Causes

Veins in the legs have valves inside them to help blood flow back into heart only in an upward direction so that blood does not flow backwards into legs due to gravity. Any damage to these valves can lead to dilatation of veins.

Risk factors

• Standing or sitting for long periods of time. Your blood doesn’t flow as well if you’re in the same position for long periods.
• Increasing Age.  Aging causes wear and tear on the valves in your veins that help regulate blood flow.
• Being Female: Women are more likely to develop varicose veins may be due to their hormones.
• Pregnancy. Increase in blood during pregnancy can cause engorgement of blood in legs.
• Family history. There is some tendency of varicose veins to run in families.
• Obesity. Being overweight puts added pressure on your veins.
  
  

Complications

• Blood clots. Enlarged veins pool blood and at times clots may form in them which is a serious condition such clots can travel to the lungs, brain etc. and cause serious health issues.
• Ulcers. Ulcers may form on the lower leg around the ankles. Skin usually first becomes dark in colour before an ulcer is formed.
• Bleeding. Thinning of skin over an enlarged vein may eventually lead to bleeding from that vein.

Prevention

There is no way to guarantee that varicose veins will not occur but the following are the ways to decrease their chances, severity or progression:

• Maintaining healthy weight
• Avoiding prolonged standing
• Avoiding high heels
• Exercising
• Eating a high-fiber, low-salt diet
• Elevating your legs
• Changing your sitting or standing position regularly
  
  

Diagnosis

Examination by a doctor may instantly diagnose the disease. Colour Doppler Ultrasound is usually the test of choice to confirm such cases. Blood vessels that are twisted and enlarged beneath the skin’s surface are known as varicose veins. Usually, these purple or blue bulges show up in your ankles, feet, and legs. They may itch or cause pain. Spider veins are tiny red or purple lines that show up on the surface of your skin. They can surround varicose veins. For most people despite they can be difficult and ugly, varicose veins are not dangerous. Severe varicose veins can occasionally result in life-threatening conditions like blood clots. The majority of varicose vein problems can be treated at home by you or by your healthcare practitioner using injections, laser therapy, or surgery

Treatment

With advancements in technology, varicose veins can now be treated without major surgery or admission. Self-care techniques, compression stockings, and surgeries or procedures are possible treatments for varicose veins. Treatment for varicose veins is frequently performed as an outpatient treatment. In other words, you typically return home on the same day. This allows patients to resume their daily activities and minimize disruption to their routine. However, it is important to follow post-treatment instructions provided by the healthcare provider to ensure a smooth recovery and optimal results. The outpatient nature of varicose vein treatment also helps in reducing healthcare costs and hospital stays, making it a convenient and cost-effective option for patients.

Compression stockings

These can be tired as first mode of treatment. They squeeze the legs helping veins and muscles to move blood more efficiently. There are various types of stockings which your doctor can prescribe after evaluation.

• Ambulatory phlebectomy. Small varicose veins are removed through a series of tiny skin punctures.
• Laser treatment. Laser is a modern tool to burn these veins by introducing a Laser fibre inside them under ultrasound guidance or directly burning them in case of small veins.
• Sclerotherapy. Small- and medium-sized varicose veins are injected with a solution or foam that causes these veins to close down and fade in a few weeks.
• Stripping. Involves the removal of vein by a small incision using a metallic wire that strips the vein out of body. Removing the vein won’t adversely affect the circulation of blood in leg because deep veins of leg take care of the larger volumes of blood.
• Endoscopic vein surgery. You might need this operation only in an advanced case involving leg ulcers if other techniques fail. Your surgeon uses a thin video camera inserted in your leg to visualize and close varicose veins and then removes the veins through small incisions. This procedure is performed on an outpatient basis.

Varicose veins that develop during pregnancy generally improve without medical treatment within three to 12 months after delivery.