For most people varicose veins and spider veins, a common and mild variation of varicose veins, are simply a cosmetic concern. Unfortunately for others, varicose veins can cause significant discomfort and are often a sign of a more serious problem.

If you have enlarged veins readily seen under your skin, an achy or heavy feeling in your legs, pain caused by prolonged sitting or standing, or are concerned about how your legs look, you should make an appointment to consult with us.

We have taken the time to answer many of our most frequently asked questions below. If you come across terminology that is unfamiliar to you, please refer to our glossary. Should you have any further questions, feel free to contact us.

What are Varicose Veins?
Varicose veins are gnarled, enlarged veins close to your skin's surface. The name varicose comes from the Latin root varix, which means twisted. Any vein may become varicose, but the most commonly affected areas are legs and feet.
What are some Signs or Symptoms of Varicose Veins?

You may have symptoms even before varicose veins appear. Signs and symptoms may include:

• An achy or heavy feeling in your legs and burning, throbbing, muscle cramping and swelling in your lower legs. Prolonged sitting or standing tends to make your legs feel worse.

• Enlarged veins readily seen under the skin of your legs.

• Brownish-gray discoloration on your ankle.

• Itching around one of your veins.

• Skin ulcers near your ankle, which represent a severe form of vascular disease and require immediate attention.

Occasionally, veins deep within your legs are involved. In such cases, your limbs may swell considerably. Any sudden leg swelling that may or may not be accompanied by pain and redness warrants urgent medical attention, as it may indicate a blood clot.

What are the Causes of Varicose Veins?

Arteries carry blood from your heart to the rest of your body's tissues. Veins return blood from your body to your heart so the blood can be recirculated. To return blood to your heart, the veins in your legs must work against gravity. This is accomplished by muscle contractions in your lower legs – which act as pumps – toned, elastic vein walls that help blood return and tiny one-way valves in your veins. The valves open as blood flows toward your heart and close to stop blood from flowing backward.

Varicose veins occur when the valves in your veins malfunction. As you get older your veins can lose elasticity, causing them to stretch preventing the valves from working properly. When that happens, blood that should be moving toward your heart may flow backward. Blood pools in your veins, and your veins enlarge and become varicose.

Are there any Factors that might put me at Risk for Varicose Veins?

These factors increase your risk of developing varicose veins:

• Age. Varicose veins usually appear between ages 30 and 70 and once present get progressively worse with time.

• Gender. Women are twice as likely as men are to develop the condition. Hormonal changes during pregnancy, premenstruation and menopause may be a factor. Female hormones tend to relax vein walls. .

• Obesity. Being overweight puts added pressure on your veins.

• Standing for long periods of time. Your blood doesn't flow as well if you're in the same position for long periods.

When should I seek Medical Advice?

If you're concerned about how your veins look and feel, and self-care measures haven't stopped your condition from getting worse, its time to make an appointment.

How is a diagnosis made?

In making a diagnosis, we will examine your legs while you're standing and look for swelling. We will ask you to describe any pain or aching in your leg. Finally, it may be necessary to perform ultrasound tests to see if there's any evidence of a blood clot, determine the location and size of the leaking valve, and to exclude other vascular conditions as contributing to your symptoms.

What are my Treatment Options?

• Sclerotherapy. In this outpatient procedure, Dr. Loiterman injects small- and medium-sized varicose veins with a sealant solution. The process closes the damaged valve redirecting your blood to healthier veins.

• Laser surgery. Dr. Loiterman uses a laser in an outpatient office procedure to seal smaller varicose veins and spider veins.

• Ambulatory Phlebectomy ("fluh-BEK-to-me"). Dr. Loiterman removes smaller varicose veins through one or two tiny skin punctures. Local anesthesia is used in this outpatient procedure. Scarring is generally minimal.

• Endoscopic Vein Surgery. You might need this operation only in an advanced case involving leg ulcers. Your surgeon uses a thin video camera inserted in your leg to visualize and close veins. Only small incisions are needed.

• Vericlose System. A new non invasive outpatient procedure for the treatment of severe superficial venous insufficiency.

• Vein Stripping. Now rarely used or necessary, involves removing a long vein through small incisions.

How long will Recovery Take?

Since we make exclusive use of the most advanced and least invasive techniques available, treatment is most often administered in our office and the great majority of patients return to work and regular activities either the same day or with a 24-28 hour period.

Are there any ways to Prevent these Problems from Occurring?

There's no way to prevent varicose veins. But, improving your circulation and muscle tone can reduce the risk of getting varicose veins or getting additional ones. To improve circulation and muscle tone, follow these tips:

• Exercise. Get your legs moving. Walking is a great way to encourage blood circulation in your legs. We can recommend an appropriate activity level for you based on your age, weight and measured circulation.

• Control your weight. Shedding excess pounds takes unnecessary pressure off your veins.

• Watch what you wear. Avoid prolonged uses of high heels. Low-heeled shoes work calf muscles more, which is better for veins. Don't wear tight clothes around your calves or groin. Tight panty-leg girdles or uniform compression hose, for instance, can restrict circulation.

• Elevate your legs. If your work involves prolonged sitting or standing, if possible, take three or four 10- to 15-minute breaks daily to elevate your legs above the level of your heart to improve your circulation.

• Avoid long periods of sitting or standing.Make a point of changing your position frequently to encourage blood flow.

Is there Anything Else I can do?

Wearing graduated compression stockings is often the first approach to try before moving on to other treatments. They sequentially massage your legs, helping veins and leg muscles move blood more efficiently toward the heart. The amount of compression varies by type and brand.

Some people think of compression stockings as being uncomfortable and unstylish, but their bad fashion reputation is no longer deserved. Stockings today come in a variety of strengths, styles and colors. With the variety offered, you're likely to find a stocking that you're comfortable wearing.

Prescription-strength stockings are available. Prices vary, and stockings generally last from 4 to 6 months.

Complementary and Alternative medicine?

You may be tempted to try one of the many herbal supplements that claim to be able to prevent varicose veins or get rid of them. The active ingredient in most of the products is horse chestnut. Although physicians haven’t ruled out the possibility of this herb having an effect on veins, it's not likely the products will do much to eliminate the veins or relieve the pain they might cause. Additionally, there are concerns about the purity of supplements. It is also important to note that the manufacture of these products isn't closely regulated by the Food and Drug Administration.

Are there any complications that can develop if varicose veins go untreated?

Sometimes, extremely painful ulcers may form on the skin near varicose veins, particularly nea r the ankles. Ulcers are the result of long-term "waterlogging" of these tissues as the result of increased pressure of blood within affected veins. Brownish pigmentation usually precedes the development of an ulcer. Ulcers require urgent medical attention.

Portions of this text are courtesy of the Mayo Clinic.