You know them when you see them — those lumpy, sometimes bluish veins that tend to show up in the legs, usually of older women. They’re called varicose veins, and while they might not conform to the current societal standard of beach body beauty, they’re not actually a health concern, despite the discomfort they can sometimes cause.
What Are Varicose Veins?
Dr. Mounir Haurani, a vascular surgeon at the Ohio State University Wexner Medical Center in Columbus, says that varicose veins are just veins, but they’ve “stretched out over time. As they stretch out, they become easier to see under your skin and can appear twisted and lumpy.”
More than just an eyesore, varicose veins don’t work optimally and “can become thickened, inflamed and painful,” Haurani says.
Not all varicose veins are made the same. Some are big, some are small, and the smallest ones can be found “very near the skin and can appear as small red or purple lines and patches. These are often called spider veins or telangiectasias,” and measure less than 1 millimeter in size, Haurani says.
“Larger veins, between 1 and 3 millimeters, are called reticular veins. They’re bluish colored and usually don’t protrude.”
At the biggest end of the spectrum are large varicose veins more than 4 millimeters in size. These large veins are the ones we most often refer to as varicose veins and they’re “bulgy and twisty and can be seen protruding from the skin,” he says.
Varicose veins are a very common complaint. “It’s estimated that 90% of adults will develop spider veins, 80% will form reticular veins, and that over 50% to 60% will develop some varicose veins or symptoms from venous circulation problems,” Haurani says.
Symptoms of Varicose Veins
While varicose veins aren’t generally a major health concern, some people may experience some uncomfortable symptoms, including:
— Dull aching or pain near the vein.
— Heaviness and fatigue in the limb with the problematic vein.
— Swelling at the vein site and in the limb.
— Restlessness or cramping in the legs at night.
— Itching or burning near the varicose vein.
What Causes Varicose Veins?
“It isn’t completely understood why the walls of some individuals’ veins stretch,” says Dr. Stacy Chimento, a board-certified dermatologist with Riverchase Dermatology in Miami. “However, certain factors provide indicators as to why some people get a lot of varicose veins while others don’t.” These factors include:
— Being genetically predisposed to varicose veins. While there are many factors that can elevate your risk for developing varicose veins, “one of the most common risk factors is a family history of varicose veins,” Haurani says.
— Trauma or injury. An injury or trauma can damage the vein and lead to poor drainage. “This damage to the veins can also happen from blood clots, which can cause scarring and narrowing of the inside of the veins, Haurani adds.
— Being female. Women are at higher risk of developing varicose veins.
— Hormonal changes. “Varicose veins occur more often in women than men, especially during pregnancy,” Haurani notes. They usually start in the first trimester, but women who aren’t pregnant may also be at higher risk “during the last 14 days of the menstrual cycle,” he adds. Using birth control pills or hormone replacement therapy can also increase risk, as can the hormonal changes associated with aging and menopause.
— Standing for long periods. Because varicose veins develop when the veins stretch, standing for a long time can predispose you to them because the blood tends to pool in the lower limbs and your body has to work harder to bring it back up to the heart when fighting against gravity.
— Getting older. Simply getting older can increase the risk of varicose veins, because over time, your vascular system becomes less elastic and loses some of its ability to fight the effects of gravity.
— Obesity. Pressure on the lower limbs from being overweight can hasten the effects of time and gravity on the venous system.
The good news is that “varicose veins are not a sign of disease or circulatory problems,” Chimento says. “Varicose veins occur due to weakened vein valves, which have nothing to do with heart trouble, heart disease, arterial disease or your current overall health.”
Varicose veins involve the venous system, or the network of blood vessels that bring blood back to the heart. “Peripheral artery disease (also called poor circulation) and heart disease, for example, are related to the arterial system,” Chimento says, which is the system that moves oxygenated blood from the heart to the rest of the body.
How to Prevent Varicose Veins
Because age, genetics, pregnancy and occupational factors can play such a big role in the development of varicose veins, some lifestyle changes often don’t make a lot of difference in trying to prevent them. “People joke about taxes and death being inevitable, but varicose veins are as well,” Haurani says.
Still, Chimento notes that living a healthy lifestyle can delay their appearance for a while, or at least prevent them from getting worse if you already have them. By that, she means:
— Avoid sitting or standing in one place for prolonged periods. “By moving around you will increase blood flow. Even if you’re stuck at a desk job, move your feet in circular motions, bend your knees under or beside your desk as if you’re marching, and get up every hour and take a walk around your office,” Chimento says.
— Wear compression socks and stockings when standing or sitting for long periods. These garments compress the skin and help prevent blood from pooling in the lower limbs while you’re sitting or standing for long periods, such as on a long flight.
— Maintain a healthy weight. “Obesity puts pressure on the veins,” Chimento says, so if you’re overweight, talk with your doctor or a dietitian about ways to bring down your weight to help alleviate some of that pressure. “Keeping your weight under control can reduce the severity of varicose veins as well as the severity of symptoms associated with them,” Haurani adds.
— Stay well hydrated. Drinking plenty of water helps support good circulation.
— Walk. “This is the best form of exercise to prevent varicose veins,” Chimento says.
— Stay active. “Yoga is another great option as it can tone the deepest calf muscles, which helps the vein valves to work optimally,” Chimento says.
— Sleep on your left side if you’re pregnant. “This is because the expanding uterus puts pressure on the big vein in your pelvic area,” Chimento says. That vein is on the right side, so blood will flow more freely if it’s not being compressed by your own — and your growing baby’s — body weight.
— Don’t cross your legs when sitting. Again, this puts more pressure on some veins and can cause them to weaken and bulge.
“If you follow the tips above, you can perhaps stave off your chances of getting varicose veins or make them more manageable if they do appear,” Chimento says.
Treatment of Varicose Veins
“There are several noninvasive ways to treat the symptoms of varicose veins,” Haurani says. First among these is compression socks or stockings, which can “help to reduce the pressure in the veins by supporting them from the outside and preventing the veins from stretching and bulging. Compression also helps to encourage the blood flow back up through the veins as you walk.”
Elevating the legs when you can will also help assist the smooth return of blood back to the heart. Anti-inflammatory medications can alleviate pain and irritation.
For more severe cases of varicose veins, eating certain foods or taking medications might help, Haurani says. Foods that are high in flavonoids, a type of powerful antioxidant, and medications “can relieve some of the swelling and pain associated with varicose veins as well,” Haurani says. High-flavonoid foods include:
— Brightly colored berries.
If varicose veins become very painful or problematic, you can explore more invasive treatments that “involve removing or eliminating the veins that are not functioning normally,” he says. “These treatment options range from injection of chemicals into the veins to cause them to scar and close, to small incisions to remove the veins from under the skin.”
Sometimes varicose veins on the surface are caused by changes to another connecting vein that’s deeper under the skin. “In these cases, the deeper vein is also closed as part of the treatment of symptoms,” Haurani says. The body automatically redirects blood flow to nearby vessels so closing off a vein in this manner isn’t a health concern.
These closure procedures can take several forms, including:
— Injecting a chemical solution to scar the vein and close it, a technique called sclerotherapy.
— Using a laser or radio waves to close the vein, a technique called endovenous or thermal ablation.
— Using polymers to glue the vein shut.
— Removing the vein surgically.
You may need a few treatments over several weeks to fully close off the vein, and you may need to take time off and stay off your feet to fully recover. Typically, you’ll be advised to wear compression stockings to support the healing process, especially if your job has you standing a lot.
In any case, “your vein surgeon can talk to you about which option is best for your individual needs. All of these treatments are very low risk and involve minimal time off work,” Haurani adds, noting then when seeking help, “it’s important to seek out a specialist who can offer you a full range of treatment options including nonsurgical ones. Many people have good relief of their symptoms through the use of compression and exercise, and there’s no risk in trying those first.”
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Update 01/06/22: This story was previously published at an earlier date and has been updated with new information.