Varicose Veins

Varicose Veins are veins under the skin that have become abnormally dilated. These veins can often be felt through the skin. They can take a winding path under the skin and bulge giving a “rope” like appearance. Varicose veins usually become more prominent with standing and can decrease in size with elevation. The most common reason these veins become dilated is because of pressure exerted on the walls by the accumulation of blood due to insufficiency within the vein. Insufficiency occurs when valves within the vein, that usually prevent backflow of blood, no longer functions.

Blood is then allowed to accumulate within the vein which increases the pressure which then dilates the vein.  They are more often a cosmetic concern. However, they can cause discomfort and may be associated with venous insufficiency to the larger veins of the leg. Varicose veins can sometimes be associated with itchiness or eczema. People with these veins that have associated venous insufficiency may have leg swelling. As a progression of vein pathology occurs in some people, patients may develop skin discoloration.

In severe cases of venous insufficiency, one can develop ulcers of the skin. In most cases, however, varicose veins are not a serious condition. This is why they are often considered more of a cosmetic issue and not a serious medical issue. The most common cause of varicose veins is probably related to genetics. If your mother happened to have varicose veins, there is a 40% chance will develop them. If your father had them, the incidence increases to 70%. Varicose veins can commonly occur during pregnancy, however, occur equally in men as they do in women.

Obesity and prolonged standing has also been known to exacerbate varicose veins. Often patients experience improvement wearing compression stockings when standing or with elevation of their legs. It is often recommended that people who suffer from varicose veins elevate their legs for 15 minutes 3 to 4 times per day to help relieve symptoms.

Surgical treatment of varicose veins can vary to simply treating the more superficial veins with excision (microphlebectomy) or sclerotherapy to additionally treating insufficient veins deeper under the skin. These insufficient veins may not be visible to the eye. If these veins that supply the varicosities are left untreated, recurrence is not uncommon. Examples of veins that may be contribute to varicose veins in the legs if they are insufficient include; the greater and lesser saphenous veins as well as the anterior and posterior accessory vein of the thigh.

This is why it is important to assess the veins that may not be visible to the eye when planning treatment. Ultrasound and vein lights are often used to evaluate veins not visible to the eye.