Varicose Vein Treatment and Prevention

Why protruding veins in the legs can pose health hazards and what you can do about them

Are vericose veins dangerous?

As we age, gravity inevitably takes its toll. Some people turn to cosmetic surgeons to help keep its effects to a minimum above the neckline. But when it comes to varicose veins — knotty, bulging, discolored protrusions in the legs that can develop with age or during pregnancy — vanity isn’t the only consideration.

“Many people think varicose veins aren’t dangerous, which is not always true,” says Sunil Rayan, MD, a vascular surgeon at Scripps Health. If left untreated for years, venous disease can cause swelling, skin discoloration, leg ulcers, bleeding, and blood clots — a condition called thrombophlebitis.

Thirty million Americans have varicose veins. They affect 25 percent of women and 15 percent of men. Family history, obesity, multiple pregnancies, heavy lifting and prolonged standing all increase the likelihood of developing varicose veins. They are typically caused by defective valves in the greater saphenous vein in the thigh. Because veins drain blood against gravity, when aging valves no longer close properly, pressure builds up behind them. In response, thin vein walls enlarge and twist, becoming varicose.

“Physical symptoms associated with varicose veins can include aching, pain, fatigue and burning in the legs,” says Dr. Rayan.

Lifestyle modifications to slow varicose vein progression

There’s no known way to prevent varicose veins. But there are ways to prevent them from worsening or delay new ones from forming.

  • Keep it loose
    Tight clothes that constrict your waist, groin or waist areas or put pressure on your leg veins can worsen varicose veins.
  • Keep your weight healthy
    Extra weight places pressure on your veins.
  • Don’t sit or stand too long without switching positions
    Change position every 30 minutes to keep your blood moving.
  • Exercise
    Any low-impact physical activity that encourages blood circulation without stressing leg veins, like walking and swimming, helps.
  • Elevate your legs while sitting or sleeping
    Take 10 minute breaks to elevate your legs above the level of your heart.
  • Hang up the high heels
    Your calf muscles get a better workout in flats or lower heels. That helps move blood through leg veins more efficiently.

Your doctor may also prescribe one of three strengths of compression stockings, which decrease swelling in the legs and prevent blood from pooling in leg veins.

Medical treatment for varicose veins

Depending on the size and extent of varicose veins, several treatment options are available, from non-invasive procedures to surgical treatments. None of the medical treatments affect blood flow from the legs, as other veins take over the removal of blood that used to be carried from veins that are removed in these treatments.

  • Sclerotherapy
    This in-office procedure uses a simple injection of a chemical to seal small and medium-sized varicose veins. Within a few weeks, the treated vein should fade away, although some veins may require more than one treatment. The treatment does not require anesthesia.
  • Laser surgeries
    Smaller veins can be treated with lasers to make them fade away. Although it is considered “surgery,” there are no cuts or incisions involved.
  • Catheter-assisted heat ablation
    In this treatment for larger veins, your doctor inserts a thin tube (catheter) into the vein and delivers heat through the tip. As the catheter is removed, the heat destroys the vein, which causes it to collapse and seal shut.
  • Vein stripping
    This procedure, today only used rarely and for severe cases, long veins are completely removed, under anesthesia, through small incisions. This is an outpatient procedure for most people but requires 1-4 weeks of recovery time.
  • Ambulatory phlebectomy
    Under local anesthesia, your doctor removes smaller varicose veins through tiny punctures in your skin. Only the parts of your leg being treated are numbed, and there is minimal scarring.