Everything You Need to Know About Varicose Veins

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If you have varicose veins, you’re not alone: As many as 30% of Americans will develop them at some point in their lives, says Kathleen Gibson, MD, a surgeon at Lake Washington Vascular in Bellevue, Washington. “Varicose veins form in the layer of fat between the muscle and skin,” she explains. As we age or experience hormone changes, the valves in our leg veins weaken, and may allow blood to leak backwards. When the blood pools like that, it can cause the veins to dilate and bulge.

The good news is that varicose veins are usually harmless. But in some cases they can cause physical discomfort—and about 10% of people suffer from more severe side effects (such as swelling and bleeding). Here, Dr. Gibson fills us in on possible treatments, whether you’re hoping to disguise them or ease troublesome symptoms.

What are some of the myths about varicose veins?

“One of the most common misconceptions I hear about varicose veins is that they’re only a cosmetic problem,” says Dr. Gibson. “They can also impact an individual’s quality of life by causing aching, throbbing, heaviness, itching, and cramps.”

And while many people believe varicose veins occur only in people who are overweight or only women, they can appear in all body types, and men, too. Dr. Gibson says. They tend to run in families, and are influenced by hormones, often appearing for the first time during pregnancy.

Another misconception? That varicose veins require invasive surgery to treat: “Most patients with varicose veins can have a minimally-invasive procedure to close them,” says Dr. Gibson. (More on that later.)

How concerned should you be if you’ve got varicose veins?

For many people, varicose veins are a cosmetic issue and nothing more. But in severe cases, they can cause leg swelling, rashes, skin discoloration, skin thickening, and painful ulcers. “Sometimes the blood flow in varicose veins can slow until a blood clot forms, called phlebitis,” says Dr. Gibson. “And in rare occasions, varicose veins can bleed after minor trauma or even spontaneously, usually around the ankle.” (If this happens to you, make an appointment with your doc right away, she says, even if the bleeding stops.)

The bottom line? It doesn’t hurt to get your varicose veins checked out, especially if they’re causing you physical discomfort. “Your clinical evaluation will determine whether your vein problems are a health issue, a cosmetic issue, or both,” says Dr. Gibson.

If they are a health problem, how can varicose veins be treated?

“We’re lucky in that there are several procedures,” says Dr. Gibson. “The old days, when patients were treated with vein stripping, a procedure that required lengthy recovery time, are in the past.”

Today’s options include sclerotherapy (injections of a solution that cause the problem vein to scar, forcing blood into healthier veins), endothermal ablation (a technique that uses a laser or high-frequency radio waves to seal off the vein), microphlebectomy (a minimally invasive surgery), or compression stockings, which can ease discomfort and are often used in conjunction with other treatments.

But remedies are quickly evolving. “In the past several years, a few new procedures using sclerotherapy have emerged,” Dr. Gibson adds, citing a device called ClariVein and a drug called Varithena. The newest treatment, VenaSeal, was approved by the FDA last year. It uses a medical adhesive (injected via catheter) to close off veins.

“Each of these treatments has advantages, and every varicose vein patient is different,” says Dr. Gibson. “The best treatment for anyone is the treatment that you discuss and agree upon with your healthcare provider.”

Are there any non-medical fixes?

Unfortunately, since varicose veins can be caused by a variety of factors (including genetics), there aren’t any reliable natural or home remedies, Dr. Gibson says. What’s known is that rapid weight gain or obesity, and standing for long periods of time can worsen any vein issues that exist; and getting regular exercise may help prevent vascular problems from arising in the first place.

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