What You Need to Know about Varicose Veins

How they're caused and what can help.



Fotolia//aijiro

You might think varicose veins only affect older women. But it turns out that lifestyle and genetics may transcend gender.

Varicose veins are common in older adults. More women than men are affected, but men are also at risk for swollen, twisted veins. In fact, 25 percent of the 40 million Americans with varicose veins are men, according to the National Institutes of Health.

It’s not clear what causes them, but genetics appears to be a factor. “I think in both men and women, there’s a family-type predisposition to valve trouble in the veins,” says F. Todd Harad, M.D., chief of Vascular Surgery at the Center for Heart & Vascular Health at Christiana Care Health System. “And when people have valve trouble in the veins, they’re likely to get varicose veins.”

Here’s what happens: One-way valves in leg veins keep blood moving up toward the heart. When the valves do not function properly, they allow blood to back up into the vein. The vein swells from the blood that collects there causing varicose veins. Smaller veins that can be seen—but not felt—on the surface of the skin are called spider veins.

Any condition that puts pressure on the legs or abdomen can lead to varicose veins, such as obesity, pregnancy or static standing. For women, additional risk factors include hormone changes related to pregnancy, menstruation and menopause, as well as taking birth control pills or hormone replacement therapy.

Inactivity also plays a role. A 2005 review of studies about who gets varicose veins and why suggests that geographical location may also be a factor. Western nations, where sedentary lifestyles are more common, report the highest incidence of varicose veins.

Age is also a factor. The older you are, the more likely the valves in your veins will weaken and not work as well, says Harad.

Fortunately, varicose veins are superficial and don’t cause major problems. Complications from varicose veins can include an achy or heavy feeling in the legs, burning, throbbing, muscle cramping or swelling in the lower legs, itching around the affected veins and minor bleeding from veins near the surface of the skin.

Infrequently, a more severe form of venous insufficiency can lead to deep blood clots, ulcers, sores and fluid build-up.

Mild cases of varicose veins can benefit from wearing compression hose, losing weight, reducing the time spent sitting or standing and keeping legs elevated.

Aerobic exercise is also important, especially exercise that tones the calf muscles. “Every time the muscles in the legs—especially the calf muscles—contract, it forces most of the blood out of the leg back up to the heart and there’s not a lot of time for pooling,” says Harad.

If lifestyle changes fail to offer relief, there are several medical procedures that can help. Doctors use lasers and catheter-assisted procedures to remove and seal shut the problem veins. For minor cases, there is sclerotherapy, a chemical injection that destroys the vein. More severe cases can be treated with vein stripping and ligation, where the doctor makes small cuts in the skin, removes the veins and ties the others closed.

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