Varicose veins are actually quite common and affect up to 30% of the population. They are more often seen in women who have had children although there is also a strong genetic component as well. Most patients with varicose veins have either a mother or father with a history of varicose veins. Patients that are obese and spend long hours standing can also have a higher incidence of varicose veins as well.
Varicose veins can cause a range of symptoms including pain, itching, swelling, heaviness and fatigue. In the most severe cases they can bleed or cause ulceration (skin tears) which can be quite difficult to heal.
Aside from weight loss, there is really no way to prevent varicose veins. The symptoms however are easily treated by wearing compression stockings. Stockings come in a variety of sizes, shapes and colors and can be either prescription or over the counter. Only knee-high compression stockings are needed in the vast majority of patients and they need only to be worn during the day. Being vigilant with wear is often enough to improve symptoms and prevent varicose veins from worsening.
When symptoms from varicose veins do not improve with compression stockings, or patients cannot tolerate their use, it is important that they see a physician who specializes in the treatment of varicose veins. There are a multitude of different procedures to treat veins today, and the old vein "stripping" is rarely done.
Most initial office evaluations begin with a medical history and physical exam. Photographs are often taken of the leg with the varicose veins. A painless ultrasound is then typically done which allows the doctor to identify where the problem is and help to cater the treatment.
The most common form of treatment in contemporary practice is either radiofrequency ablation or laser ablation of the varicose vein. This procedure is typically done in the office without sedation or anesthesia. A small needle is inserted into the vein after the treatment area is numbed and a catheter (about the size of a piece of spaghetti) is placed in the vein. The catheter is then turned on which treats the entire vein. There is minimal discomfort during the procedure and after the procedure is over the leg is wrapped up with an ace wrap for support.
Another treatment option involves injecting a medicine into the vein that chemically treats the vein. The medicine is very safe (it is essentially a soap-like substance) and only takes about five minutes to apply.