Varicose Veins
What are varicose veins?
From the Latin varix, a varicose is aptly defined as abnormal dilatation or enlargement of a blood vessel, especially accompanied by tortuous development. Varicose veins can range in size from tiny blue tangles just under the surface of the skin (or spider) to large bulging vessels located in the tissues under the skin. Painful varicose veins affect about 26 million Americans. The large size and bulging appearance of this larger class of varicose veins has earned them descriptions such as "ropy", "wormy" and "knotted".
What causes varicose veins?
In a healthy vein, blood flows upward toward the heart, assisted by one-way valves that prevent gravity from reversing the flow. However, if the valves weaken, blood leaks down and pools (or refluxes) in the veins in the lower leg. Eventually these veins bulge with the pressure of the excess blood. As the condition worsens, the veins become varicose. Risk factors include standing in place for long periods, family medical history, and pregnancy. Retail and factory workers, security guards, and others who stand for hours without a break are especially susceptible to the development of severe varicose veins. Women are afflicted with varicose veins in far greater numbers than are men.
What are the symptoms of varicose veins?
Unlike smaller surface veins that are typically repaired solely for cosmetic reasons true varicose veins are not just unsightly, they can cause discomfort. Aches, itching, night cramps, fatigue, and sensations of heaviness or restlessness in the affected leg are a daily fact of life for many with this condition. In some cases, varicose veins can lead to chronic venous insufficiency, which in turn can cause leg swelling, eczema, changes in skin pigmentation, and ulceration. Varicose veins occur in varying degrees in their appearance and severity of symptoms, largely dependent, on the size of the vein affected.
What are the treatment options for varicose veins?
The first line of attack against any type of varicose vein disease is to make lifestyle changes: maintain a healthy weight, exercise (especially walking or running), elevate legs while resting, and wear elastic support stockings. For medium-sized varicose veins, a procedure called ambulatory phlebectomy may be effective. These veins are frequently very unsightly and may cause painful symptoms. Ambulatory phlebectomy is a minimally invasive procedure done under local anesthetia, and most patients can return to normal activity the next day.
Large, deep varicose veins are most likely to cause painful and irritating symptoms, in addition to being unsightly. Traditional surgical treatment must be done under general anesthesia and may keep patients from their normal routine for up to three weeks. The newer laser treatment requires only a local anesthetic, has few adverse effects and lower recurrence, and has a recovery period of about 24 hours.
What are the treatment options for spider veins?
Spider veins are the smallest and least symptomatic type of varicose vein, so called because of the thin, web-like appearance of the veins. Spider veins may occur on the face as well as on the legs but are not raised or bumpy as are larger varicose veins. Spider veins can be treated with sclerotherapy or laser treatment. Sclerotherapy is a simple procedure-a solution is injected into the vein and causes the vein walls to swell and stick together, eventually closing shut. In a short time, the vein turns to scar tissue and is no longer visible. Sclerotherapy requires no anesthesia, is performed in a doctor's office, and has few adverse effects. However, recurrence is common-some veins may require several treatments to eliminate them, and the procedure cannot prevent spider veins from cropping up in new places.
Laser treatment for spider veins is also relatively painless and easy, performed in the office without anesthesia. Laser light is directed at the surface of the skin, along the course of the vein. In our experience, laser is not usually as effective and durable as sclerotherapy.
Peter Hathaway treats varicose veins with the VNUS Closure procedure. VNUS also provides helpful information on varicose veins and varicose vein treatment.