Varicose veins are veins that have become enlarged and tortuous. The term commonly refers to the veins on the leg,although varicose veins can occur elsewhere. Veins have leaflet valves to prevent blood from flowing backwards (retrograde).
Leg muscles pump the veins to return blood to the heart, against the effects of gravity. When veins become varicose, the leaflets of the valves no longer meet properly, and the valves don't work. This allows blood to flow backwards and they enlarge even more.
Normal Vein and Varicose Vein. Image Credit: NHLBI
Varicose veins are most common in the superficial veins of the legs, which are subject to high pressure when standing. Besides cosmetic problems, varicose veins are often painful, especially when standing or walking. They often itch, and scratching them can cause ulcers. Serious complications are rare. Non-surgical treatments include sclerotherapy, elastic stockings, elevating the legs, and exercise.
The traditional surgical treatment has been vein stripping to remove the affected veins. Newer, less invasive treatments, such as ultrasound-guided foam sclerotherapy, radiofrequency ablation and endovenous laser treatment, are slowly replacing traditional surgical treatments. Because most of the blood in the legs is returned by the deep veins, the superficial veins, which return only about 10 per cent of the total blood of the legs, can usually be removed or ablated without serious harm.
Varicose veins are distinguished from reticular veins (blue veins) and telangiectasias (spider veins), which also involve valvular insufficiency, by the size and location of the veins. Many patients who suffer with varicose veins seek out the assistance of physicians who specialize in vein care. These physicians are called phlebologists.
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