Varicose veins are swollen veins that sometimes look like cords. They often appear on the legs and feet but can appear on the vagina and buttocks during pregnancy. Some are visible through the skin, while others are not as easy to detect.
Varicose veins develop over time. If left untreated, they can lead to pain and swelling in the affected area and skin changes, such as rash and lesions. Varicose veins can also lead to more serious conditions, such as venous stasis (swelling of feet, ankles and legs that worsen with leg elevation) or deep vein thrombosis (blood clot in a deep vein). Varicose veins are more common in people over the age of 50 and affect women more than men.
What causes varicose veins?
Varicose veins are caused by damaged valves in the veins. When you are in an upright position, the blood in your veins has to travel upwards, against gravity, toward your heart. Veins carry blood to the heart through a series of valves that open to push blood up toward the heart. When these valves become impaired or weakened, blood flows downward and pools, causing the veins to enlarge.
Varicose veins most often appear in the legs due to increased blood pressure inside the superficial veins. The veins in your legs must work extra hard to push blood up toward the heart. This increased blood pressure in addition to other risk factors causes veins to weaken and become damaged.
Risk factors that contribute to varicose veins are:
- Age older than 50
- Family history of vein problems
- Hormone changes
- Overweight or obesity
- Sedentary lifestyle
Many of these risk factors can be reduced or eliminated by changing your lifestyle.
Preventing varicose veins
It's impossible to completely prevent varicose veins. Some risk factors such as age and family history are difficult to avoid. However, improving your body's blood flow and muscle tone can reduce your risk of developing varicose veins. Here are some measures to treat discomfort from varicose veins and prevent more injury:
- Avoid prolonged periods of sitting or standing
- Live a healthy lifestyle
- Pick clothing options that increase blood circulation
What are the symptoms of varicose veins?
Symptoms of varicose veins include:
- Heavy, tired or restless legs that worsen when standing or sitting for long periods of time
- Night leg cramps or aches
- Skin changes on your legs, including discoloration or sores
- Jagged veins or veins that appear in a cluster
You should consult your doctor if you notice the veins have become red or tender to the touch, if you develop skin changes or if one of your veins begins to bleed. Any symptom that interferes with your everyday life should be evaluated.
Diagnosing varicose veins at Ohio State
Your physician will conduct a history and physical, which includes questions about your health and an evaluation of your symptoms. You may also undergo diagnostic tests.
The following tests can be used to diagnose varicose veins:
- Duplex ultrasound – A painless, noninvasive test that shows how blood is moving through your arteries and veins. It examines the structure of your blood vessels and indicates if there are any blockages within your arteries.
- Venography – A test performed by injecting a radiographic material into a vein on the top of your foot. The material mixes with blood and flows toward your heart. An X-ray of your leg and pelvis will show any blockages in the calf and thigh.
Varicose vein treatment at Ohio State
Varicose veins can sometimes be treated with lifestyle modifications, such as leg elevation, losing weight or avoiding long periods of sitting or standing. Compression stockings can be worn to apply even pressure on the affected area, relieving symptoms and preventing complications. Varicose veins may also be treated with various procedures and surgeries.
- Sclerotherapy is the most common noninvasive therapy for varicose veins. A liquid chemical is injected into the vein to stop the flow of blood. After a few weeks, the vein turns to scar tissue and is eventually absorbed by the body. The vein may need more than one injection. Another form of sclerotherapy called ultrasound-guided sclerotherapy uses ultrasound images to guide the needle.
- Ablation sends electrodes into a varicose vein through a catheter (small, thin tube). The electrodes destroy the vein, which is eventually absorbed into the body.
- Surface laser treatments may be used for smaller varicose veins. Strong bursts of light are applied to the vein, fading its appearance. Though noninvasive, laser therapy can cause pain that may be reduced by cooling the area.
- Radiofrequency and laser techniques are used on larger varicose veins in the legs. A small probe is inserted into the vein through a catheter (small, thin tube). Closure of the vein is performed using radiofrequency or laser.
Varicose vein surgery
- Surgical ligation or stripping removes the varicose veins by tying the veins shut and then removing them through small cuts in the skin. The remaining veins then take over blood circulation. This procedure requires general anesthesia.
- Ambulatory phlebectomy uses hooks to pull the vein out of the leg through small cuts in the skin. This procedure can be done together with surgical ligation or stripping.
Why choose treatment at Ohio State?
Since The Ohio State University Wexner Medical Center is an academic medical center, our patients benefit from innovative research, a depth of medical expertise and the newest technologies and treatment techniques available.
We offer all available minimally invasive techniques for treatment of varicose veins, including endovenous laser therapy, radiofrequency ablation, sclerotherapy, and also phlebectomy. We perform these procedures on many patients in our outpatient clinic, allowing for convenience, a quick visit, and short recovery time.
Treatment of Varicose Veins
New Treatment for Varicose Vein Pain
Treatment for varicose veins used to involve stripping the veins from the legs. Patrick Vaccaro, MD, Director of Vascular Diseases and Surgery at The Ohio State University Wexner Medical Center, explains the new treatment which involves ablation with a laser or radio frequency catheter to close the vein from within.
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