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Johns Hopkins Symptoms and Remedies

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Varicose Veins

In a normal vein, the valve permits blood to flow in only one direction. In a varicose vein, defective valves never fully close, allowing backflow.

What is it?

Varicose veins are twisted, swollen veins near the surface of the skin. Veins are the vessels that return blood to the heart after oxygen has been delivered to the body's tissues. Valves along the walls of the veins permit blood to flow in only one direction. Varicose veins occur when weak or defective valves allow blood to flow backward or stagnate within the vein. Chronic obstruction of the veins can also cause varicose veins, but in most cases no underlying abnormality can be identified. Varicose veins are quite common, though women are affected twice as often as men. Usually appearing in the legs, varicose veins may also occur in the anus, where they are known as hemorrhoids (see Hemorrhoids for more information). While not a serious health risk, varicose veins can be eliminated for cosmetic reasons or if they cause discomfort.

What Causes It?

  • The cause of most cases is unknown.
  • Chronic venous (vein) obstruction may play a role.
  • Hereditary factors appear to have an effect. People of Irish or German descent are at highest risk.
  • Other risk factors include pregnancy, prolonged standing or sitting, obesity, lack of exercise, and increased age.

Prevention

  • Maintain a healthy weight and engage in regular, moderate exercise.
  • Avoid standing or sitting for long periods.
  • Elevate the legs above hip level periodically throughout the day. Do not cross your legs.
  • Avoid tight shoes, belts, or other restrictive clothing.

Diagnosis

  • Diagnosis may be made by observation of veins and does not require a doctor.
  • In some cases x-rays may be taken after a contrast medium is injected into the veins (venography) to highlight them.

How to Treat It

  • Follow prevention tips.
  • Raise the foot of your bed from two to four inches with blocks to aid circulation at night.
  • Avoid scratching itchy skin above varicose veins; this may cause ulceration or profuse bleeding.
  • Special elastic support stockings that prevent blood from pooling in the veins may be recommended.
  • For superficial varicose veins, sclerotherapy (injection of chemicals that harden and shrink the vein) is an option. Blood is rerouted through other veins.
  • Surgical ligation (tying off) and removal (stripping) of the varicose vein is the definitive therapy in severe cases.Other veins compensate for the absent one(s).

When to Call a Doctor

  • Call a doctor if symptoms of varicose veins interfere with normal activities, or if you develop skin ulcers over the veins.