varicose veins

Varicose veins are unsightly, enlarged veins that bulge beneath the skin. This condition can cause a great deal of discomfort to a person, as well as make them feel self-conscious. There are a number of factors that cause varicose veins in men and women — from bearing children to obesity to genetics. What many people may not realize is that they do not necessarily have to live with varicose veins. There are a several ways to treat the condition. Here are some commonly asked questions about varicose veins, Symptoms, and the latest advancements in treatment for the condition.

Q.  Who suffers from varicose veins?

A. Varicose veins are actually quite common and affect up to 30% of the population. They are more often seen in women who have had children although there is also a strong genetic component as well. Most patients with varicose veins have either a mother or father with a history of varicose veins. Patients that are obese and have spent long hours standing can also have a higher incidence of varicose veins as well.

Not all people with varicose veins will have a clear underlying cause, says Natalie Sridharan, MD, a vascular surgeon with UPMC, but there are a number of risk factors related to the condition. Women who are pregnant – or as they age or gain weight – are more likely to develop varicose veins. Many of the patients Dr. Sridharan treats are people with jobs requiring extended periods of standing, she said, such as nurses and restaurant workers.  

“Some of it is luck of the draw, but there are certainly things that put patients at higher risk of developing varicose veins,” she says. “Patients with a history of a DVT (deep vein thrombosis) 

or blood clot can be at increased risk… and patients with a family history. There’s a strong genetic component to varicose veins.” 

Q. What symptoms do varicose veins cause?

A. Varicose veins can cause a whole spectrum of disease including pain, itching, swelling, heaviness and fatigue. In the most severe cases they can bleed or cause ulceration (skin tears) which can be quite difficult to heal.

“For the most part, it’s not terribly dangerous, although it can really affect people’s quality of life,” says Dr. Dr. Sridharan. “However, there is a very severe spectrum of disease…that can have such severe venous insufficiency, or such severe pressure in the leg, that they have debilitating swelling, or even to the point that they get venous ulcerations that require special dressing and specialized wound care.” 

Q.  What can be done to prevent the symptoms from varicose veins?

A. Aside from weight loss, there really is no way to prevent varicose veins. The symptoms however are quite easily treated with simple compression stockings. These come in a variety of sizes, shapes and colors and can be either prescription or over the counter. Only knee high compression stockings are needed in the vast majority of patients and they only need to be worn during the day. Being vigilant with them is oftentimes enough to improve symptoms and prevent them from worsening

Q.  What if the compression stockings don’t work?

A. When symptoms from varicose veins do not improve with compression stockings, or patients cannot tolerate their use, it is important that they see a physician who specializes in the treatment of varicose veins. There are a multitude of different procedures to treat veins today, and the old vein “stripping” is rarely done.

Q.  What happens when you see a vein doctor?

A. Most initial office evaluations begin with a careful history and physical exam. Photographs are often taken of the leg with the varicose veins. A painless ultrasound is then typically done which allows the doctor to identify where the problem is and help to cater the treatment.

Q.  What treatments can the doctor offer for varicose veins?

A. The most common form of treatment in contemporary practice is either radiofrequency ablation or laser ablation of the varicose vein. This procedure is typically done in the office without sedation or anesthesia. A small needle is inserted into the vein after the skin in numbed and a catheter (about the size of a piece of spaghetti) is placed in the vein. The area around the vein it is numbed and the catheter is then turned on which treats the entire vein. There is minimal discomfort during the procedure and after the procedure is over the leg is wrapped up with an ace wrap for support.

Another treatment option involves injecting a medicine into the vein that chemically treats the vein. The medicine is very safe (it is essentially a soap like substance) and only takes about 5 minutes to

We hope we’ve answered some of your questions about varicose veins. If you are dealing with this condition or have additional questions, visit the Vein Center of the UPMC Heart and Vascular Institute website or call 412-802-3333 to make an appointment.

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