In the legs, varicosities are common along the inner side of the leg, near the ankles and posterior calf region. The dilated veins appear blue, distended or elongated, looped or curled. Those suffering from varicose veins can experience any of the following symptoms:

• A dull ache in the legs
• A sense of pressure or weight in the legs
• Swollen feet and ankles
• Itching skin near the damaged veins

In more severe cases of chronic venous insufficiency, the sluggishness of blood flow through the veins can cause localized skin changes like excessive dryness, itching, throw a erythematous rash or brownish discoloration and ulcers. The sluggish blood flow can also produce a clot in the vein. This clotting is known as thrombosis and is a common complication of varicose veins.

Generally, the symptoms of varicose veins worsen at the end of the day, especially due to prolonged standing throughout the day. Occasionally, women find that their symptoms are exaggerated before their menstrual periods, and during pregnancy.

• Pain

  Conclusion Pain secondary to truncal ablation is less painful with MOCA than RFA with similar short-term technical, quality of life and safety outcomes. [ncbi.nlm.nih.gov]

  […] associated with larger varicose veins is usually a dull ache that is worse after prolonged standing Pain caused by venous insufficiency is often improved by walking or by elevating the legs, in contrast to the pain of arterial insufficiency, which is [emedicine.medscape.com]

  Taking self-care steps can help relieve achiness and pain, keep varicose veins from getting worse, and prevent more serious problems. When to Contact a Medical Professional Call your provider if: Varicose veins are painful. [mountsinai.org]

• Fatigue

  Common sypmtoms of superficial venous reflux: Pain Swelling Leg heaviness and fatigue Varicose veins in your legs Highlights of the Closure Procedure Relief of symptoms Short recovery Same day procedure Local or regional anesthesia Resume normal activities [lubbockvvc.com]

  Symptoms may include fullness, fatigue, pressure, bleeding and pain or hyperesthesia in the legs; stasis dermatitis and venous stasis ulcers are uncommon. [msdmanuals.com]

  Clinical presentation includes lower extremity pain, fatigue, itching and/or heaviness, which often worsen with prolonged standing, associated with dilated tortuous veins. Underlying venous insufficiency can be documented by duplex ultrasound. [bestpractice.bmj.com]

  Varicose veins can cause leg pain, discomfort and fatigue. So it’s important to know your options. At Park Nicollet, treatment is minimally invasive. That means less time missed at work and home. [parknicollet.com]

• Ankle Swelling

  Those can include ankle swelling, fatigue, restlessness and pain of the legs, skin damage and ulcers. [amarilloheartgroup.com]

  The symptoms of varicose veins include the following: Enlarged veins that are visible directly under the surface of your skin Feet or ankle swelling Leg discomfort, such as pain and cramping Itchiness Varicose veins: what you should know Varicose veins [rush.edu]

  One of the most noticeable differences between varicose veins that cause no symptoms and those that do, is that feet and ankles may swell and ankle skin may change color or texture. [prnewswire.com]

  Steve Lin As you reach middle age, you may experience bulging veins in your calves, ankle swelling, or a feeling of heaviness in your legs with prolonged standing. [kentucky.com]

• Inguinal Mass

  Contrast enhanced multislice-CT showed round and oval shaped inguinal and retroperitoneal masses in one patient and inguinal mass lesions in the other patient. The mass lesions were suspicious of lymphadenopathy related to cancer recurrence. [ncbi.nlm.nih.gov]

  Typically, they manifest as an inguinal mass that mimics a complicated hernia during pregnancy or the postpartum period. [oadoi.org]

• Anemia

  The results of this study suggest that androgens might be of value in advanced cases of myelofibrosis with transfusion-requiring anemia or severe thrombocytopenia. [ncbi.nlm.nih.gov]

  The population was not only studied because of bleeding but also for many others reasons, like abdominal complaints, changes in defecation pattern, family history of colorectal cancer, anemia and so on. [dx.doi.org]

• Overeating

  Effectiveness was measured by re-intervention on the truncal vein, re-treatment of residual varicosities, and quality-adjusted life-years (QALYs) over 5 years. [ncbi.nlm.nih.gov]

  However, in one study, the varicose veins returned in over half of those treated. [hse.ie]

  These treatments block the affected veins, but this doesn’t damage the circulation in your legs as other veins take over. [bupa.co.uk]

  The Private Clinic vascular clinics have carried out over 7,000 procedures in treating Veins. [theprivateclinic.co.uk]

• Venous Insufficiency

  Chronic nonhealing leg ulcers, bleeding from varicose veins, and recurrent phlebitis are serious problems that are caused by venous insufficiency and can be relieved by the correction of venous insufficiency. See the image below. [emedicine.medscape.com]

  […] system called venous insufficiency. [mdveinprofessionals.com]

  Advanced Varicose Vein Treatments of Manhattan provides innovative care and customized solutions for venous insufficiency to improve your quality of life. After performing over 11,000 vein procedures, our vein expert, Dr. [treatmentsofmanhattan.com]

  Chronic Venous Insufficiency <https://vascular.org/patient-resources/vascular-conditions/chronic-venous-insufficiency#causes> accessed 2018.9.12. [medtronic.com]

• Vascular Disease

  Deep venous thrombosis (DVT), pulmonary embolism (PE), and peripheral artery disease (PAD) are also vascular diseases but associated with serious systemic effects. [ncbi.nlm.nih.gov]

  Annals of Vascular Diseases, 10, 4, (364), (2017). Kiyoshi Tamura and Toshiyuki Maruyama, Mid-Term Report on the Safety and Effectiveness of Endovenous Radiofrequency Ablation for Varicose Veins, Annals of Vascular Diseases, 10, 4, (398), (2017). [doi.org]

  Vascular centers. Mayo Clinic's campuses in Arizona, Florida and Minnesota each offer a vascular center staffed by trained doctors and nurses who have experience treating vascular diseases. [mayoclinic.org]

  EVLT and Insurance Coverage Most insurance carriers either fully or partially cover expenses associated with the treatment of varicose veins if those treatments alleviate symptoms associated with vascular disease. [theskincentermd.com]

• Heart Disease

  Women's Heart Disease Treatment, Peripheral Vascular (or Aerterial Disease) Management, Cardiac and Vascular Imaging, Vascular Surgery, and Endovascular Venous Laser Treatment for Varicose Veins. [tulane.edu]

  Disease Cuts Both Ways AHA News: Woman's Frozen Face, Garbled Speech During Zoom Call Were Signs of a Stroke View All News > View All News > ABOUT Overview History Editors and the Editorial Process Publishing and Production Staff Editorial Board Contributors [msdmanuals.com]

  Swelling can happen for many other reasons, but younger patients and/or patients who have no history of heart disease or other causative factors should get an appointment to see if chronic venous insufficiency can be ruled out. [farewellveins.com]

  It also reduces your risk of heart disease, stroke and Type 2 diabetes. 3. Avoid standing or sitting for a long time. Today’s office workers are at greater risk of developing varicose veins or making them worse. [conwaymedicalcenter.com]

  Some stronger compression stockings can hurt people with certain medical conditions, such as certain types of heart disease or heart failure. [womenshealth.gov]

• Vein Disorder

  At the time of your consultation, the severity of your vein disorder will be evaluated to determine if EVLT treatment is considered "medically necessary." [theskincentermd.com]

  […] title=Category:Varicose_veins&oldid=312958176 " Categoria : Diseases and disorders of veins Categoria nascosta: Uses of Wikidata Infobox [commons.wikimedia.org]

  Statistics further show that 17% of men and 33% of women have varicose veins. In fact, more peopleare unable to work due to vein disorders than due to arterial disease. (Vascular Disease Foundation Newsletter, Spring 2005). [sigvaris.com]

  According to The National Women's Health Information Center, as many as 60% of all American women and men suffer from some form of vein disorder. [footsmart.com]

  These classifications are based on their blood drainage systems and how the vein disorder influences the blood flow in the vein’s trunks and branches. [westmedical.com]

• Eczema

  They can also present with clinical features of venous insufficiency*(Fig. 2), including oedema, varicose eczema or thrombophlebitis, ulcers (typically found over the medial malleolus), haemosiderin skin staining, lipodermatosclerosis (tapering of legs [teachmesurgery.com]

  CEAP classification C0 — No visible or palpable signs of venous disease C1 — Telangiectasias or reticular veins C2 — Varicose veins; diameter >3mm C3 — Oedema C4 — Changes in skin and subcutaneous tissue: pigmentation, eczema, lipodermatosclerosis or [bjgp.org]

  For more serious complications such as varicose eczema or varicose ulcers it would be wise to have the varicose veins treated in order to improve the eczema or ulcers. [palmclinic.co.nz]

  Venous Eczema/Venous Dermatitis The skin surrounding the severe varicose vein becomes scaly, red and wet. This can be mild and limited to the localised areas, or it can cover the whole lower leg, where the skin is very inflamed. [veinhealth.com.au]

  In some cases, they can cause pain, discomfort, swelling, dry and itchy skin and an eczema rash. [healthnavigator.org.nz]

• Hyperpigmentation

  In modified case vignettes complicated with hyperpigmentation and lipodermatosclerosis or ulceration, more participants chose traditional surgery for great saphenous vein (73.2% vs 63.8% [P < .001]; 75.9% vs 63.8% [P < .001]) compared with the basic case [ncbi.nlm.nih.gov]

  Hyperpigmentation – Discolouration of the skin A typical sign of venous disease is the development of a brown discolouration in the area above the ankle. [veinhealth.com.au]

  *Occasionally, patients may present following a bleed from a varicosity post-trauma Adapted from work by James Heilman, MD [CC BY-SA 4.0], via Wikimedia Commons Figure 2 – Skin changes associated with venous insufficiency (A) hyperpigmentation of the [teachmesurgery.com]

  As varicose veins progress to become CVI, other painful symptoms like leg swelling, pain, chronic itching, restless legs, skin damage, hyperpigmentation, cellulitis, dermatitis, eczema as well as ulcers. [memphisvein.com]

  Thermocoagulation and cutaneous laser therapy may result in skin damage as well as hypo- or hyperpigmentation. [ahajournals.org]

• Pruritus

  Patients present with brown discolouration, pruritus, and discoid or circumferential, acute or chronic eczema on the distal lower limbs [7]. [dermnetnz.org]

  Signs and symptoms Common chronic symptoms of varicose veins that should be elicited include the following: Leg heaviness Exercise intolerance Pain or tenderness along the course of a vein Pruritus Burning sensations Restless legs Night cramps Edema Skin [emedicine.medscape.com]

  Initial symptoms and signs localized to the areas of varicose veins include aching or throbbing discomfort, burning, pruritus, and dry irritated skin. [ahajournals.org]

  This common disease has been neglected because most patients have mild complaints including cosmetic embarrassment, leg aching, pruritus, and skin rashes. [oadoi.org]

• Leg Pain

  I asked her to describe her leg pain and she said they mostly hurt at the end of the day. She got short winded when she walked but had no leg pain when she walked. [myavls.org]

  Other causes of lower leg pain could be painful inflammation of the sciatic nerve that runs down the leg from the spinal cord. Medications also can be the problem, causing dehydration and electrolyte imbalance. [courier-journal.com]

  Lifestyle Management Many patients benefit from the daily use of tight-fitting compression stockings that improve blood flow and, in some cases, relieve leg pain. Other recommendations may include weight loss or increased physical activity. [dukemedicine.org]

  John Hatchett reveals help for some sufferers of chronic leg pain. A recent interview conducted with Dr. John Hatchett reveals help for some sufferers of chronic leg pain. Is chronic leg pain a common complaint? Dr. [examiner-enterprise.com]

  Many patients benefit from the daily use of tight-fitting compression stockings that improve blood flow and, in some cases, relieve leg pain. Other recommendations may include weight loss or increased physical activity. [dukehealth.org]

• Leg Cramp

  If you spend long hours on your feet as a construction worker, teacher, medical professional, factory worker, hairdresser, et.al, you could develop problem veins such as leg swelling, throbbing, pain and leg cramps. • Weight: If you suddenly gain or lose [veinexpertspa.com]

  These symptoms often worsen with long periods of standing and can lead to leg swelling, throbbing and leg cramps. Severely compromised vessels can cause phlebitis, dermatitis, or even ulceration of the skin. [mdveinprofessionals.com]

  Make a doctor's appointment if you have these symptoms: Varicose veins around the ankles Swelling in legs or ankles Skin changes around the ankles, especially tight and/or fibrous skin, or darkening skin Leg cramps or spasms Painful, open sores on ankles [prnewswire.com]

  Signs and symptoms of varicose veins include bulging, bluish veins; swelling; aching pain; a feeling of heaviness in the legs and feet; itching; changes in skin color; and nighttime leg cramps. Sometimes varicose veins can limit your activities. [nhlbi.nih.gov]

• Muscle Cramp

  Leg symptoms were defined as pain, itching, muscle cramps, throbbing, and swelling. Ulcers, pigmentations and ecchymosis were recorded as signs of varicose vein. [ncbi.nlm.nih.gov]

  Symptoms usually appear before the age of 40 and might include: Swollen, twisted clusters of purple or blue veins Swollen legs, ankles, and feet Muscle cramps, throbbing, soreness, or aching in the legs Legs that feel "heavy" Soreness behind the knee [my.clevelandclinic.org]

  Muscle cramps, throbbing, soreness, or aching in the legs. Legs that feel “heavy.” Treatment options include sclerotherapy (injections) and laser therapy, both which can make veins disappear. [health.clevelandclinic.org]

• Calf Pain

  Thirty patients with no experience of elastic stockings, presenting with primary varicose veins causing calf pain or aching were randomised to a GECS (18-21 mmHg at the ankle level, n=15) or a placebo stocking (0 mmHg, n=15). [ncbi.nlm.nih.gov]

  Thigh or calf cramps (often at night) Mild swelling of feet or ankles Itching If flow of blood through the veins becomes worse, symptoms may include: Leg swelling Leg or calf pain after sitting or standing for long periods Skin color changes of the legs [mountsinai.org]

  pain, inflammation with color changes in the skin, or open sores which may bleed if trauma is incurred. [docdoc.com.sg]

• Paresthesia

  Postoperative complications included saphenous nerve paresthesia in three legs (10%) and thermal skin injury in one limb (3.3%). [ncbi.nlm.nih.gov]

  […] symptoms Common chronic symptoms of varicose veins that should be elicited include the following: Leg heaviness Exercise intolerance Pain or tenderness along the course of a vein Pruritus Burning sensations Restless legs Night cramps Edema Skin changes Paresthesias [emedicine.medscape.com]

  Complications for ELA include minor skin burns (0.4%)[46] and temporary paresthesia (2.1%). The longest study of endovenous laser ablation is 39 months. [en.wikipedia.org]

Varicose veins can be diagnosed easily on physical examination due to their characteristic presentation. But to know the extent of affection, various other tests have to be performed as follows:

The most useful techniques are contrast venography, color-flow duplex ultrasonography and magnetic resonance imaging (MRI).

Duplex ultrasonography is the ideal imaging modality for diagnosing varicose insufficiency syndromes, planning out a treatment plan and pre-operative vein mapping.

Magnetic resonance venography (MRV) can reach and diagnose varicosities in the deepest veins in the pelvis and calves, and is thus the most specific and sensitive test available.

Direct contrast venography is a very labor-intensive imaging technique. Being invasive, it has been replaced by duplex ultrasonography for routine evaluation of venous disease, at a number of centres, but the technique is very useful in remains extremely useful in tough cases [5].

Color-flow ultrasound imaging has become accepted as the standard for evaluation of venous anatomy and dense physiology. In many patients, color-flow imaging itself is sufficient.

Blood (laboratory) tests are not helpful in making a diagnosis of varicose veins.

Majority of people with mild symptoms of varicose veins are treated by use of compression stockings and leg elevations intermittently all day.

For varicose veins lying closer to skin, sclerotherapy or laser therapy may be useful. Sclerotherapy involves injecting a sclerosing agent into the affected vein, which leads to scarring of the vein and permanently shuts it down. Laser therapy is effective in tiny varicosities.

People with severe insufficiency may have recurrent thrombi and varicose ulcers. The conventional surgery known as vein stripping and ligation can be useful. During this procedure, the abnormal veins are tied and removed from the body through a series of small cuts in the skin. A similar surgical procedure, known as ambulatory phlebectomy, also rips out veins via small skin incisions, but it is not as invasive as the actual stripping and ligation.

Cryosurgery is a variant of stripping. The only agenda of this technique is to prevent a distal incision to remove the stripper [6].

Newer therapies include transilluminated power phlebotomy (a modified form of ambulatory phlebotomy) and endovenous thermal ablation. Endovenous thermal ablation uses a laser fiber placed inside the vein [7]. These newer procedures are less invasive and are associated with lesser complications, with comparable efficacy [8] [9].

External laser therapy is used basically for cosmetic removal of the smaller spidery veins that are visible.

Recently FDA has approved a polidocanol foam (Varithena) which is a pharmaceutical-grade low nitrogen foam that is used in treatment of incompetent veins and varicosities affecting the great saphenous vein. It has been found to be effective in reducing the manifestations of the visible varicosities and the superficial venous incompetence [10].

Varicose veins are a chronic condition whose symptoms can be controlled with the help of leg elevation and therapeutic stockings.

Varicose veins can be treated permanently by various surgical procedures but they cannot prevent development of new varicose veins.

Varicose veins can be linked to genetics [1]. Factors that affect the varicose veins are pregnancy, menopause, prolonged standing, obesity, ageing, injury to the leg, abdominal straining, prior surgery or trauma to the leg.

Increased homocysteine levels in the body can also cause varicose veins, as it leads to degradation and inhibits the formation of 3 important structures of the artery i.e. collagen, elastin and proteoglycans.

Varicose veins are more common in females as compared to their male counterparts [2]. It is due to hormonal factors that varicosities are more frequent in women than men of any age group [3].

Death can take place as a result of bleeding from fragile varicose veins [4], but mortality rates reported with varicose veins is chiefly due to the combination of this condition with venous thromboembolism.

Varicose veins are normal veins that have dilated due to increased venous pressure. Blood collects in superficial venous capillaries, which then flows into bigger superficial veins, and ultimately through valves, empties into deep veins. Then it is carried back to the heart. Superficial veins are situated superficially in the skin, whereas deep veins are embedded in the muscle fascia. Blood passes from superficial veins to the deep system via perforating veins.

Chronic exposure to high pressure will cause any superficial vein to dilate and eventually varicose. Normal veins too dilate and become tortuous under continued high pressure, which might be due to dialysis shunts, spontaneous arteriovenous malformations, and hereditary vein wall weakness. Occasionally, even normal venous pressures produce varicose changes and venous insufficiency, for reasons unknown.

Prolonged high pressure in veins might be caused by an outflow obstruction, either from extrinsic compression or intravascular thrombosis.

Most commonly, superficial venous valve failure results from excessive dilatation of a vein from high pressure of reverse flow within the superficial venous system. Failure of valves can be an outcome of direct trauma or from thrombotic valve injury. When unveiled to high pressure chronically, superficial veins dilate to an extent, such that their fragile valve leaflets loose the contact.
When multiple valves fail in a series, the affected vein cannot efficiently pump the blood upwards. Venous blood then just flows along the pressure gradients i.e. downwards due to gravity and outwards to a congested and swollen leg. With passage of more time, many more superficial veins become dilated and tortuous.
During pregnancy due to hormonal changes that render the vein wall and the valves more pliable, varicose veins develop.

There's no way to completely prevent varicose veins. A person cannot change his or her genes, but they can take measures to avoid it as far as possible by pursuing the following regimen:

Exercising regularly to improve the circulation and muscle tone helps in keeping obesity at bay by maintaining healthy weight; obesity is a major risk factor for varicose veins.

Do not remain in the same position for long periods of time i.e. if you are sitting continuously, take a break and move around and if you are standing continuously, sit down for some time and relax.

Avoid wearing high heels everyday and binding clothes on day to day basis as tight clothes block movement of blood up the leg.

A varicose vein is a medical condition characterized by tortuous, dilated and often visibly enlarged veins. It is commonly seen in the lower extremities of the body.

Varicose veins are not a skin condition but it affects the veins of the body especially of the legs. Exact cause of varicose veins is not known hence preventing its development is not possible. Various factors like lifestyle, occupation, surgery, heredity, obesity etc. are seen to affect the veins. Having knowledge of these factors and accordingly making changes in our life can help to keep this disease at bay.

Diagnosing and taking proper steps to treat this disease is necessary because if not treated it can lead to complications like deep vein thrombosis which can be sometimes life threatening.

In case you are already suffering from varicose veins, you can avoid exacerbation of symptoms by timely lying down or sitting down. Use support stockings or compression stockings so as to avoid blood from pooling in the veins. Knocking off extra pounds is essential so that there is less stress on your legs. Regular exercises helps to maintain good body weight and your leg muscle tone remains good.

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