Varicose veins

Varicose veins can cause discomfort, affect the appearance of your legs and lead to more serious complications. They are a common condition we treat at Atrium Health Floyd and Harbin Clinic. Our vascular medicine specialists and vascular surgeons offer a full spectrum of treatments to improve how your legs look and feel.

What are varicose veins?

Varicose veins are blue, rope-like veins that develop under the skin on your legs. They affect as many as 40 million people in the U.S.

When not treated, varicose veins tend to worsen over time. Sometimes, they can lead to more serious conditions, such as:

• Blood clots in the veins just under the skin (superficial thrombophlebitis)
• Blood clots in the deep veins in your legs (deep vein thrombosis)
• Skin sores (venous ulcers)

What are spider veins?

Spider veins are similar to varicose veins but occur in smaller blood vessels (capillaries), usually on the legs and face. They can be red or blue and often form a web or branching pattern.

Causes of varicose veins

Veins have one-way valves that prevent blood from flowing backward. In your legs, the veins are working against gravity to return blood from your feet to your heart.

Varicose veins happen when the valves inside the leg veins become damaged and the pressure inside the veins increases (venous insufficiency). The vein walls stretch, becoming swollen and distorted.

Varicose vein symptoms

In addition to having blue, bulging veins in your legs, you may experience other symptoms, such as:

• Achy, painful or tired legs
• Swelling in your ankles or feet
• Itching or skin changes around the veins
• Leg cramps at night

Varicose vein diagnosis

Diagnosis is often based on a physical exam and a review of your symptoms and medical history. Your doctor may also order an imaging test called a duplex ultrasound to measure blood flow in your leg veins.

You may receive care from your primary care provider, a vascular medicine specialist or a vascular surgeon. Vascular doctors specialize in conditions that affect the blood vessels.

Varicose vein risk factors

Many factors can increase your risk of varicose veins, including:

• Family history
• Female sex assigned at birth
• Leg injuries
• Obesity
• Older age
• Pregnancy
• Sitting or standing for long periods
• Smoking

Varicose vein prevention

You cannot always prevent varicose veins, but healthy habits may help. Prevention strategies mirror the lifestyle changes doctors recommend for treating varicose veins.

Varicose vein treatment

Varicose vein treatments fall into two categories: lifestyle changes and medical procedures. Treatment goals are to ease symptoms, improve appearance and prevent complications.

Doctors usually recommend one or more of the following lifestyle changes as a first step in treatment:

• Avoid standing and sitting for long periods.
• Elevate your legs when resting.
• Exercise routinely.
• Maintain a healthy weight.
• Wear compression stockings.

Nonsurgical and surgical procedures are available to close off or remove a varicose vein. After treatment, blood starts moving through other veins. Closed veins fade over time and disappear. Your options will depend on which veins are affected and how enlarged they are, but may include:

• Sclerotherapy: A liquid solution is injected into the vein to cause scarring and closure.
• Venaseal™: A medical adhesive is delivered into the vein to close it.
• Endovenous ablation therapy: Laser or radiofrequency energy heats the vein, causing it to collapse and close.
• Microphlebectomy: The vein is removed through a small incision.
• Vein stripping and ligation: The vein is cut, tied shut and surgically removed.