Varicose Veins

Varicose veins are swollen, twisted veins that often appear on the legs and can be a source of discomfort and aesthetic concern.

At WashU Medicine, we provide expert care to help manage and treat varicose veins, ensuring our patients regain their comfort and confidence. Our team is dedicated to providing comprehensive care and tailored treatment plans to alleviate discomfort and improve your vascular health.

Risk factors and venous disease

Varicose veins develop when the valves in the veins malfunction, causing blood to pool and veins to enlarge.

Risk factors include:

• Age
• Gender
• Genetics
• Obesity
• Pregnancy
• Prolonged standing or sitting

While often a cosmetic concern, varicose veins can lead to venous disease, which may include symptoms like aching pain, skin changes and ulceration.

Common symptoms of varicose veins

Varicose veins can manifest through a range of symptoms that vary in severity. Understanding these symptoms can help you identify the condition early and seek appropriate treatment.

Visible symptoms

• Enlarged veins: Veins that appear swollen, twisted, and blue or dark purple in color
• Spider veins: Smaller red or blue veins that are visible on the surface of the skin

Physical symptoms

• Aching or throbbing pain: Persistent pain in the affected legs, especially after prolonged periods of standing or sitting
• Swelling: Noticeable swelling in the lower legs and ankles, often worsening throughout the day
• Heaviness in legs: A feeling of heaviness or fatigue in the legs, particularly after physical activity
• Muscle cramping: Nighttime leg cramps or muscle spasms
• Itching or burning: Skin around the varicose veins may itch or burn
• Skin changes
  • Discoloration: Areas of the skin around the varicose veins can become discolored or darker
  • Ulcers: In severe cases, painful ulcers or sores can develop on the skin near the varicose veins, usually near the ankles
  • Thickening of the skin: Skin may become thicker or harder over time.

Recognizing these symptoms early on and consulting with a health care provider can help you manage varicose veins effectively and prevent further complications.

Screening and diagnosis

Screening is typically recommended for people with a family history of varicose veins or those experiencing symptoms.

Diagnosis typically involves a physical examination and non-invasive imaging like a duplex ultrasound, which helps visualize blood flow and identify faulty veins.

Treatment options

WashU Medicine offers a range of treatments for varicose veins:

Non-surgical treatments

For many people, non-surgical treatments for managing and alleviating the symptoms of varicose veins can be effective.

These methods are designed to be minimally invasive while providing significant relief.

• Compression stockings: These help reduce swelling and relieve symptoms by improving blood flow. They help alleviate pain, fatigue and the visible appearance of varicose veins.
• Pharmaceutical treatment: Medications can reduce pain and swelling but are often used alongside other treatments.

These non-surgical treatments are tailored to meet the individual needs of each patient, ensuring optimal outcomes with minimal disruption to daily activities.

Minimally invasive procedures

• Sclerotherapy: A solution is injected into the vein, causing it to collapse and fade
• Endovenous laser treatment (EVLT): Laser energy seals the vein shut
• Radiofrequency ablation (RFA): Radiofrequency energy heats and closes the vein

Surgical care options

• Vein stripping and ligation: Removal of the affected vein through small incisions
• Ambulatory phlebectomy: The vein is removed via tiny skin punctures

Recovery

After treatment, patients may experience mild bruising and swelling, typically resolving within days to weeks.

Wearing compression stockings as recommended and avoiding strenuous activities for a brief period can help with recovery.

Most patients resume normal activities shortly after their procedure.

Complications and chronic conditions

Untreated varicose veins can lead to chronic venous insufficiency (CVI), causing skin changes, leg ulcers and deep vein thrombosis (DVT). Post-procedure complications are rare but may include infections, nerve injury or recurrence of varicose veins.