. They almost always affect legs and feet. Visible swollen and twisted veins -- sometimes surrounded by patches of flooded capillaries known as spider veins -- are considered superficial varicose veins. Although they can be painful and disfiguring, they are usually harmless. When inflamed, they become tender to the touch and can hinder circulation to the point of causing swollen ankles, itchy skin, and aching in the affected limb.

Besides a surface network of veins, your legs have an interior, or deep, venous network. On rare occasions, an interior leg vein becomes varicose. Such deep varicose veins are usually not visible, but they can cause swelling or aching throughout the leg and may be sites where blood clots can form.

Varicose veins are a relatively common condition, and for many people they are a family trait. Women are at least twice as likely as men to develop them. In the U.S. alone, they affect about 23% of all Americans.

What Causes Varicose Veins?

To help circulate oxygen-rich blood from the lungs to all parts of the body, your arteries have thick layers of muscle or elastic tissue. To push blood back to your heart, your veins rely mainly on surrounding muscles and a network of one-way valves. As blood flows through a vein, the cup-like valves alternately open to allow blood through, then close to prevent backflow.

In varicose veins, the valves do not work properly -- allowing blood to pool in the vein and making it difficult for the muscles to push the blood "uphill." Instead of flowing from one valve to the next, the blood continues to pool in the vein, increasing venous pressure and the likelihood of congestion while causing the vein to bulge and twist. Because superficial veins have less muscle support than deep veins, they are more likely to become varicose.

Any condition that puts excessive pressure on the legs or abdomen can lead to varicose veins. The most common pressure inducers are pregnancy, obesity, and standing for long periods. Chronic constipation and -- in rare cases, tumors -- also can cause varicose veins. Being sedentary also may contribute to varicosity, because muscles that are out of condition offer poor blood-pumping action.

The likelihood of varicosity also increases as veins weaken with age. A previous leg injury may damage the valves in a vein which can result in a varicosity. Genetics also plays a role, so if other family members have varicose veins there is a greater chance you will, too. Contrary to popular belief, sitting with crossed legs will not cause varicose veins, although it can aggravate an existing condition.

What Are the Symptoms of Varicose Veins?

Symptoms of varicose veinsinclude:

• Prominent dark purple or blue blood vessels, visible on the thigh and calf
• Aching, tender, heavy, or sore legs, often accompanied by swelling in the ankles or feet after standing for a prolonged length of time

Call Your Doctor About Varicose Veins If:

• • Symptoms becomes incapacitating, or the skin over your varicose veins becomes flaky, ulcerated, discolored, or prone to bleeding -- you could be developing stasis dermatitis. If left untreated, stasis dermatitis can lead to skin infections and chronic leg ulcers.
  • You have red, warm, and tender varicose veins. This may be a sign of phlebitis, which is caused by a blood clot in the vein.
  • You have injured a varicose vein. Control the resulting burst of bloodwith direct compression and leg elevation. Have your veins evaluated by a vein specialist as this can be a potentially serious complication.
  Seek emergency medical help for any excessive bleeding or bleeding that does not stop.
• Endoscopic vein surgery: This procedure uses a small camera on a tiny tube. Your doctor threads it into your vein through a cut in your skin. She uses a surgical device at the end of the tube to close your vein.
  You probably won’t need this procedure unless your varicose veins cause severe skin ulcers. If you have endoscopic vein surgery, you can go back to your normal routine within a couple weeks.

Ways to Remove Veins

• You and your doctor may decide that the best plan is to remove your varicose veins. There are 2 procedures to do that:
  Ambulatory phlebectomy: This is the less complicated procedure, and it is used to remove varicose veins close to the surface of your skin. Your doctor will numb the area and remove veins through small cuts. You remain awake and generally can go home the same day.
  Vein stripping and ligation: This is the solution for the most serious cases. You will be given general anesthesia so that you will not be awake during the procedure.
  Your doctor will make cuts in your skin, tie off the veins, and remove them. If possible, though, the doctor will try to leave what’s called the saphenous vein, just in case you need it later for a heart bypass surgery. You might go home the same day you have the surgery. Recovery time ranges from 1 to 4 weeks.
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