Angie's LIST Guide to
Varicose Vein Treatment

Varicose veins, including smaller spider veins, can be unsightly and uncomfortable, and may even put you at risk for a blood clot. Find out what causes these visible veins and how a qualified, experienced vascular surgeon or specialist can treat this cosmetic medical issue.
 

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Visible veins, such as spider and varicose, can often be treated with compression socks and lifestyle changes, or can disappear with the help of laser treatments or vein stripping surgery. (Photo courtesy of Angie's List member Alice O. of Redmond, Washington)
Visible veins, such as spider and varicose, can often be treated with compression socks and lifestyle changes, or can disappear with the help of laser treatments or vein stripping surgery. (Photo courtesy of Angie's List member Alice O. of Redmond, Washington)
 
 
Illustration courtesy of Society for Vascular Surgery

Illustration courtesy of Society for Vascular Surgery

What causes varicose veins?

The Vascular Disease Society Foundation estimates that roughly 27 percent of American men and women suffer from some sort of venous disease. Patients most commonly seek out vein treatment to remove unsightly and uncomfortable varicose and spider veins.

As many as 40 million Americans, mostly women, have varicose veins, according to the Society for Vascular Surgery.

Varicose veins are enlarged, superficial veins that often swell, twist and bulge from the skin and usually appear red, blue or flesh-colored. Spider veins are smaller varicose veins that don't always bulge from the skin.

Instead, they look like small red or blue spider webs just below the skin. They're mainly a cosmetic issue, but can cause some syptoms of aching pain and itching, the SVS reports.

You'll most commonly find both varicose and spider veins on the legs, particularly the calves. Sometimes you'll see spider veins on the face.

A combination of weak blood vessel valves and the effects of gravity most commonly cause these types of vein conditions, as does high blood pressure inside your superficial leg veins. If blood vessel valves at the top of the leg become weak or damaged, the blood cannot flow properly.

Gravity can then cause the blood to fall and pool in the veins in the lower part of the leg. Standing for an extended period of time or pressure in the abdomen may cause or worsen varicose veins.

Sun exposure, injury and hormonal changes can cause unsightly varicose veins. Some scientists even believe that this condition may be hereditary. Other risk factors include being overweight, inadequate exercise, smoking, sitting or standing for long periods of time, or having deep vein thrombosis.

Varicose veins typically affect patients between 30 and 70 years old, and pregnant women have an increased chance of developing them (but the veins usually return to normal within a year after childbirth.) Multiple pregnancies increase the likelihood that the varicose veins will become permanent.

Are varicose veins a health risk?

Although varicose and spider veins usually aren't dangerous, they can cause problems in some people, especially if the varicose veins are severe. Blood can sometimes clot in the veins, and if these clots reach the lungs or the heart, you could face dangerous or even fatal risks.

Watch out for any sudden, severe leg swelling — which could indicate deep vein thrombosis and requires immediate medical attention.

Varicose veins can cause discomfort in some people. Patients often report feeling aching and fatigue in the legs, as well as skin problems like rashes, redness and sores. If left untreated, varicose veins can worsen.

If you experience aches or cramping in your legs near varicose veins, you may want to consider seeking vein treatment from a vascular surgeon or vein specialist. You should also seek help if your varicose veins are bleeding, swelling or feeling warm to the touch.

Varicose veins can also cause or aggravate Restless Leg Syndrome (RLS), which symptoms include an uncontrollable urge to move the legs and an aching feeling in the legs. RLS can make you uncomfortable, especially at night and when you sit or stand for a long period of time.

You should consider seeking treatment for these types of visible veins if you find that your veins are particularly unsightly. Eliminating the appearance of these veins can help boost your self-esteem and confidence. Consult Angie's List to find a qualified vascular surgeon near you and to see member reviews.

How to treat varicose veins

During an intial exam, a physician will often apply a tourniquet or direct hand pressure to see how your veins fill with blood. Your doctor may then order a duplex ultrasound test to confirm a diagnosis of varicose veins.

It's a painless procedure that takes approximately 20 minutes per leg. This test will also help the vascular specialist rule out other possible medical conditions.

You can sometimes treat minor varicose vein problems with compression socks, which are made from a strong elastic material. Compression socks fit tightly on the feet and ankles and become less tight as they travel up the leg.

CHECK OUT: Angie's List Guide to Vascular Surgery

They squeeze the legs constantly, increasing circulation. Many types of compression socks require a medical prescription from a vascular surgeon or specialist.

More stubborn varicose veins require more drastic measures. One method of eliminating these bulging veins involves injecting them with a sclerosing chemical that causes the vein to close and die. This is known as sclerotherapy.

When using this method of treating unsightly veins, doctors use roughly one injection for every inch of vein they're removing. The body eventually absorbs the dead veins.

A surgery called vein stripping can also remove varicose veins. During this type of procedure, a vascular surgeon makes small incisions in the skin. He or she then inserts tools into the incisions, ties off the veins and removes them.

Along with vein stripping, doctors can perform a procedure called small incision avulsion (or ambulatory phlebectomy), where the vascular surgeon removes vein clusters using hooks passed through small incisions, or employ a similar technique with a suction device placed through a tiny incision. 

Laser treatment and ablation are the most common methods for treating varicose veins and often replace the surgeries described above. These techniques are less invasive than surgery and require less healing time.

Ablation uses a thin, flexible catheter tube inserted into a leg vein, where tiny electrodes heat the wall of the vein and destroy it, according to the SVS. Laser treatment for veins involves delivering pulses of light at the veins through a catheter. These pulses cause the blood inside the vein to coagulate, stopping blood flow.

The vein eventually dies and the body absorbs them, causing them to disappear.

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