Varicose vein risk factors and treatment

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If you stand for most of your workday, you may be at greater risk of developing varicose veins, the bulging blood vessels you often see in adults mostly over 40. Sitting for most of your workday and rarely moving around also can put you at risk for varicose veins.

Varicose veins are so common that the American Heart Association estimates that 23 percent of American adults have this condition, which typically has more cosmetic implications than medical ones.

Varicose vein risk factors and treatment

Varicose veins "tend to occur more often in people who have jobs where they stand for the majority of the day," said Ali Wait, MD, a Scottsdale vascular surgeon on the HonorHealth medical staff, "but this may be because it stresses already abnormal veins. Not everyone who stands all day has varicose veins, but if you were predisposed to getting varicose veins, this could be the trigger."

On the other hand, being seated can predispose you to dilation (enlarging of veins) "and even blood clots, so I encourage patients to get up and move around occasionally," she said. "If possible, elevate your legs on a stool or cushion when sitting down."

How do varicose veins form?

As you age, tiny valves inside the veins in your legs can begin to wear out or get damaged, from either standing too long at a time, too much uninterrupted sitting over the years or other risk factors. These damaged valves result in what's called venous insufficiency – not enough blood flow. When there's not enough blood flowing in the legs, the blood that is there can build up inside the veins. This can lead to vein swelling and what becomes a varicose vein.

Dr. Wait said common risk factors for varicose veins include:

  • Family history: While it's not a certainty, a family history of varicose veins can increase your chances of getting them.
  • Older age: The majority of people who develop varicose veins are between 40 and 80.
  • Gender: Women are more likely than men to develop varicose veins.
  • Pregnancy or obesity: Added body weight can put pressure on the legs.
  • Crossing your legs: It doesn't cause varicose veins but can make the symptoms worse, Dr. Wait said.
  • Leg trauma: Injury can lead to damage in the valves of the veins or the veins themselves.

Varicose vein symptoms include:

  • Veins that noticeably protrude or bulge under the skin, looking and feeling ropey.
  • Achy, heavy-feeling and itchy legs. These symptoms may intensify after a day of standing.
  • Severe pain when standing or leg cramps at night.

Spider veins refer to the enlargement of the smallest, most superficial veins in your skin, Dr. Wait explained. These usually only present a cosmetic challenge, rarely a medical issue.

When to seek treatment

You should contact your doctor when:

  • You notice inflammation, discoloration or a break in the skin or swelling in the calf or leg. This could indicate the presence of a blood clot.
  • Pain in the leg seems to worsen. This could be serious.
  • A bump or minor irritation causes the vein to bleed, and the bleeding doesn't stop after elevating the leg and applying pressure. You may need a stitch from a doctor to completely close the wound.
  • You feel chest pain or have trouble breathing. This could indicate the presence of a blood clot in the blood vessels of the heart or lungs. Go to an HonorHealth emergency department immediately.
  • The veins are painful.

Treatments for varicose veins

Support hose help keep your veins tucked close to your body, Dr. Wait said, and can prevent the veins from getting progressively dilated over time. "They won't undo your genetics or your hormones, but they will certainly help with symptoms and may reduce progression of varicosities (swelling and dilation of veins)."

Other treatments include:

  • Compression stockings. These reduce strain on the veins by exerting a bit of extra pressure near the ankles and feet and helping blood flow back toward the heart.
  • Elevating your feet whenever possible.
  • Surgical procedures to address problem veins if they are painful or causing wounds. The most common surgical procedure is called catheter ablation, which involves radiofrequency or laser energy to cauterize (heat) and close varicose veins in the legs.
  • Superficial procedures, such as injections or laser therapy, to close veins for cosmetic purposes.

"The objective is to reduce the work of the veins," Dr. Wait said, "so they aren't as likely to swell."

Ready to relieve the pain and swelling of varicose veins? Find a doctor.