About 40 million Americans have varicose veins. Many people assume it’s just something they have to live with. But thanks to surgical and minimally invasive treatments, varicose veins can often be treated quickly and with very little discomfort.
What are varicose veins?
Varicose veins are veins that become enlarged when pressure builds up inside them. This happens when the tiny valves inside the veins stop working properly.
“Veins rely on valves to move blood back to the heart,” explains James Drougas, MD, a vascular surgeon with Carilion Clinic. “When the valves don’t work correctly, blood can pool in the vein. This usually happens in the legs and feet. Over time, this extra pressure causes the veins to bulge and twist, becoming varicose.”
Symptoms of varicose veins
Common symptoms include:
- Veins that are enlarged or bulging (this can look like lumps or ropes under the skin)
- Throbbing, aching, or burning pain
- Swelling in your legs, ankles, or feet
- Discolored skin
- Skin ulcers
Some people may also notice spider veins, which are a milder version of varicose veins. These small red, blue, or purple veins are closer to the skin’s surface and may look like a spider’s web.
What causes varicose veins?
Genetics play a role, but several things can increase your risk. They tend to be more common in women, but men may develop them as well. Other risk factors include:
- Being overweight
- Sitting or standing for long periods of time
- A history of deep vein thrombosis (DVT)
How are varicose veins treated?
Before recommending treatment, your doctor will use an ultrasound to assess how the valves are functioning. This helps determine the best way to treat the varicose veins.
Treatment usually starts with conservative options, like:
- Wearing compression stockings
- Exercising regularly
- Elevating your legs when possible
“A course of 3 months of nonsurgical treatment is usually required by insurance companies. If symptoms persist, then we can pursue treatment such as ablation therapy,” Dr. Drougas explains.
What is ablation therapy?
Ablation therapy uses heat—either from a laser or radiofrequency energy—to close the problem vein. This outpatient procedure takes less than 30 minutes and involves very little pain or downtime.
“The incision is so small that we usually just use a Band-Aid,” Dr. Drougas says. Patients wear a compression wrap for about 48 hours but can still move around. After that, they can return to normal activities with no restrictions.
Dr. Drougas also notes that most of his patients generally have no pain issues. When they do, they usually only need to take acetaminophen (Tylenol).
However, not everyone is a candidate for in-office treatment. “Those patients are frequently treated with an outpatient, minor surgical procedure. It typically takes about an hour and patients return to normal activity in a day or 2,” says Dr. Drougas.
Can varicose veins be prevented?
You can’t change your genetics, but you can lower your risk by:
- Maintaining a healthy weight
- Elevating your legs when resting
- Avoiding long periods of sitting or standing
- Wearing compression stockings when you’re going to be standing or sitting for long periods of time
If you have varicose veins, reach out to your family doctor to see if a referral to a vascular surgeon may be right for you.
