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Superficial varicose veins that become swollen, enlarged and twisted are known as varicose veins. These can our anywhere in the body, but are most common in legs and thighs.

The main function of the veins is to return blood from all the organs in the body towards the heart. Sometimes, veins fail to circulate the blood properly causing blood to pool in the veins, forming a bulge.

These large bulging, swollen and palpable veins are known as varicose veins.

Sometimes non-palpable, short, cluster like, or a spider web-like veins found on the surface of the skin. These are known as Spider veins. These are most common in thighs, feet and ankles.

In the majority of the cases, there’s no pain. Some people may experience following signs and symptoms:

  • A heavy feeling in the legs
  • Burning, throbbing, muscle cramping and swelling in  lower legs
  • Worsened pain after sitting or standing for a long time
  • Itching around one or more veins
  • Skin discoloration around a varicose vein

Some less common, but more severe symptoms of varicose veins may include:

  • Bleeding
  • Thrombophlebitis (formation of a blood clot within the varicose vein)
  • Skin ulceration
  • Oozing dermatitis or stasis dermatitis.
  • In long standing venous disease, the skin may become fibrotic and scarred, forming an inverted “hourglass” appearance.

The causes of varicose veins include:

  • An absence or weakness of valves in the veins may cause poor venous circulation.
  • Weaknesses in the vein walls may cause pooling of the blood. The walls of the blood vessels can become weaker and less competent than normal, causing the volume of blood in the veins to increase, thus leading to varicose veins.
  • Less commonly, varicose veins are caused by such diseases such as phlebitis (inflammation of the veins), blood clots or any obstruction to blood flow in the veins, or congenital abnormalities of the veins.

Certain factors are linked to causing higher risk of varicose veins. They include:

  • menopause
  • pregnancy
  • age above 50
  • standing for long periods
  • family history of varicose veins
  • obesity

However, in the majority of cases, varicose veins have no complications. If complications do occur, they may include:

  • Bleeding
  • Thrombophlebitis: Blood clots in the vein of the leg cause inflammation of the vein.
  • Chronic venous insufficiency – the skin does not exchange oxygen, nutrients, and waste products with the blood properly because the blood flow is weak.

A physical examination, mainly visual, by a doctor will decide whether or not a patient has varicose veins. The patient will be asked to stand while the doctor checks for signs of swelling.

The doctor might recommend following diagnostic tests:

Doppler test: An ultrasound scan to check the direction of blood flow in the veins, blood clots or obstructions in the veins.

Color duplex ultrasound scan: This provides color images of the structure of veins, which helps the doctor identify any abnormalities. It can also measure the speed of blood flow.

Usually not all cases require treatment and are just of a cosmetic concern. The treatments for varicose veins involve:

  • Leg elevation while sitting or sleeping
  • Compression dressings with single or multi layered systems
  • Compression stockings
  • Sclerotherapy (injection of a liquid or foam into the vein to form a clot and permanently destroy the vessel)
  • Ablation (destruction) of abnormal veins with techniques using laser, radiofrequency or other modalities
  • Surgery (removal of the varicose veins, including “phlebectomy” or vein stripping).

For spider veins or telangiectasias:

  • Sclerotherapy
  • Laser therapy

In case of larger varicose veins:

  • Ablation
  • Surgery

The following measures can help prevent varicose veins:

  • Exercising
  • Watching your weight
  • Eating a high-fiber, low-salt diet
  • Avoiding high heels and tight hosiery
  • Elevating your legs
  • Changing your sitting or standing position regularly

Visit CMC Mohali for more knowledge and treatment of Varicose or Spider veins.