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A varicose vein is a large and winding blood vessel. These twisted, swelled and bulging vessels are commonly found on the insides of the legs and at the back of the calf and are visible on the surface. Varicose veins also show up in other areas of the body as hemorrhoids, esophageal varices and in the scrotum.

They form because the blood flow is too slow and the vein piles up with the excess. Another possible reason is that the valve in the vein is not working properly so the blood drops down from gravity and collects in the veins of the legs. Nearly 15% of all adults are affected. Varicose veins are more likely to occur in women than in men.

What are the symptoms?

Leg veins become bigger, blue and twisted. Most people feel severe pain in the area, swelling, and a constant itch. Blood can pool in the veins and the tissues won't get enough blood and nutrients causing the skin to become thin, hard, dry and discolored. Ulcers may also form in the area. Sitting down with the legs raised is the only way that these problems will be relieved. Bumping can cause severe bleeding so contact with the vein should be limited.

Why does it seem to mostly effect the legs?

The legs have of two systems of veins. The first system is of deep veins, which carry about ninety percent of the blood. The other system consists of surface veins, which are visible just below the skin and are not as well supported.

After the blood has gone through the tissues in the leg it is pumped back up through the leg and up to the heart. As the blood is pumped upwards, there are valves in the veins that prevent the blood from falling back down the leg. If these valves become defective the blood will pool and flow back down the leg causing superficial veins to form. These veins become swollen and distorted. Obesity and hormonal changes during pregnancy contribute to the formation of varicose veins. Deep vein thrombosis is sometimes associated with varicose veins.

What are the risks of getting varicose veins?

Some of the factors that lead to varicose veins are out of our control. The incidence increases with age and may affect 50% of people over 50 years of age. Women are affected more often than men are. The extra weight of the pregnant uterus can compress the veins and cause increased backpressure in them. Varicose veins can be inherited and if there is a strong predisposition in your family, this may be the most influential risk of all. Surgery on or near the hips can cause vein problems. Congestive Heart Failure and thrombus obstruction can also lead to the development of varicose veins.

Some risk factors can be controlled. Posture is important. Standing up can increase the pressure in the veins, while lying down relaxes them. People who are required to stand for long periods of the day have an increased incidence of varicose veins. Being overweight increases abdominal pressure that impedes blood flow in the veins or decreases support for the veins themselves.

What can be done about them?

The goal of any treatment or care is to improve blood flow back up to the heart. Elevate your legs while you are sitting and exercise or walk every day. Elastic stockings will help support the dilated veins; don't stand for long periods of time.

Sclerotherapy is used to treat small varicose veins and spider veins. This is a minor procedure where an irritant is injected into the veins that makes them scar and seal off. This forces the blood to detour to healthier veins. The doctor might place an elastic stocking around the treated leg to reduce bruising and bleeding. The risks of sclerotherapy are brown spots at the injection site and clots in superficial veins. There may also be a reaction to the injected chemical and new spider veins may form.
Stripping or vein removal is used to remove larger varicose veins. This is a hospital procedure-requiring anesthesia. Parts of the vein are removed or tied off, or the entire vein can be removed. Swelling may occur and can last 6-8 weeks. The risks of stripping are possible bruising, bleeding or formation of new varicose veins.