Tortuous, enlarged veins just underneath the surface of the skin. Varicose veins most frequently occur in the legs but can also arise in the anus, scrotum, and oesophagus.
A defect of the valves in the legs perforating veins (which lie between the superficial veins (those near the skins surface) and deep lying veins) causes blood to pool in the superficial veins. The build-up of pressure in these veins causes them to become varicose. Factors that contribute to varicose veins include, hormonal change, obesity, and pressure on the pelvis during pregnancy, hormonal changes occurring at menopause, and standing for lengthy periods of time. Varicose veins are widespread, affect more women than men, and seem to run in families.
Varicose veins may not cause any problems, but they can give severe aches and the ankles and feet can become swollen; constant itching can also arise. These symptoms can worsen during the day and can be elevated by sitting with the affected leg raised. In women, symptoms are usually worse just before menstruation. In extreme cases, leg ulcers can arise. Thrombophlebitis (clotting and inflammation of blood in the veins) can be linked with varicose veins.
In certain cases, the symptoms can be adequately controlled by wearing compression stockings, regular walking, and sitting with the feet up as much as is possible. However, these measures do not actually treat the varicose veins themselves and, if they are ineffective, surgery to seal or remove off the varicose veins can be advised.
A number of surgical techniques can be carried out, including avulsion, in which individual varicosed sections of vein are taken away; powered or stripping phlebectomy , two methods of removing whole veins; and radiofrequency ablation or laser therapy, which seals off the veins. Sclerotherapy, in which an irritant is injected into a vein to seal it, can also occasionally be used. Varicose veins have a tendency to recur, and repeat treatment may be necessary.