What Can Be Done Today About Varicose Veins?

By John F. Gallagher, MD

Varicose veins are very common, especially in women, and especially as they age. About one-quarter to one-third of all adults and half of those over fifty have some degree of varicosity, visible as blue veins under the skin, most often on their legs. Varicose veins are unsightly and though they sometimes cause no discomfort or risk to health, they may cause significant pain, swelling, and other symptoms as well as emotional distress. In severe cases and when lifestyle changes are an insufficient remedy, we have several treatment options that are highly effective in closing or removing the veins.  

What causes varicose veins?

Arteries deliver blood filled with oxygen and nutrients from the heart to all parts of the body and veins return it to the heart so it can be recirculated. Blood being returned to the heart from the lower body must work against gravity and is kept on its upward path to the heart by tiny valves in the veins that close to prevent it from flowing backward. When the valves become worn and fail to work, the blood collects in the veins and the veins become enlarged and swollen, sometimes appearing twisted and bulging. You can think of varicose veins as the price we pay for being upright. Standing and walking put pressure on the veins in the legs and over time, as the veins become weaker and less supple, they collect more pooled blood.  

Spider veins are a common milder variety of varicose veins, generally appearing small and red, but flat to the skin, without the bulging that is characteristic of varicosity. Spider veins seldom cause any difficulty beyond cosmetic effects.

Who is at risk for varicose veins?

Women are more likely to have varicose veins than men, particularly as they age. Many women first develop varicose veins in pregnancy when additional blood is pumped through the body to support the pregnancy and more pressure is put on the veins. The varicosity may disappear a few months after giving birth or it may continue and become more prevalent with succeeding pregnancies. Other risk factors include a family history of varicose veins, being overweight or obese, hormonal changes at menopause, and standing or sitting for long periods.

What are the symptoms of varicose veins?

Many people have no signs beyond visible blue and/or bulging veins. Other symptoms include aching or a heavy feeling in the legs, burning, throbbing, muscle cramping or swelling in the lower legs, and itchiness around the veins. Discomfort is often worse in hot weather, at the end of the day, and after sitting or standing for an extended period. In severe cases, the veins may bleed or ulcerate.

How are varicose veins treated?

Self-care options and lifestyle changes might include losing weight, elevating the legs when sitting, and wearing compression stockings to improve blood flow from the legs. If these remedies are insufficient to reduce the effects of varicose veins, a consultation with a vascular surgeon will help you understand options for removing, closing, or collapsing varicose veins.

Sclerotherapy is used on smaller varicose and spider veins. Medication is injected into the vein that causes the vein walls to swell, stick together, and seal shut, stopping the flow of blood.

Endovenous ablation is a minimally-invasive procedure that is used to treat the great or short saphenous veins when they malfunction and cause bulging varicose veins. After endovenous ablation is performed, ambulatory phlebectomy is done to remove the painful, unsightly, bulging varicose veins on the surface of the skin. This can usually be done with needle punctures or small incisions.

After veins are removed or closed off, healthy veins take over the flow of blood and the pain and appearance of the varicose veins dissipate.

We continue to see remarkable advances in the techniques used to treat varicose veins. Depending on the characteristics of each person’s condition, we can determine an individualized course of treatment that will relieve the physical and emotional discomfort of varicose veins.

John F. Gallagher, MD, is a board-certified general and vascular surgeon with more than 30 years of experience treating varicose veins and pioneering advanced techniques that minimize discomfort and improve results.

Island Vein Specialists, a division of Advanced Dermatology, PC, is Long Island’s premier clinic for vein treatment services offering state-of-the-art treatment for varicose veins, spider veins, and other vein issues.  https://www.islandveinspecialists.com/ https://www.advanceddermatologypc.com/