What is varicose veins?

Varicose Veins

Varicose veins: Overview

Varicose veins are twisted, enlarged veins near the surface of the skin. They develop most often in the legs and ankles.

Some people may be more likely than others to get varicose veins because of several things. These include aging, pregnancy, being overweight, or because a parent has them. Standing or sitting for long periods of time can also increase risk of varicose veins.

Varicose veins

Varicose veins are twisted, enlarged veins near the surface of the skin. They're most common in the legs and ankles. They usually aren't serious.

What happens when you have varicose veins?

Varicose veins usually don't cause problems. There are things you can do at home to help with symptoms and keep varicose veins from getting worse. But if you have symptoms or the way your veins look bothers you, there are procedures that may help.

What are the symptoms of varicose veins?

Varicose veins look like swollen and twisted blood vessels under the skin. They may not cause any symptoms. Mild symptoms may include:

  • Heaviness, burning, aching, tiredness, or pain in your legs. These symptoms may be worse after you stand or sit for long periods of time.
  • Mild swelling in your feet and ankles.
  • Itching over the vein.

More serious symptoms include:

  • Leg swelling.
  • Swelling and calf pain after you sit or stand for long periods of time.
  • Skin changes, such as:
    • Color changes.
    • Dry, thinned skin.
    • Inflammation.
    • Scaling.
  • Open sores.
  • Bleeding after a minor injury.
  • Superficial thrombophlebitis. This happens when a blood clot and inflammation form in a small vein near the surface of the skin.

How are varicose veins treated?

Home treatment may be all you need to ease your symptoms and keep the varicose veins from getting worse. Wear compression stockings. Stay at a healthy weight. Prop up (elevate) your legs. Avoid long periods of sitting or standing. And get regular exercise. Procedures to close or remove varicose veins may also be done.

How are compression stockings used to treat varicose veins?

Compression stockings can improve blood flow and help relieve the symptoms of varicose veins. Specially fitted, or graduated, compression stockings are tightest at the foot. They gradually loosen as they fit higher on the leg.

If your doctor recommends compression stockings, wear them during the day to help relieve symptoms.

  • For very mild symptoms, you may want to start out using over-the-counter compression options. These can include support panty hose or compression socks or stockings which end just above the calf, below the knee. You may find that these help swelling and aching considerably. They are available at most department stores or online.
  • Your doctor may prescribe special compression stockings. You can buy these from a medical supply store, where you can be fitted for them.

Compression stockings can be expensive. They may be hard to put on, and it may take you awhile to get used to wearing them all day. But if they fit right, they should be snug but comfortable. If you have problems wearing the stockings, be sure to talk to your doctor.

Avoid elastic bandages for varicose veins unless your doctor specifically suggests them. If this type of bandage is recommended, ask how to wrap it.

Preventing varicose veins

Varicose veins may be prevented to some extent. Here are a few things you can try.

  • Stay at a healthy weight.

    Lose weight if you need to.

  • Get regular exercise.

    Exercise may help improve blood flow in your legs.

  • Avoid long periods of standing or sitting.
  • Avoid crossing your legs at the knee while sitting.
  • Do not smoke.

How are varicose veins diagnosed?

To diagnose varicose veins, your doctor will look at your legs and feet. The doctor will check your legs for tender areas, swelling, skin color changes, sores, and other signs of skin breakdown. You might need tests if you plan to have treatment or if you have signs of a deep vein problem.

Treating varicose veins at home

Self-care, or home treatment, is recommended for most people with varicose veins. Home treatment may relieve symptoms and slow down the progress of varicose veins. For many people, home treatment is the only treatment they need.

Your doctor can help you create a home treatment plan that is right for you. Here are some examples of things you can do at home.

  • Exercise.

    Exercise can help relieve symptoms and slow the progression of varicose veins by improving blood circulation in your legs.

    • Try to take several short walks every day.
    • Try to do moderate activity for at least 2½ hours a week. Or do vigorous activity for at least 1¼ hours a week. You can choose to do one or both types of activity. And it's fine to be active in shorter periods of time throughout the day and week that add up to the recommended goals.
    • Do calf muscle exercises every day. When you are sitting down, rotate your feet at the ankles in both directions, making small circles. Extend your legs, and point and flex your feet.
  • Stay at a healthy weight.

    Staying at a healthy weight, and losing weight if you need to, may help relieve symptoms caused by your varicose veins. Being overweight can increase the swelling and discomfort of varicose veins.

  • Elevate your legs.

    When you elevate your legs, ideally at or above heart level, it helps keep the blood from pooling in your lower legs and improves blood flow to the rest of your body.

    • Prop up your legs when you are sitting. Use a footrest at work and a footstool or ottoman at home to elevate your feet.
    • Lie down and prop your legs above heart level. Try to do this for about 30 minutes at a time, about 3 times a day. You can lie in a recliner, bed, or couch with your feet propped on pillows to improve blood flow back to the heart.
  • Avoid crossing your legs at the knees when sitting.

    Keep your feet flat on the floor or cross them at the ankles. Crossing legs at the knees squeezes veins and blocks blood flow.

  • Avoid long periods of sitting or standing.

    Sitting or standing still for long periods of time puts added stress on the veins in your legs.

    • If you stand when working, try to sit down for a few minutes regularly (with your feet up). Some people use a small stool to prop up first one foot, then the other when standing at work.
    • If you are sitting, get up and move around every hour or so.
  • Wear compression stockings.

    Compression stockings are a main treatment for varicose veins that are causing symptoms. They improve circulation and help relieve symptoms.

  • Take good care of your skin.

    Your skin may be more fragile and even minor injuries can lead to skin ulcers.

    • Treat cuts and scrapes on your legs right away.
    • Keep your legs clean and moisturized to prevent drying and cracking.
    • Prevent sunburns.
  • Do not smoke.

    Smoking can make varicose veins worse. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.

What increases your risk for varicose veins?

Factors that increase your risk of developing varicose veins include:

  • Pregnancy.
  • Advancing age.
  • Being overweight.
  • Family history of varicose veins.
  • Prolonged sitting or standing.
  • Smoking.
  • Injury to the veins.
  • Blood clots.

What problems can happen with varicose veins?

Most varicose veins aren't a serious medical problem, but they sometimes can lead to complications.

Complications can include:

  • Bleeding from a varicose vein, which may occur without an injury or after an injury to the thin skin over the varicose vein. Bleeding can be heavy, but it can be controlled by elevating the leg and applying pressure to the area that is bleeding.
  • Blood clots or inflammation (superficial thrombophlebitis), when a blood clot and inflammation develop in a small vein near the surface of the skin.
  • Dry, stretched, swollen, itching, or scaling skin.
  • Thin, fragile, easily injured skin at or above the ankle.
  • Open sores (ulcers), usually near the ankles.
  • Skin color changes (stasis pigmentation) around the ankles and lower legs.
  • Fungal and bacterial infections, which may arise from skin problems resulting from fluid buildup (edema) in the leg and increased risk of tissue infection (cellulitis).

Varicose veins most often are a result of problems in the superficial veins just under the skin. But they can happen along with problems or disease in the deep veins and perforating veins, which connect the deep and the superficial veins. Complications are much more common when varicose veins are caused by or linked with these deeper veins.

What causes varicose veins?

Varicose veins are caused by weakened valves and veins in your legs. Normally, one-way valves in your veins keep blood flowing from your legs up toward your heart. When these valves don't work as they should, blood collects in your legs, and pressure builds up. The veins become weak, large, and twisted.

Varicose veins often run in families. You may be born with defective valves or weak walls in your veins, or you may develop them later in life. Varicose veins happen more often as people get older.

Varicose veins often form during pregnancy. They might become less prominent after pregnancy and may disappear completely.

Varicose veins

External view of legs with and without varicose veins, with details of healthy vein and twising varicose veins

Varicose veins are caused by weakened valves and veins in your legs. Normally, one-way valves in your veins keep blood flowing from your legs up toward your heart. When these valves don't work as they should, blood collects in your legs, and pressure builds up. The veins become weak, large, and twisted.

Varicose veins: When to call

Call 911 anytime you think you may need emergency care. For example, call if:

  • You have sudden chest pain and shortness of breath, or you cough up blood.

Call your doctor now or seek immediate medical care if:

  • You have signs of a blood clot in your leg (called a deep vein thrombosis), such as:
    • Pain in your calf, back of the knee, thigh, or groin.
    • Swelling in the leg or groin.
    • A color change on the leg or groin. The skin may be reddish or purplish, depending on your usual skin color.
  • A varicose vein begins to bleed and you cannot stop it.
  • You have a tender lump in your leg.
  • You get an open sore.

Watch closely for changes in your health, and be sure to contact your doctor if:

  • Your varicose vein symptoms do not improve with home treatment.

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