By James B. Alexander, MD, FACS
Treatment for varicose veins can give your legs new life!
Varicose veins, most commonly found in the legs and ankles, can appear as blue, twisted and enlarged beneath the skin. While unsightly, they usually aren’t serious. However, varicose veins can sometimes be painful and may be a sign of blockage in other veins located deeper under the skin.
What causes varicose veins?
Varicose veins develop when the one-way valves within the veins, which keep blood
flowing to the heart, stop working. Blood then pools within the veins and increases pressure on the vein walls. The veins then weaken, bulge and twist, leaving a roadmap of bumpy lines on the legs. Varicose veins – and their less conspicuous variety, spider veins – can be painful and contribute to leg fatigue and restlessness. They may also cause a feeling of heaviness or throbbing in your legs.
Varicose veins generally will worsen with time. If varicose veins are not treated, they may cause inflammation, ulcers and other skin sores, itching, redness, thickening and hardening of the skin. More severe problems include bleeding, superficial blood clots and deep vein thrombosis, which is a blood clot in a deeper vein.
What factors increase the risk of varicose veins?
Increasing age: Varicose veins are more common as people age and the veins lose elasticity. Varicose veins affect about half of the population age 50 and older.
Gender: Women are four times more likely to develop varicose veins, but men get them too.
Pregnancy: Blood volume increases during pregnancy which may cause veins to enlarge, while the additional weight of a growing uterus puts pressure on the abdomen and veins in the legs. Multiple pregnancies bring an increased risk of developing more varicose veins.
Hormonal changes: Hormonal changes that occur with pregnancy and menopause, as well as medications containing estrogen or progesterone, can contribute to the formation of varicose veins.
Obesity: As with pregnancy, additional weight puts extra pressure on the veins, weakening and enlarging them.
Medical history/heredity: People born with weak or defective veins are more likely to develop varicose veins, as are people who have family members who have vein problems.
Work: People who stand for long periods of time may be more prone to developing varicose veins because of the increased pressure on the legs.
Sedentary lifestyle: Sitting and a general lack of movement forces the veins to work harder to move blood through the body. Sitting with your legs bent or crossed inhibits circulation and may worsen varicose veins.
When should I consult a doctor?
Do not hesitate to see a doctor if:
- You want to improve the appearance of the veins.
- Discomfort interferes with your daily activities.
- The veins are swollen, tender or warm to the touch.
- There are unusual sores or a rash on the leg or ankle.
- The skin on the leg or ankle becomes thick or discolored.
- There is suspicious bleeding from the leg.
How are varicose veins diagnosed?
The vascular professionals at Cooper Vein Center will look closely at your legs and feet for signs of swelling, discoloration, sores and tenderness. A painless and non-invasive ultrasound can assess the vein structure and can show blood flow, as well as blood clots, in your veins.
What are my treatment options?
After diagnosis, vascular surgeons from the Cooper Vein Center will discuss the best course of treatment for your individual needs. In some cases, a combina¬tion of procedures will provide the best results.
If the physician determines that your varicose veins should be removed, several minimally-invasive op¬tions are available and can conveniently be performed in Cooper’s outpatient offices. Most patients are back on their feet in as little as a day or two, and can resume normal activities within a week.
Endovenous Laser Therapy (EVLT) is performed most frequently and uses laser energy, guided by ultrasound, to collapse and seal off the damaged vein. The procedure is performed under local anesthesia and requires no surgical incisions.
Radiofrequency Ablation (RFA) uses a tiny catheter to deliver heat to the vein wall, which shrinks and seals the abnormal vein. No surgical incisions are necessary. The procedure is performed under local anesthesia.
Sclerotherapy is a common, non-surgical procedure in which a solution is injected directly into the vein. The solution causes the vein walls to swell and seal shut, stopping the blood flow. Anesthesia is typically not needed. Over time, the vein will fade. Multiple injections may be needed to treat the vein, depending on its size and location. Recovery may take up to five days.
Phlebectomy is used when larger veins become swollen and inflamed. In this minimally-invasive procedure, physicians remove individual vein clusters from the leg through a series of small incisions. Phlebectomy is performed under local anesthesia using micro instruments and magnification. No stitches are necessary. Patients are typically up on their feet immediately and can resume normal activities within a week.
Compression socks and stockings can support the veins to prevent swelling and stop the blood from flowing backward. They can help heal sores, relieve pain and prevent varicose veins from returning.
How can I prevent or diminish varicose veins?
Watch your weight and your diet. Maintain a low sodium/high-fiber diet. You can increase your daily fiber by eating whole grains, fresh fruits and vegetables. A daily multivitamin can help you get the recommended allowance of vitamins and minerals. And drink plenty of water, up to six- to eight-glasses daily.
Exercise regularly. Regular exercise boosts your circulation and helps keep your muscles and bones strong. Incorporating more exercise and activities into your day will improve your overall health.
Avoid sitting or standing for long periods. Avoid sitting with your legs crossed at the knees or wearing tight garments that inhibit circulation. If you sit or stand for a long time at your job, be sure to get up and stretch, or move around, several times during the day. Prop up legs if necessary. Always speak with your physician before making any lifestyle changes.
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