The most common form of venous disease is the condition called varicose veins. Varicose veins are swollen, dilated vessels that rise to the skins surface and occur when weak or defective valves allow blood to flow backwards or stagnate in the vein. Sometimes, spider veins or thin, red capillaries surround the surface of the varicose vein.Women develop varicose veins twice as often as men. Varicose veins are more prevalent with age and a sedentary lifestyle affecting between 30 and 60% of the American population. Varicose veins and spider veins can appear anywhere on the body, but most often appear on the legs or in the pelvic area.The risk factors that contribute to the development of varicose veins are:
- pregnancy-related pressure increases in the legs;
- advancing age;
- consistent standing for long periods of time (especially for people who work in occupations such as nurses, beauticians, teachers, factory workers and others);
- being overweight;
- hormonal influences during pregnancy;
- the use of birth control pills;
- post-menopausal hormonal replacement therapy;
- prolonged sitting with legs crossed;
- wearing tight undergarments or clothes;
- a history of blood clots;
- injury to the veins and;
- conditions that cause increased pressure in the abdomen including liver disease, fluid in the abdomen, previous groin surgery, or heart failure.
Physical symptoms other than the appearance of protruding veins through the skin include:
- swollen legs;
- muscle cramps, soreness or aching in the legs;
- tiredness, burning, throbbing, tingling or heaviness in the legs, typically as the day progresses;
- soreness behind the knee;
- itching around the vein and;
- brown discoloration of the skin, especially around the ankles;
- infections (cellulitis) in the legs;
- wounds in the calves or ankles;
- legs feeling ‘older’ than they should.
While varicose veins are not life-threatening and may not require treatment, a number of options are available to reduce the symptoms and prevent further complications. The most conservative approach to treatment is to wear properly fitting support hose or compression stockings. Losing weight, exercising regularly, especially walking, avoiding prolonged periods of sitting or standing, and elevating your legs while sitting or sleeping can minimize the symptoms. If conservative treatments do not work, a number of other options are available including:
- Sclerotherapy: An outpatient procedure requiring an injection of a solution, or foam, directly into the vein. The solution turns the vein into scar tissue until it fades from view.
- Photoderm: Intense, pulsed light can be used to selectively damage or destroy abnormal veins including small spider veins, certain sizes of varicose veins and vascular birthmarks.
- Laser therapy or Radiofrequency: This option is most effective for leg vessels. Laser therapy and radiofrequency (RFA) heats the blood vessel and closes it.
- Surgical ligation: Severe or very large varicose veins may require surgical treatment in which the dilated vein is either removed or tied off through a small incision in the skin. The surgery is done in the hospital or outpatient setting by a vascular surgeon.
Varicose veins are not inevitable with age. Walking, controlling your weight, wearing low-heeled shoes, and avoiding long periods of sitting or standing in one position are important preventive measures.
Superficial thrombophlebitis, or a clot in a superficial or varicose vein, is a condition with a red, engorged, cord-like vein, associated with localized swelling, pain or tenderness. It usually occurs in a vein with valve damage.
Deep-vein thrombophlebitis is a generalized swelling, warmth and redness in the affected limb; distention of superficial veins; bluish skin color in the limb or toes (cyanosis); and rarely, fever, and chills. However, 25% of these are asymptomatic (no symptoms of having any issue).
Patients with deep-vein thrombophlebitis (DVT) may require hospitalization. A number of treatment approaches are utilized including:
- bed rest and elevation of the affected limb;
- anti-clotting medication;
- clot-dissolving agents, such as urokinase or tissue plasminogen activator;
- mechanical removal of DVT;
- use of balloons and stents;
- special elastic support stockings and;
- implantation of a small filter in the main vein of your abdomen to prevent clots in the legs from travelling to the lung.