Varicose veins and their precursors, spider veins can signal serious vascular problems. Full-blown varicose veins appear as twisted, enlarged veins close to the surface of the skin while milder varicose spider veins appear as sunbursts of small blue or red vessels near the surface of the skin. Spider and varicose veins are often misunderstood as merely a cosmetic problem. However, if left untreated, spider and varicose veins can progress to a more serious form of vein disease called chronic venous insufficiency (CVI).
Veins are the vessels that return blood to the heart from the body. To keep the blood flowing up from extremities, and not back down, the veins contain one-way valves. Failure of leg veins’ valves to hold blood against gravity leads to swelling in the lower legs and ankles, aching or tiredness in the legs, new varicose veins, leathery-looking skin on the legs, and/or flaking , itching, or ulceration on the skin of the legs or feet.
Varicose veins and vein valve damage is more likely among women, persons over 50, and persons with a personal or family history of leg clots (known as deep vein thrombosis). Obesity, smoking, sedentary lifestyle, and sitting or standing for long periods have also been found to increase the risk of varicose veins and vein disease. To prevent and reduce the progression of venous diseases try to maintain a healthy weight, avoid smoking or quit if you already smoke, exercise regularly, and avoid long periods of standing or sitting. Elevating your legs to the level of your heart when sitting or lying down as well as wearing compression stockings can also support venous blood flow in the lower extremities.
It is estimated that more than 40 million Americans suffer from vein disease but less than 3% get treated. Because varicose veins are a potential risk factor for vein disease, persons with varicose veins, should have their risk for CVI assessed and be treated when indicated. A vascular ultrasound can examine the blood circulation in the legs. Non-surgical treatments for existing varicose veins and spider veins include sclerotherapy in which an injection into the veins causes them to collapse and disappear and endovenous thermal ablation in which laser or high-frequency radio waves create intense local heat in the affected vein causing it to close. For more severe cases, surgical venous stripping or ligation may be necessary.
What to do: To maintain healthy veins in the legs aim for good cardiovascular health by not smoking, maintaining a healthy weight, and exercising regularly. Also, try to avoid long periods of sitting or standing. If you are traveling or will be sitting for a long time, flex and extend your legs, feet, and ankles about 10 times every 30 minutes to keep the blood flowing in the leg veins. If you need to stand for long periods of time, take frequent breaks to sit down and elevate your feet. If you are experiencing varicose veins or other symptoms of leg vein disease, discuss assessment and treatment options with your provider.
Sources: “Chronic venous insufficiency.” Vascular Web. Society for Vascular Surgery, Jan. 2011. Web. http://www.vascularweb.org/vascularhealth/Pages/chronic-venous-insufficiency.aspx and Gloviczki P, Comerota A, Dalsing M, Eklof B, Gillespie D, Gloviczki, M, et al. The care of patients with varicose veins and associated chronic venous diseases: Clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum. J Vasc Surg. 2011 May; 53(5 Suppl): 2S-48S.
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