What are varicose veins?

Varicose veins are veins close to the skin that are swollen or stretched. Veins in the legs and lower belly area are most often affected. Varicose veins are more common in women. They can appear at any time in adulthood, especially during or after pregnancy. They may worsen as you get older.

What is the cause?

When the muscles in your feet and legs tighten and relax, they help to return blood to your heart. To help this process, the veins have a series of one-way valves in them. The valves open as blood flows toward your heart and then close to prevent blood from flowing backward toward your feet. Problems with the leg veins, with valves, or with muscles can keep the blood from moving up toward your heart. The blood backs up in your veins and causes them to swell or stretch. These swollen veins are varicose veins.

Varicose veins may be caused by

• Hormone changes during pregnancy that cause the veins and valves to relax. Late in pregnancy the baby puts pressure on the large veins, causing blood to back up.
• Being overweight, which may put pressure on the veins
• Sitting or standing for long periods

Varicose veins tend to run in families.

What are the symptoms?

Varicose veins in your legs are enlarged and may look blue, twisted, or ropelike. Other symptoms may include:

• Swelling in your legs, ankles, or feet
• Cramps or general aching in the legs or aching in the area where the veins are swollen
• Feeling of heaviness in your legs, or leg muscles that tire easily
• Itching of the skin around the veins
• Large blue veins on your legs

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. You may have tests or scans to check for other possible causes of your symptoms.

How is it treated?

There are many ways to treat varicose veins. A combination of treatments often gives the best results.

The main treatment is wearing elastic stockings for support during daily activities. Elastic stockings provide helpful pressure on the veins. Nonprescription stockings are available in most drugstores. Your provider may recommend prescription stockings that are made to fit your body. Your provider may also recommend that you:

• Walk often to help the muscles move the blood out of your legs and up toward your heart.
• Raise your feet when you are sitting.
• Avoid sitting or standing for long periods of time.
• Do not wear tight clothing, especially around your waste and thighs.
• Avoid wearing high heels for long periods of time. Lower heels help keep the calf muscles in shape to move the blood through the leg veins better.

If these treatments do not help, you may need to have a procedure to treat or remove the veins.

• Sclerotherapy uses an irritating liquid that your provider injects into your veins. This causes the veins to close and forces the blood to flow through healthier veins. This procedure may decrease the swelling and make your legs look better. Injections may be done in a healthcare provider’s office. Several treatments may be needed. There is a risk of scarring and blood clots with this treatment.
• Laser treatment works by sending very strong bursts of light onto the vein. The light makes the vein slowly fade and disappear. Two or three treatments are usually needed.
• Surgery may be needed to remove large varicose veins. Tiny cuts can be made in the vein, and then the vein is pulled out of the leg with surgical hooks.

How can I take care of myself?

Follow the full course of treatment prescribed by your healthcare provider. In addition:

• Keep your legs raised when you are in bed or sitting down. Keeping your legs up helps the return of blood from the leg veins.
• Avoid long periods of sitting or standing. When you are traveling, move your feet and legs often. Go for short walks if possible.
• Avoid crossing your legs and ankles when you sit.
• Exercise as recommended by your healthcare provider.
• Avoid wearing control-top pantyhose, leg garters, and other tight-fitting garments.
• Keep a healthy weight. If you are overweight, try to lose some weight.
• If you smoke, try to quit. Smoking increases the risk for blood clots that can block the flow of blood in your veins.

Ask your provider:

• How and when you will hear your test results
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

How can I help prevent varicose veins?

Regular exercise may help you keep good muscle tone, good blood flow, and a healthy weight.