Varicose veins are swollen, twisted, painful veins, close to the skin’s surface, that result from poorly functioning valves.

When vein valves become damaged, they hold more blood at higher pressure than normal, causing pain, fatigue, and skin changes. If vein disease is left untreated, symptoms generally worsen and may lead to skin ulceration.

The normal function of leg veins is to carry blood back to the heart. During walking, for instance, the calf muscles act as a pump, contracting veins and forcing blood back to the heart.

To prevent blood from flowing in the wrong direction, veins have numerous valves. If the valves fail, blood flows back into superficial veins and back down the leg. This results in veins enlarging and becoming varicose.

To succeed, treatment must stop this reverse flow at the highest sites of valve failure. In the legs, veins close to the surface of the skin drain into larger veins, such as the saphenous vein, which runs up to the groin. Damaged valves in the saphenous vein are often the cause of reversed blood flow back down into the surface veins.

Varicose veins can cause considerable discomfort and anguish. Symptoms may include:

• Aching leg pain and a feeling of heaviness, fatigue, and/or tenderness
• A burning, throbbing, and/or itching sensation
• Leg cramps, particularly at night
• Unusual ankle swelling
• Skin discoloration at the ankle
• Skin ulcers above the ankle

In women, symptoms may worsen during the menstrual cycle and pregnancy.

Many factors are believed to contribute to the development of varicose veins, including heredity, gender (women appear to be affected nearly four times more than men), pregnancy, occupations and activities that require long periods of continuous standing, obesity, trauma, and hormonal levels (i.e., estrogen and progesterone). Additionally, the incidence of varicose veins increases to 50 percent of people age 50 and older.

Vein disorders can range from large, bulging varicose veins, to smaller blue veins called reticular veins, to tiny web-like veins called spider veins.

Varicose veins can usually be traced from the upper inside of the thigh, sometimes branching extensively into the calves, ankles and even into the foot. Reticular veins are most often noted in the outer thighs, extending into the backs of the thighs and knees. Spider veins often occur in the ankles, lower inner thighs and the front and sides of the thighs. Spider veins do not enlarge, but can cause painful symptoms, despite their small size.

Varicose and spider veins do not disappear by themselves. Faulty valves and the pressure of gravity can cause these veins to enlarge, stretch further, and become more extensive and problematic. Though a small number of varicose veins do not enlarge over time, studies indicate that many untreated varicose veins will worsen and develop into painful leg ulcers, which are difficult to heal.

Every patient’s situation is unique, and changes in veins are difficult to predict. That’s why we recommend you pay close attention to your symptoms.