You may not think much about how blood gets from your feet and legs to your heart until you notice varicose veins. These twisted, thick, blue veins just below your skin appear on the calves or lower legs of up to 40 million people in the United States. They can cause aching and pain, and even swelling or rashes. Fortunately, minimally invasive vein surgery can help when other remedies arenâ€™t effective.
Who Gets Varicose Veins?
About 55 percent of women and 45 percent of men have some type of problem with their veins, with varicose veins affecting half of all people 50 and older.
Before age 50, varicose veins are more common in women, says Amy Reed, MD, a vascular surgeon and associate professor of surgery at the University of Cincinnati, but among people in their fifties, sixties, and beyond, varicose veins are as common in men as they are in women.
Causes of Varicose Veins
The veins in your body carry blood back to your heart. They contain small valves that open to let blood through and then close to prevent blood from back- flowing in the wrong direction, Dr. Reed says. But for people with varicose veins, the valves in the legsâ€™ superficial veins â€” the veins that are only 1 to 2 centimeters beneath the skin â€” stop closing, and gravity pulls blood back down so that it pools inside the vein.
The most common reason for varicose veins is heredity. If you have one family member with a history of varicose veins, your risk of developing them is 25 to 30 percent, Reed says. If two family members had them, your risk rises to 30 to 45 percent.
Women who have had three or more pregnancies are also at higher risk because the extra weight from the uterus puts pressure on the veins in the legs, which makes it harder for the blood to get through. Itâ€™s also the reason people who are obese are at higher risk of varicose veins, Reed says. Having a history of blood clots also increases your risk.
Varicose Vein Symptoms
People with varicose veins may experience:
- Visible blue, bulging veins, though they can also be invisible
- Swelling around the ankles or lower legs that goes away after having the legs elevated overnight
- Aching and a feeling of heaviness in the leg
- Itching, rashes, and a feeling of warmth or heat around the areas of the varicose veins
- Cuts or scratches around the veins that donâ€™t heal well, which happens because the leg is filled with extra blood, Reed says.
What You Can Do at Home for Varicose Veins
You may not be able to avoid varicose veins, but the following tips can lower your risk of developing them or of needing vein surgery:
- Keep up good leg circulation. Exercising every day by walking or moving your lower body for about 30 minutes is good for your overall health as well as for leg circulation, Reed says. While itâ€™s sometimes difficult to avoid, standing or sitting for long periods can cause gravity to pull blood down into your veins. Try shifting your weight from one foot to another while youâ€™re standing, or get up every 30 minutes when you're sitting and take a brief walk to increase leg circulation.
- Get some leg support. Reed recommends using support stockings that help to compress the leg and push the blood in the right direction. The stockings are available in different gradient compressions, so you should talk to your doctor about which ones are right for you, Reed says. Donâ€™t groan or stop reading: Not all compression stockings are the type your Great Aunt Sadie wore. Some look like traditional knee-high or thigh-high nylons for women or white sports socks or black trouser socks for men.
- Elevate your legs. Raising your legs above heart level can help blood drain out of swollen varicose veins, Reed says. However, most people donâ€™t elevate their legs high enough. Youâ€™ll need to be on a recliner or lying on a couch with your legs higher than your heart for it to be effective.
Professional Treatments for Varicose Veins
If youâ€™re not getting relief from compression stockings and exercise, itâ€™s time to see a vascular surgeon and think about vein surgery, Reed says. Here are options your surgeon may recommend:
- Sclerotherapy. This procedure involves injecting a chemical into the vein that scars the varicose veins and stops blood from filling them. This type of procedure is typically used for varicose vein â€œbranchesâ€ and spider veins, Reed says.
- Ablation. This outpatient procedure involves inserting a catheter with a slender tube into the vein using an ultrasound as a guide. As the catheter is slowly removed, it emits an energy source, either laser or radiofrequency energy, to close the vein from the inside vein wall, Reed says. Patients walk away with a puncture wound the size of a needle and can exercise within 72 hours.
- Vein stripping. This procedure is centuries old, Reed says. Itâ€™s used rarely today, and only in patients whose varicose veins are too large to close with ablation. Vein stripping involves making an incision in the groin and in the calf, tying off the varicose vein branches, and then removing the vein.
With any procedure, thereâ€™s always a risk of developing a blood clot afterwards, but your surgeon should check for clots after the procedure is finished and a couple of days later, Reed says. It is also possible for a new varicose vein to develop in the future.
While taking measures to prevent varicose veins is always a smart step, itâ€™s good to know that less invasive procedures than were available in the past can get rid of varicose veins, should you develop them.
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