Varicose veins are twisted, dilated veins most commonly located on the lower extremities. Risk factors include chronic cough, constipation, family history of venous disease, female sex, obesity, older age, pregnancy, and prolonged standing. Some of the symptoms of varicose veins include – heavy, throbbing legs and swollen ankles. The symptoms are usually worse at the end of the day or after sitting or standing for a long time.
Symptoms of varicose veins
In the majority of cases, there is no pain, but signs and symptoms of varicose veins may include:
- veins look twisted, swollen, and lumpy (bulging)
- the veins are blue or dark purple
What are some of the symptoms?
Some patients may also experience:
- aching legs
- legs feel heavy, especially after exercise or at night
- a minor injury to the affected area may result in longer bleeding than normal
- lipodermatosclerosis – fat under the skin just above the ankle can become hard, resulting in the skin shrinking
- swollen ankles
- telangiectasia in the affected leg (spider veins)
- there may be a shiny skin discoloration near the varicose veins, usually brownish or blue in color
- venous eczema (stasis dermatitis) – skin in the affected area is red, dry, and itchy
- when suddenly standing up, some individuals experience leg cramps
- a high percentage of people with varicose veins also have restless legs syndrome
- atrophie blanche – irregular whitish patches that look like scars appear at the ankles
Spider veins are similar to varicose veins, but they’re smaller. Spider veins are found closer to the skin’s surface and are often red or blue.
They occur on the legs, but can also be found on the face. Spider veins vary in size and often look like a spider’s web.
The exact pathophysiology is debated, but it involves a genetic predisposition, incompetent valves, weakened vascular walls, and increased intravenous pressure.
A heavy, achy feeling; itching or burning; and worsening with prolonged standing are all symptoms of varicose veins. Potential complications include infection, leg ulcers, stasis changes, and thrombosis.
Some conservative treatment options are avoidance of prolonged standing and straining, elevation of the affected leg, exercise, external compression, loosening of restrictive clothing, medical therapy, modification of cardiovascular risk factors, reduction of peripheral edema, and weight loss.
More aggressive treatments include external laser treatment, injection sclerotherapy, endovenous interventions, and surgery.