Varicose Veins FAQ

Varicose Veins

When should I see a vein care specialist?

You should see a vein specialist if:

  • Your leg symptoms are interfering with your daily activities
  • One of your veins becomes red, hard, warm or painful
  • You have sudden increase in swelling in your leg
  • The skin on your leg or ankle becomes dark or thickened
  • You develop a sore or rash near your ankle
  • You are unhappy with the appearance of your leg veins
  • You had significant vein problems during pregnancy and plan to get pregnant again. Treating the underlying problem before the next pregnancy can help prevent a lot of misery.

How are varicose veins diagnosed?

The first step in diagnosing varicose veins is taking a history and performing a physical exam. While most people with venous disease have a problem limited to their legs, there are other less common causes of vein problems that can be detected with a careful history and physical.

Depending on the results of your history and physical exam, you may have an ultrasound of your legs. This allows your doctor to see how the veins below the skin surface are working and determine the full extent of the problem.

Less commonly, other tests like a CT scan, MRI, or rarely a venogram may be ordered.

How can I prevent varicose and spider veins?

Not all varicose and spider veins can be prevented, but there are some steps you can take to decrease your risk.

  • Exercise regularly to improve your circulation and improve your overall health. Walking and running are some of the best exercises you can do to help your leg circulation.
  • Elevate your legs while you’re resting to let gravity help relieve the pressure in your leg veins.
  • Avoid putting too much pressure on your legs. Control your weight, avoid repetitive strenuous activities, and don’t keep your legs crossed for prolonged periods of time.
  • Avoid standing still or sitting for prolonged periods of time. Your calf muscles are the pump for your leg veins. Use them! When you are standing, shift your weight from one foot to another. When you are sitting, flex your feet up and down. Get up and take a walk periodically.
  • Wear compression stockings for support if you will be standing or sitting for a prolonged period of time. Particularly, people who work in jobs that require these activities may benefit from getting in the habit of wearing compression stockings at work.
  • Eat a healthy diet low in salt and high in fiber. Fiber helps decrease the risk of constipation which increases pressure on leg veins. Salt contributes to water retention which can cause swelling in the legs.

What causes varicose veins?

Varicose veins are caused by weak or damaged valves in the veins. These valves are supposed to keep the blood moving up toward the heart. If they’re not working, they allow blood to pool in the veins and stretch the veins out. Occasionally the problem is limited to veins you can see on the surface. More often, there is a problem in an underlying vein that causes the surface problem.

Am I at increased risk for vein problems?

Factors that increase risk of venous disease include:

  • Family history of venous disease including varicose veins, spider veins, and venous ulcers
  • Certain medical problems such as a history of blood clots,  invasive procedures performed on a vein, or history of trauma to the legs increase the risk of developing venous disease.
  • Hormonal changes including puberty, pregnancy, and menopause increase the risk of venous disease in women. These hormonal changes stretch and weaken veins and can lead to permanent damage.  Taking hormone supplements or oral contraceptives may play a role in developing vein problems as well.
  • Pregnancy causes varicose veins through several mechanisms. The hormonal changes can cause varicose veins even very early in the pregnancy. As the infant grows, there is increased pressure in the abdomen which makes it harder for the leg veins to empty, causing them to stretch and swell. The fluid retention and increased blood volume associated with pregnancy also strains leg veins. Although most symptoms improve after delivery, the damage caused may be permanent.
  • People in jobs that require them to stand or sit most of the day have an increased risk of venous disease. Furthermore, these activities may exacerbate symptoms once vein problems do develop.

Are varicose veins and spider veins dangerous?

Most people with varicose and spider veins do not go on to more serious problems, but there is an increased risk of some complications:

  • Phlebitis – clot and inflammation in a surface vein
  • Damage to the skin of the lower legs – Discoloration, thickening, or rash caused by inflammation in the tissues due to chronically elevated pressure in the veins.
  • Ulcers/sores – This is the end stage of skin and tissue damage from chronically elevated pressure in the veins. Often these ulcers will not heal without correcting the underlying vein problem.
  • Bleeding – Results from stretching and thinning of the skin overlying the vein and the vein wall from high pressures in the vein. Little to no trauma can cause the vein to break open and hemorrhage.
  • Deep Vein Thrombosis – Blood clot in a deep vein. It may cause symptoms such as pain in the calf or thigh or leg swelling. It may not cause any symptoms at all. If a portion of it breaks off it can travel to the lungs and may be fatal.