Varicose veins are a common condition causing twisted, enlarged veins commonly visible in the legs and feet. While varicose veins are generally benign, certain health considerations should be determined before chalking it up to a cosmetic issue. Because the severity of varicose veins varies, Andrew Seiwert, MD, FACS, a vascular surgeon at ProMedica, debunks common varicose vein myths.
Myth: Varicose veins are a cosmetic issue and do not need to be treated.
According to the Society for Vascular Surgery, nearly two in five Americans will experience venous insufficiency in their lifetime. This happens when blood flows too slowly, not at all, or backward – causing it to pool in the blood vessels of the legs and not be able to pump back up to the heart. When the blood pools, some veins will become enlarged and appear dark, twisted and bulging from the skin. This occurrence is what we commonly refer to as varicose. Varicose veins can cause increased pressure, fatigue, bulging veins, itching, swelling, skin changes, ulceration, heavy legs and skin discoloration. Some varicose veins may appear due to changes in hormones, as a result of being overweight or are inherited from family members.
“Varicose veins are never life or limb-threatening, but they are at the very least a daily aggravation,” Dr. Seiwert explains. “Left unchecked, advanced venous disease can lead to painful, disabling symptoms. It’s important to remember that all major vein problems started out as small ones.”
If you have varicose veins, seeking early treatment can help to prevent more serious health problems from occurring.
Myth: Only women get varicose veins.
Women are more likely to develop varicose veins, likely due to cyclic monthly hormones and blood flow changes associated with pregnancy, but genetics and other factors also play a big role in the likelihood of developing the condition.
Varicosities tend to be passed down through families. If a woman has varicose veins, her daughter has a 90% chance of developing the condition and her son will only have around a 20% chance.
“Men, however, tend to comprise around 40% of all cases,” Dr. Seiwert shares. “Obesity and prior blood clots also factor heavily.”
Myth: Crossing your legs when sitting will give you varicose veins.
“Crossing of the legs has nothing to do with varicose veins,” said Dr. Seiwert.
External pressure like crossing the legs or wearing tight pants does not exert enough force to damage the veins or cause varicosities. The concern arises when an individual works a job in which walking is minimized. Sitting or standing in one spot for an extended period puts the calf muscle in standby mode, allowing blood to pool in the leg.
Making an effort to alternate between sitting and standing throughout the day can help prevent blood from pooling in the legs. Also wearing compression stockings can help if it isn’t possible to move around throughout the day.
Myth: Surgery is the only treatment for varicose veins.
There are several options for the treatment of varicose veins, and the first is always non-surgical. “Varicose vein treatment plans include a three-month trial of exercise, weight loss, limb elevation and compression stockings.” Dr. Seiwart explains. “Commonly, symptoms improve after this three-month treatment plan.”
Minimally invasive treatment options are available for patients who do not have a resolution after trying a non-surgical approach.
Two of the most common treatments are sclerotherapy and endovenous thermal ablation. Both sclerotherapy and endovenous thermal ablation close off the vein and redirect the blood flow to healthier veins. The difference is in the method. Sclerotherapy involves a chemical solution that is injected into a vein and endovenous thermal ablation uses heat to cauterize the vein lining. Both of these treatments are done under local anesthesia and have a 96-96% success rate.
“Patients will get off of the procedure table after having treatment and are surprised that their leg feels better right off the bat,” said Dr. Seiwert. “Some will even go back to work the same day. Remembering that vein operations 25 years ago required general anesthesia, hospitalization and occasional blood transfusion, this improvement in patient care is truly remarkable.”
