What Causes Varicose Veins?

Temperatures are up and so are hemlines as shorts and skirts help us beat the heat. But varicose veins, typically on the legs, can cause some people to feel insecure about showing bare skin. Understanding the causes of this common condition can help people understand what they are and why they’re typically only a cosmetic issue.

John Fish III, MD, a vascular medicine specialist at Jobst Vascular Institute, defines varicose veins as visible veins on the skin that are enlarged and twisted and often appear blue in color. They can develop from weakness in veins or damage to a vein. Damage can result from trauma affecting the blood flow or an inflammation in or around a vein.

Although they do appear in men, women seem to develop varicose veins more often. “This could be contributed to fluctuations in female hormone levels,” Dr. Fish explains. “Estrogen tends to have a relaxing effect on veins, and can promote clotting.”

Varicose veins are often painless and develop unnoticed for a number of reasons, according to Dr. Fish. Sometimes, the cause may be related to a person’s occupation. “Often people who stand a lot and don’t move around will find themselves with varicose veins,” Dr. Fish said. “Also, people who put a lot of pressure on their venous system, such as workers who perform heavy lifting are at risk of developing them.”

Those with varicose veins usually do not experience any pain. But there are cases when this is not strictly a cosmetic issue. Dr. Fish said people with varicose veins could experience swelling, inflammation, irritation, itching, severe pain or bleeding.

While rare, varicose veins can precipitate the development of a deep vein thrombosis, which is a blood clot that can cause serious problems with the leg and can that can potentially move to the lungs.
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Treatment and Prevention

Fortunately, treatment for varicose veins usually does not include a hospital stay or a long recovery, but is primarily managed in an out-patient setting.

Treatment can come in many different forms. One common form is compression stockings, which gently squeezes legs to promote blood flow. In more severe cases, doctors can wrap patient’s legs or use specialized devices that provide compression. Compression allows fluid in the leg to move back into the vessels and assists in allowing valves to work better in the leg order to keep blood from pooling down to the lowest part of the leg, which in turn prevents varicose veins from getting worse.

Exercise and controlling your weight are other big components of managing varicose veins, and even preventing them. “By exercising and being active, you are actually pumping blood out of the leg,” Dr. Fish said. Likewise, being overweight puts additional pressure on your veins, which means they have to work harder to send the blood back to your heart.

In addition, Dr. Fish said some over-the-counter medications such as horse-chestnut extract, can be used to decrease inflammation and minor aching and swelling.

In many cases, it may become medically necessary to have varicose veins surgically removed with procedures such as laser or radiofrequency ablation and surgical vein removal through small incisions called micro-phlebectomy. But it really comes down to each individual patient.

“Not all cases of varicose veins are alike and each patient will have different symptoms and experience them differently,” Dr. Fish said. “It is important to tailor the right treatment for each individual person.”