What Causes Varicose Veins? Risk Factors & Treatments

What Are Varicose Veins

When veins begin to pool with blood, circulation is impacted. As a result of the pooling, vein walls start to weaken and enlarge, developing into what is known as varicose veins. Typically blue or dark purple, varicose veins often appear as bulging or twisted-like ropes.

They are most often found on the legs and thighs; however, varicose veins may develop anywhere in the body.

What Are The Symptoms of Varicose Veins?

Some individuals may have little to no symptoms from their varicose veins. Others, however, may experience some uncomfortable symptoms, such as:

• Cramping
• Burning
• Itching
• Aching
• Swelling in the feet and ankles
• Heaviness and fatigue
• Dry skin or eczema
• Skin discoloration in the lower leg

Less common but more severe symptoms of varicose veins include:

• Bleeding
• Superficial Thrombophlebitis – a blood clot within the varicose vein
• Skin Ulcer – that may ooze fluid
• Dermatitis
• Stasis dermatitis

What Causes Varicose Veins

In healthy veins, blood flows smoothly without obstruction, towards the heart. Unique, one-way valves, work to push blood toward the heart, ensuring that blood does not leak backward into the lower limbs. 

When vein disease sets in, these one-way valves are weakened or damaged, allowing blood to flow backward (known as venous reflux) and pool in the veins. 

This pooling causes the veins to swell and enlarge, eventually developing in varicose veins.

Varicose veins may also be caused by certain conditions or diseases, such as:

• Blood clots (deep vein thrombosis or DVT)
• Phlebitis (inflammation of the veins)
• Congenital vein abnormalities
• Chronic Venous Insufficiency (CVI)

Are Some People More Likely to Develop Varicose Veins?

While both men and women can develop varicose veins, they are more common in women and in people over the age of 50. They are extremely common, some estimating that 10% to 15% have varicose veins. 

Are There Risk Factors That Increase The Chance of Developing Varicose Veins?

Several risk factors increase your chance of having varicose veins and venous disease:

• Obesity
• Lack of exercise
• Sitting or standing for long periods of time
• Pregnancy
• Family history of varicose veins 

How To Diagnose Varicose Veins

To properly varicose veins, a healthcare professional will perform a thorough physical examination and discuss your symptoms, medical history, and any family history of vein disease.  The surface of the skin will be examined and palpated to feel for any hardening or thickening of the veins.

An ultrasound may be ordered to evaluate the presence of varicose veins.  This will allow your doctor to get a deeper look at the severity and overall health of the veins.

What Type of Imaging is Available to Diagnose Varicose Veins?

Ultrasound

Ultrasound is a painless, non-invasive test that uses sound waves to produce imaging of the veins. Imaging can assist your doctor in pinpointing the source of vein disease and whether any veins require further treatment or intervention.

Venogram

A venogram uses a special contrast that is administered intravenously (IV). This contrast makes the veins appear opaque in x-ray images, which will allow your doctor to see any blood clots deep inside the veins and body.

Duplex Ultrasound

Duplex ultrasound uses soundwaves to produce images that show the speed and direction of blood flow through the veins, as well as the presence of blood clots.

Treatment Options for Varicose Veins

Several treatments are available for varicose veins and will depend on the severity of your symptoms and overall health. For some people, varicose veins may be more of an unsightly, cosmetic concern. For others, however, circulation may be at risk, requiring intervention.

Conservative Treatment for Varicose Veins

If your symptoms are not severe, your doctor may prescribe the following treatment over some time:

• Wear compression stockings (Compression Therapy)
• Regular exercise and maintain a healthy diet
• Lowering sodium intake
• Avoid alcohol
• Avoid wearing tight clothing that can impact circulation
• Avoid crossing your legs when sitting
• Elevating your legs above your heart when possible
• Get up and walk around if your occupation requires prolonged sitting or standing

What Is Compression Therapy?

Compression therapy is the use of compression stockings, which come in a variety of strengths and lengths that help to gently squeeze the lower leg, reducing any pooling of blood in the lower limbs and leg swelling. They also help to squeeze and push blood upward, increase blood circulation back up to the heart.

A healthcare professional can help determine what prescription strength best suits your needs.

Should you notice that conservative therapies are not minimizing your symptoms, or if the varicose veins are worsening, contact your doctor to discuss additional treatments.

Additional Treatments for Varicose Veins

Sclerotherapy

Sclerotherapy uses a particular chemical that is injected directly inside the diseased vein. Once administered, the solution shrinks and causes the vein to scar and collapse. 

Once complete, blood flow is directed to nearby healthy veins, restoring circulation. The diseased vein is eventually absorbed by the body.

Laser Therapy to Treat Varicose Veins

Typically, laser therapies will be used to treat smaller veins known as spider veins or telangiectasias. 

Is Surgery Every Necessary to Treat Varicose Veins

There are several surgical treatments available to treat varicose veins, most performed on an out-patient basis. Your healthcare provider will discuss what options are suitable for your unique case, and determine what the best option is for treatment.

Endovascular Laser Therapy

Endovascular laser therapy uses laser therapy to treat varicose veins.

Typically performed in a doctors’ office with the use of local anesthesia, the laser is inserted directly into the diseased vein through a catheter with the guidance of ultrasound. Once inserted, the laser will shrink and collapse the diseased vein.

Radiofrequency Ablation

Radiofrequency Ablation is very similar to Endovascular Laser Therapy. Rather than laser, Radiofrequency Ablation uses high amounts radiofrequency energy to create heat to destroy the diseased vein.

This procedure is typically performed in a doctor’s office and takes no more than 30 minutes. Local anesthesia is commonly used.

Vein Stripping

For more severe cases, stripping may be necessary.

Look into other less invasive and less painful treatment options before you consider vein stripping.

Stripping involves making two incisions at the groin and knee.  A tunneling device will be placed beneath the skin between these two points to pull the saphenous vein out. 

Avulsion

Avulsion involves making many small incisions in the skin and the removal of the varicose vein through those points.

Ligation

Not as common as once before, ligation involves making an incision at the groin and tying off the saphenous vein where it enters the femoral vein. This procedure is performed under local anesthesia.

Varicose Vein Prevention

While you may be genetically prone to developing varicose veins, there are certain lifestyle changes you can make that will help to reduce your chances of developing venous disorders, such as varicose veins.

• Maintain a healthy weight
• Exercise regularly
• Eat a healthy diet with high fiber intake
• Watch sodium intake
• Wear loose and comfortable clothing