Symplicured

Cardiovascular

Varicose Veins

Also known as: Varicose Veins (Chronic Venous Insufficiency)

Varicose veins are enlarged, twisted veins that typically appear in the legs, caused by weakened or damaged valves that allow blood to pool. While often considered cosmetic, they can cause significant discomfort and may lead to complications.

Understanding Varicose Veins

Varicose veins affect approximately 23% of adults, with the prevalence increasing significantly with age. They are more common in women, though men are also frequently affected. The condition is part of the spectrum of chronic venous disease, which ranges from simple spider veins to severe venous ulceration.

Normally, one-way valves in leg veins prevent blood from flowing backward. When these valves become weak or damaged, blood pools in the veins, causing them to enlarge and become varicose. The saphenous veins (great and small) and their tributaries are most commonly affected.

While many people seek treatment for cosmetic reasons, varicose veins can cause significant symptoms including aching, heaviness, swelling, and skin changes. In advanced cases (CEAP classification C4-C6), chronic venous hypertension leads to skin pigmentation, eczema, lipodermatosclerosis (hardened, inflamed skin), and ultimately venous ulceration.

Modern treatment has shifted from traditional surgical stripping to minimally invasive endovenous techniques (laser or radiofrequency ablation, foam sclerotherapy), which offer excellent results with less pain and faster recovery.

Common Symptoms

People with Varicose Veins often experience the following symptoms.

Visible Varicosities

Enlarged, tortuous, blue or purple veins visible beneath the skin surface, most commonly on the legs and feet. They may be raised and rope-like in appearance.

Leg Pain and Heaviness

Aching, throbbing, or heavy sensation in the legs that worsens with prolonged standing or sitting and improves with elevation. Symptoms tend to worsen throughout the day.

Swelling

Ankle and lower leg edema, particularly later in the day, resulting from venous hypertension and fluid leakage into surrounding tissues.

Skin Changes

Brown discoloration (hemosiderin staining), eczema, thickening, and hardening of the skin around the ankles may indicate advanced chronic venous insufficiency and risk of ulceration.

Risk Factors

Certain factors may increase your likelihood of developing Varicose Veins.

Age over 50

Female sex

Prolonged standing or sitting

Family history

Pregnancy

Treatment Options

Common approaches to managing varicose veins. Always consult a healthcare provider for personalized treatment.

Compression Therapy

Graduated compression stockings (20-30 mmHg or higher) reduce venous pressure, improve blood return, and alleviate symptoms. They are the first-line conservative treatment and are worn during the day.

Endovenous Thermal Ablation

Laser or radiofrequency energy is delivered inside the vein through a catheter, sealing the incompetent saphenous vein. Performed under local anesthesia as an outpatient procedure with high success rates.

Sclerotherapy

A sclerosing solution (liquid or foam) is injected into the vein, causing it to collapse and be absorbed by the body. Effective for smaller varicosities and spider veins.

Ambulatory Phlebectomy

Small varicose veins are removed through tiny incisions under local anesthesia. Often performed in conjunction with endovenous ablation of the underlying saphenous vein.

How It's Diagnosed

Clinical examination supplemented by duplex ultrasound scanning is the standard diagnostic approach. Ultrasound maps the venous anatomy, identifies incompetent valves (reflux), and excludes deep vein thrombosis. CEAP classification categorizes disease severity.

When to See a Doctor

See a doctor if you develop skin changes near varicose veins (darkening, hardening, or ulceration), significant swelling, bleeding from a varicose vein, or sudden painful swelling that may indicate a blood clot.

Prevention Strategies

Steps that may help reduce the risk of developing or worsening varicose veins.

Regular exercise, especially walking and calf exercises

Avoid prolonged standing or sitting without breaks

Elevate legs when resting

Maintain a healthy weight and wear compression stockings when at risk

Potential Complications

If left untreated or poorly managed, varicose veins may lead to:

  • Venous ulceration (most severe complication)
  • Superficial thrombophlebitis
  • Spontaneous bleeding from varicose veins
  • Lipodermatosclerosis (chronic skin changes)

Frequently Asked Questions

Are varicose veins just a cosmetic problem?

Not always. While many varicose veins are asymptomatic, they can cause significant pain, swelling, and skin changes. Advanced cases may lead to venous ulcers that are difficult to heal.

Can exercise help varicose veins?

Yes. Regular exercise, particularly walking and calf-strengthening exercises, improves the calf muscle pump function that helps return blood to the heart. However, exercise alone may not reverse established varicose veins.

Do varicose veins come back after treatment?

Recurrence rates vary by technique but may occur in 10-25% of patients over 5 years. New varicose veins may also develop from other incompetent veins. Compression stockings and healthy habits help reduce recurrence risk.

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This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

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