Keep Them Flowing

Treating Varicose Veins is Not Just About Vanity

Varicose veins may make you want to leave your shorts packed up no matter how enticing the weather. But you don’t have to live with these ropy looking veins. Treatment is much improved compared to 15 years ago. Varicose veins aren’t just a cosmetic issue—they also affect your health.

Varicose veins are created when the valves on the veins start leaking, causing the blood to flow backward, says Dr. Keith Nichols of The Circulatory Centers in Virginia Beach and Suffolk. They bulge out of the skin and can be blue, red or flesh-colored. There are three major risk factors, he says.

“Even if you’re not vain about your varicose veins, it’s still important to treat them because varicose veins can cause or worsen other health problems.”

Women are twice as likely to get varicose veins as men. Risk increases with the number of pregnancies, he says. Finally, you can thank genetics—if one or both parents have varicose veins, you’re more likely to get them too.

Varicose veins affect half of people 50 years old and older, according to the U.S. Department of Health and Human Services’ website,

Contributing factors include working at jobs that involve either standing on your feet or sitting at a desk all day, Nichols says. “Having your legs lower than the rest of your body increases the pressure,” he says. Other factors include lifestyles that involve a lot of traveling, especially on airplanes.

A typical patient is a woman in her 40s or 50s with several children and one or more parents with varicose veins.

Other problem veins include spider veins, which are like varicose veins but smaller and closer to the surface, and reticular veins, a lacy pattern of greenish blue veins, also can pose problems. Spider veins can be caused by the backup of blood, hormone changes, exposure to the sun and injuries, according

Wearing compression stockings, elevating the legs and taking breaks to walk around while at work or flying helps these veins from getting worse, Nichols says. Other measures to reduce risk include wearing sunscreen, getting regular exercise, eating a diet rich in low-salt and high fiber foods, controlling your weight, wearing low heeled (instead of high heeled) shoes and avoiding crossing your legs for long times while sitting, according to

Fifteen years ago, treating varicose veins meant vein stripping, which involved general anesthesia, a hospital stay and about six weeks of recovery, Nichols says.

Today’s treatment, called Endovascular Laser Ablation (EVLA), is minimally invasive, performed with local anesthesia, and is done in the physician’s office through a needle stick, he says. Recovery is usually one day and you’re ready to go back to work in one to two days, Nichols says.

EVLA is 99 percent effective, meaning that the vein with backwards blood flow will be closed. Fixing this high-pressure leak is the most important step in treating varicose veins and preventing new ones, he says. For this reason, it’s important to fix varicose veins first before proceeding to their smaller cousins—reticular veins and spider veins.

EVLA has been used for about 10 years, but many people still haven’t heard about it and are apprehensive about treatment based on what they’ve read about vein stripping, Nichols says.

EVLA involves using a laser fiber that is inserted into the vein through a needle stick to heat the varicose vein from the inside out, which kills the vein, Nichols says. The body then reabsorbs the vein. With this technique, physicians typically eliminate one vein at a time, he says.

Even if you’re not vain about your varicose veins, it’s still important to treat them because varicose veins can cause or worsen other health problems, Nichols says. Varicose veins can cause restless leg syndrome, which makes it difficult to sleep at night, he says. Varicose veins also can lead to fatigue as well as swelling, heaviness and aching in the legs. People with varicose veins also can get an itchy rash around the calves caused by the blood flowing backward and plasma leaking out in to the surrounding tissue, he says.

More serious problems can include pain, ulcers, external bleeding and potentially life threatening blood clots, Nichols says.

Having diabetes can make these health issues worse because the skin breaks down quicker, and people with diabetes often don’t have as much sensation in their feet and legs, Nichols says.

Because of these medical issues, health insurance covers varicose vein treatment 95 percent of the time, Nichols says. Spider veins and reticular veins usually are not covered, he says.

In addition to EVLA, other treatments include sclerotherapy, injecting a medication into the veins that causes them to stick together, he says. This closes the treated veins and your body reabsorbs them. This treatment can be used on varicose, reticular or spider veins.

Surface lasers also can be used to treat spider veins, he says. But the success rate is usually lower than it is with sclerotherapy, he says.

See your doctor if the vein has become swollen, red, tender or warm to the touch; if there are sores or a rash on the leg or near the ankle; if the skin on the ankle or calf changes color and becomes thick; a varicose vein begins to bleed; your leg symptoms are interfering with your daily activities; or the appearance of the veins is causing you distress, according to

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