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]

• Weakness

  When the valves become weak and don't close properly, they allow blood to flow backward, a condition called reflux. Veins that have lost their valve effectiveness, become elongated, rope-like, bulged, and thickened. [lubbockvvc.com]

  The precise cause of varicose veins is unknown, but the main problem is probably a weakness in the walls of superficial veins (located just under the skin). This weakness may be inherited. [msdmanuals.com]

  Causes Weak or damaged valves can lead to varicose veins. Arteries carry blood from your heart to the rest of your tissues, and veins return blood from the rest of your body to your heart, so the blood can be recirculated. [mayoclinic.org]

• Inflammation

  […] convert 454.1 to ICD-10-CM 454.2 Varicose veins of lower extremities with ulcer and inflammation convert 454.2 to ICD-10-CM 454.8 Varicose veins of lower extremities with other complications convert 454.8 to ICD-10-CM 454.9 Asymptomatic varicose veins [icd9data.com]

  Inflammation of veins at the time of clinical onset or aggravation Inflammation of veins should occur at the time of the thrombophlebitis. Inflammation can result from such factors as infection and toxins. [veterans.gc.ca]

  Localized forms of cutis laxa not preceded by inflammation are exceptional; localization on the leg has never been described. This clinical form of elastolysis calls into question the classification of acquired elastolysis. [ncbi.nlm.nih.gov]

  New preclinical research further explores inflammation's role in inciting the ... read more Simulations Characterize Turbulence Caused by Common Connection for Dialysis Sep. 27, 2019 — The complex interplay among the arteriovenous grafts, the vessels [sciencedaily.com]

• 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]

• 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]

  DISCUSSION: Results show a reduction of the number of limbs affected by ulcer, skin pigmentation and stasis eczema, demonstrating correction of haemodynamic overload to be effective. [ncbi.nlm.nih.gov]

• 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]

• 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]

• Unable to Walk

  However, in certain groups of people, such as those individuals who are unable to walk (non-ambulatory), sclerotherapy should be avoided. [medicinenet.com]

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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3. Chiesa R, Marone EM, Limoni C, Volonte M, et al. Chronic venous insufficiency in Italy: the 24-cities cohort study. Eur J Vasc Endovasc Surg. 2005 Oct;30(4):422-9.
4. Racette S, Sauvageau A. Unusual sudden death: two case reports of hemorrhage by rupture of varicose veins. Am J Forensic Med Pathol. 2005 Sep;26(3):294-6.
5. Cho ES, Kim JH, Kim S, Yu JS, Chung JJ, Yoon CS, et al. Computed tomographic venography for varicose veins of the lower extremities: prospective comparison of 80-kVp and conventional 120-kVp protocols. J Comput Assist Tomogr. 2012 Sep;36(5):583-90.
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7. Mao J, Zhang C, Wang Z, Gan S, Li K. A retrospective study comparing endovenous laser ablation and microwave ablation for great saphenous varicose veins. Eur Rev Med Pharmacol Sci. 2012 Jul;16(7):873-7.
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9. Nijsten T, van den Bos RR, Goldman MP, et al. Minimally invasive techniques in the treatment of saphenous varicose veins. J Am Acad Dermatol. 2009 Jan;60(1):110-9.
10. Dudelzak J, Hussain M, Goldberg DJ. Vascular-specific laser wavelength for the treatment of facial telangiectasias. J Drugs Dermatol. 2009 Mar;8(3):227-9.