Varicose Veins Causes, Symptoms, & Treatments
What Are Varicose Veins?
Varicose veins are swollen, bulging veins that protrude from the surface of the skin often with a blue or purplish color. They commonly have a rope-like or cord-like appearance on the skin. Varicose veins are extremely common, affecting up to 15 percent of men and up to 25 percent of women in the United States.
The word ‘varicose’ comes from the Latin root ‘varix’ which means twisted. While veins anywhere in the body can become varicose, the veins most affected by varicose veins are those in the legs (often on the backs of calves or inside of legs). This is due to the larger pressure exerted on these veins from sustained standing, walking or other factors. An example of painful varicose veins found elsewhere in the body is hemorrhoids, which are simply varicose veins found in the anus.
While varicose veins are often unsightly and do cause cosmetic concerns, they can cause very significant symptoms and also be indicative of underlying vein disease, which may progressively get worse if not treated. Varicose vein symptoms (aside from the bulging veins) may include painful varicose veins, leg heaviness, leg fatigue, swelling, skin discoloration, itching and burning.
Cause of Varicose Veins
Blood circulates through the body and the extremities via a system of arteries (which carry blood away from the heart) and veins (which carry the blood back). To facilitate the return trip of blood towards the heart, veins typically have a series of one-way valves. As we age (and due to a series of other risk factors including heredity, pregnancy, obesity etc.), these valves can begin to fail, allowing blood to flow backwards. This often occurs as the elasticity in the vein wall weakens, the vein distends, and the valve leaflets can no longer function properly.
When this valve failure (or venous reflux) occurs in veins of the leg, the blood flows backwards (or back down the leg) and pools in the veins of the lower leg. This increased blood pressure causes the veins to bulge or swell, and may cause fluid to leak outside the vein (causing generalized swelling in the ankles and feet). Since the blood in these veins is deoxygenated, it often makes the varicose veins appear blue in color.
Without treatment, this increased pressure within the legs can progress to cause additional valve failure (causing the varicose veins to ‘grow’ up or down the leg), skin color changes, and in its worst case, non-healing venous ulcers.
Painful varicose veins can be treated with a number of safe and effective options. Only a trained vein specialist can determine the extent and severity of any vein disease you may have, so consult with a physician to learn more.
Varicose Vein Treatments
Endovenous Radiofrequency Ablation (VNUS Closure®) procedure (or RF Closure)
The VNUS Closure® procedure or RF closure (radiofrequency closure) offers a minimally invasive alternative to traditional vein surgery and is used to treat saphenous, superficial, and varicose veins. In RF closure, a tiny radiofrequency catheter is inserted into the vein. The catheter delivers gentle RF energy as it is withdrawn, heating the vein wall and causing the collagen in the wall to shrink and the vein to close. Once the diseased vein is closed, blood is re-routed to other healthy veins.
Unlike traditional vein surgery, RF closure is performed in the convenience of our office under local anesthesia. The procedure also offers a quick recovery, and most patients resume normal activities within a day.
Endovenous Laser Treatment (EVLT®)
EVLT can get rid of varicose veins that previously could only be treated with vein surgery. It is a minimally-invasive procedure using a laser fiber inserted directly into the vein. EVLT is performed in the office under local anesthesia, and usually in less than 45 minutes. It involves little to no pain, and most patients are back to normal activities the next day.
Deeper veins that are not visible on the surface may be treated by using duplex ultrasound together with sclerotherapy. Ultrasound-guided sclerotherapy is particularly helpful in treating larger, non-saphenous varicose veins.
Ambulatory phlebectomy is a minimally invasive technique for the direct removal of residual unsightly bulging and varicose veins. It is performed under local anesthesia, through tiny punctures that typically leave no scars and require no skin sutures. After treatment, a compression bandage or compression stockings are worn and the patient is able to walk and drive. This technique differs significantly from vein stripping and should not be confused with that procedure.