Veins are blood vessels that bring blood back to the heart for cleaning and oxygenation. Veins have valves, or flaps, that open and close. These allow blood to move toward the heart instead of down to the legs and feet due to gravity.
What are varicose veins and when should you get treatment for them?
Varicose veins are twisted, enlarged veins near the surface of the skin with weak or damaged valves that allow the blood to flow backward into the lower extremities. This results in swelling, bulging, pain, itching, redness, and possibly wounds or venous ulcers in the legs.
“We usually see this happen in the lower extremities, like the legs, because these veins receive the highest amount of pressure due to gravity,” explains Lindsey Haga, MD. Dr. Haga is a vascular surgeon who sees patients at UPMC East, UPMC McKeesport, and the UPMC Outpatient Center on Clairton Boulevard in West Mifflin.
What are the symptoms of varicose veins?
“Varicose veins pose a problem because, as they become enlarged, the valves start to lose their ability to keep pushing the blood flow in the right direction. If you have a lot of fluid going in the wrong direction, that can eventually cause swelling and inflammation in the leg, which are the main symptoms we see with patients who have varicose veins,” says Dr. Haga.
In addition to swelling and inflammation, other symptoms of varicose veins include:
- Bulging appearance on the legs.
- Fatigue at the end of the day.
- Tenderness over or near the veins.
- Wounds, mainly on the foot/ankle area.
What should I do if I have varicose veins?
If you’re worried you may have varicose veins, Dr. Haga recommends making an appointment with a doctor. Doctors you may want to see for this condition include your primary care provider or a vascular surgeon in your area.
“Patient history and examination are the most important factors when it comes to assessing your symptoms,” says Dr. Haga. “Being able to evaluate you in person helps give us a good idea of the cause of these symptoms.”
After your doctor evaluates you, there’s a good chance they’ll refer you for an ultrasound. This process uses gel and special equipment with sound waves to look at the blood vessels in question.
Through ultrasound, the vascular surgeon assesses the veins. This way, they can determine their size and how long the blood flow is going in the wrong direction. With that information, the surgeon can recommend the best course of treatment for you.
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Check out the Varicose Vein and Spider Vein Virtual Care Center
The UPMC Varicose Vein and Spider Vein Virtual Care Center can help correct cosmetic vein conditions and manage severe venous disorders. For your first visit, our experts will assess the severity of your condition and recommend a personalized treatment plan virtually. Based on your assessment, your provider and care team will help schedule any necessary follow-up in-person exams, testing, or treatment.
Your video visit will take place using your MyUPMC account, and a smartphone, tablet, or computer. Ensure that your legs and feet are visible during your video visit with the provider. If you have any wounds, you can still use the virtual care center.
What treatments are available for varicose veins?
Treatment for varicose veins varies but typically starts with conservative management. You can:
- Exercise to improve blood flow in your legs.
- Lose weight if necessary.
- Prop up your legs when sitting or lying down to reduce the extra pressure caused by gravity.
- Wear compression stockings.
“A lot of times conservative management is enough,” explains Dr. Haga. “It’s definitely enough to help prevent wounds, if that’s a concern for you.”
When conservative management isn’t enough, other options are available.
Minimally invasive procedures include:
- Laser treatment: Heat from the laser damages the vein and causes scar tissue to form, which closes the vein. Lasers may apply:
- To the outside of the skin (external laser) to close off small veins near the surface.
- Inside a vein (endovenous laser) to close large veins. The doctor places a thin tube called a catheter into the vein through a small cut in the skin.
- Phlebectomy: Other terms for this include microphlebectomy or stab avulsion, and it usually takes place alongside another surgery to treat varicose veins. Several tiny cuts in the skin allow for the removal of the veins through them. Stitches usually aren’t necessary.
- Radiofrequency closure: This procedure uses a type of energy different from the laser to close off large varicose veins in the legs. A small cut in the vein allows energy to travel through a thin tube placed in the cut.
- Sclerotherapy: A chemical injected into the varicose vein damages and scars the inside of the vein. This closes the vein.
As with any procedure, varicose vein treatment can carry some risk. Make sure to talk with your PCP or vascular surgeon about the risks before moving forward.
Dr. Haga, Natalie Domenick Sridharan, MD, and other vascular specialists in the South Hills treat varicose veins. These other specialists include those at UPMC Outpatient Center on Clairton Boulevard. Schedule an appointment online or call 412-802-3333.
Editor's Note: This article was originally published on , and was last reviewed on .
The UPMC Heart and Vascular Institute has long been a leader in cardiovascular care, with a rich history in clinical research and innovation. As one of the first heart transplant centers in the country and as the developer of one of the first heart-assist devices, UPMC has contributed to advancing the field of cardiovascular medicine. We strive to provide the most advanced, cutting-edge care for our patients, treating both common and complex conditions. We also offer services that seek to improve the health of our communities, including heart screenings, free clinics, and heart health education. Find an expert near you.