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Are Varicose Veins Dangerous? (podcast)

While unsightly, they’re mostly harmless but can signal problems

Dr. Jeffrey Weiss, vascular surgeon, discusses varicose veins in San Diego Health podcast.

Dr. Jeffrey Weiss, Vascular Medicine, Scripps Clinic

While unsightly, they’re mostly harmless but can signal problems

According to the American Heart Association, about 23 percent of adults in the United States have varicose veins. The condition marked by swollen and twisted veins in the lower legs can be painful and unsightly and may also be an indicator of more serious health problems.

 

In this episode of San Diego Health, host Susan Taylor and guest, Jeffrey Weiss, MD, a vascular surgeon at Scripps Clinic Anderson Medical Pavilion in La Jolla, discuss what causes varicose veins to form, who’s most likely to develop them and the risks associated with varicose veins.


Dr. Weiss outlines common treatment options and how doctors can get rid of varicose veins for good. 

Listen to the episode on causes and treatments for varicose veins

Listen to the episode on causes and treatments for varicose veins

Podcast highlights

What’s the function of the vein? (0:46)

Veins bring blood back to the heart. While the arterial system has a heart to pump blood around, the vein makes its way back to the heart via a series of valves that stair step the blood back toward the heart.

What causes varicose veins to be swollen or twisted? (1:02)

Valves in the veins can become dysfunctional. They can allow blood to go back, in reverse direction, and cause the veins to engorge beyond that valve.

Who’s most at risk for varicose veins? (1:22)

Patients at risk of having these valves become dysfunctional are those who have had lots of pregnancies, patients that have had previous blood clots, patients with a family history of varicosities and patients in a profession that puts them at risk, such as nursing or a waitress. Anyone who’s on their feet for a prolonged period of time can develop varicose veins.

What’s the difference between varicose veins and spider veins? (1:47)

A varicose vein is something you can actually see. It often protrudes. The skin sticks out and you can see it. It’s unsightly. Spider veins are in the dermis or in the skin of the patient. They often just look kind of ugly. They are just like they sound, like a spider with little tentacles of vein that spread through the skin, but it’s just in the skin.

When are varicose veins a sign of a more serious problem? (2:16)

The main thing we’re worried about with patients with long-standing varicose veins is changes at the ankle. The skin can become brown and discolored from long-standing high blood pressure, high venous blood pressure in that location. Eventually, you can end up with an ulcer that can be very difficult to heal. That’s the main thing we’re concerned about.


There’s not really a risk necessarily of pulmonary embolism or a clot going to your lung. Varicose veins can be a sign of some compressive effect of the veins in the pelvis. We’d want to check that out when you’re evaluated to make sure there’s nothing more sinister going on. But for most cases, it’s mostly a cosmetic issue, or it’s an ache, or itch that patients present with for evaluation.

What are the signs and symptoms of problems with varicose veins? (3:13)

Some patients present with just itching. The itching can be pretty intense. It can get worse throughout the day. Most symptoms do worsen throughout the day. You can have swelling. You can have pain. Pain is probably the more common complaint. Patients come in with all sorts of tingling pain, burning pain, achy pain, pain at night. They really just want some relief from those symptoms.

Is there a way to prevent or slow down progression of varicose veins? (3:43)

A compression hose or hosiery is the main way to do it. It’s tough here in San Diego because it gets so warm, but a compression hose will definitely prevent progression. That is our mainstay of treatment. There are other ways to treat veins besides just wearing compression hose.

How effective is elevating your legs or avoiding high heels? (4:21)

High heels, not so much, but definitely elevating your legs will help as well as avoiding situations that put your legs in sort of a gravity-dependent state. That often is hard to do if you’re working. At night, if you elevate your legs, that will certainly help alleviate some of those symptoms.

How do you treat these varicose veins? (4:42)

We start off with an ultrasound. That helps us identify what the underlying problem might be. If we see that it’s in a major vein, then we can treat that with a catheter-based system. A catheter is inserted through an IV in your lower leg, and we can treat the vein in 30 minutes. You’re back to normal activity within a day or two.


The other ways we can treat it are with laser, or radiofrequency ablation, which are heat-based, or VenaSeal, which is glue-based.


Other methods of treatment are surgery. We can go in and remove the veins if they’re large and unsightly through a series of small incisions. The last way we do this, and probably the most common method is with sclerotherapy. We use ultrasound to help us guide the needle, or we can just use a vein lamp and treat the vein directly.

What is the downtime for these procedures? (5:36)

Most office-based procedures, with the exception of the phlebectomy, can be done within 30 minutes. You’re back to normal activity within a day or two.


The phlebectomy takes a little bit more recovery because it is surgery. But usually within a couple days, you’re back to doing what you normally do.

If you’ve got varicose veins, when should you go see a doctor? (5:58)

You could have a varicose vein checked out for any reason. The most common complaint patients have is pain. If you have pain, or you have swelling, or itching, or something that’s bothering you, you should just get it checked out to make sure it’s not something more serious.

If varicose veins are left untreated, what can happen? (6:22)

If they’re untreated, first it’s a quality of life issue. People suffer with pain, itching, swelling. The worst case scenario is that they end up with a skin breakdown, an ulcer, and that requires months of wound care.


If you have varicose veins, you don’t need to suffer. We have treatment and we’re happy to assist you here, anytime.

Watch the video on varicose veins

Watch the San Diego Health video with host Susan Taylor and Dr. Weiss discussing causes and treatments for varicose veins.