I hate wearing shorts in the summer because I have varicose veins. They also hurt! What’s the best way to get rid of them?
Varicose veins are not only unsightly and in some cases painful, but they can also be dangerous. Varicosities come from a weakness in the wall of the vein, or in the tiny valves that prevent blood from flowing in the wrong direction as it travels up from the legs back to the heart. The veins enlarge, become painful, and, in advanced cases, can allow fluid to leak from the veins out into the tissue so that the ankles and legs become swollen, particularly after periods of prolonged standing.
Varicosities can either be in the venous system that is close to the skin (superficial) or in the deeper veins of the legs. Since the damaged vein wall can cause the formation of blood clots (called thrombosis) varicose veins are not simply a cosmetic problem. While a venous thrombosis in the superficial system can usually be treated with leg elevation and warm soaks, clots in the deep venous system are more serious. When these deep clots extend above the knee, they need to be treated with blood thinning medication.
The symptoms of varicose veins include
- Unsightly dilated, tortuous blue-colored blood vessels in the legs.
- A sensation of pressure, heaviness, or even a dull ache in the legs after standing for long periods of time.
- Swelling of the ankles and legs.
- Ulceration of the skin over veins because of blood pooling in the area.
The treatment for varicose veins varies depending on the severity of the problem. In milder cases, frequent elevation of the legs and the avoidance of long periods of standing can help to keep symptoms under control. Elastic or “support” hose can also help to avoid leg and ankle swelling. Although many brands of support hose are sold over-the-counter, I recommend that patients see a vascular specialist to have their support hose expertly measured and designed specifically for them. Individually tailored products fit better, are more comfortable, and provide better support.
In more severe cases, your physician will refer you to a competent vascular surgeon for a consultation. In some cases, the surgeon may decide to perform a procedure called slower therapy in which she injects into the veins a solution that permanently occludes it and then applies a compression bandage to the site. Within a short time, the vein disappears. Stripping, or actually removing the troublesome vein, is another surgical option that eliminates the problem. The downside with this procedure, however, is some women may be left with a series of small, unsightly scars. You and your surgeon will decide which procedure will work best for your particular situation.
Specialist in internal medicine and primary care.