Varicose veins

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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 flow or reflux). Leg muscles pump the veins to return blood to the heart (the calf muscle pump mechanism), against the effects of gravity. When veins become varicose, the leaflets of the valves no longer meet properly, and the valves do not work (valvular incompetence). This allows blood to flow backwards and they enlarge even more. Varicose veins are most common in the superficial veins of the legs, which are subject to high pressure when standing. Besides being a cosmetic problem, varicose veins can be painful, especially when standing. Severe long-standing varicose veins can lead to leg swelling, venous eczema, skin thickening (lipodermatosclerosis) and ulceration. Life-threatening complications are uncommon, but varicose veins may be confused for deep vein thrombosis, that may be life-threatening



Signs and symptoms

Aching, heavy legs (often worse at night and after exercise).
Appearance of spider veins (telangiectasia) in the affected leg.
Ankle swelling, especially in evening.
A brownish-yellow shiny skin discoloration near the affected veins.
Redness, dryness, and itchiness of areas of skin, termed stasis dermatitis or venous eczema, because of waste products building up in the leg.
Cramps may develop especially when making a sudden move as standing up.
Minor injuries to the area may bleed more than normal or take a long time to heal.
In some people the skin above the ankle may shrink (lipodermatosclerosis) because the fat underneath the skin becomes hard.
Restless legs syndrome appears to be a common overlapping clinical syndrome in patients with varicose veins and other chronic venous insufficiency.
Whitened, irregular scar-like patches can appear at the ankles. This is known as atrophie blanche.


Causes

Varicose veins are more common in women than in men, and are linked with heredity. Other related factors are pregnancy, obesity, menopause, aging, prolonged standing, leg injury, and abdominal straining. Varicose veins are not caused by crossing the legs or ankles. Less commonly, but not exceptionally, varicose veins can be due to other causes, as postphlebitic obstruction or incontinence, venous and arteriovenous malformations.


Varicose Veins - Home Treatment
Home treatment is recommended for most people with varicose veins that aren't causing more serious problems. Home treatment can relieve symptoms and slow down the progress of varicose veins. For many people with varicose veins, home treatment is the only treatment they need.

If you have varicose veins, you can help control the problem and keep it from getting worse if you:

Wear compression stockings. Compression stockings improve circulation and are the mainstay of treatment for varicose veins.
Elevate your legs. Prop up your legs at or above the level of your heart when possible.
Avoid long periods of sitting and standing. Standing or sitting for long periods puts added stress on the veins in your legs.
Exercise and control your weight. Walk, bicycle, or swim to improve blood circulation in your legs.
Superficial varicose veins can sometimes cause minor problems like bruising or bleeding if you scratch or cut the skin over a larger vein. Small blood clots may occasionally form in the surface veins (superficial phlebitis). Most of these problems can be safely treated at home.

If you bump your leg so hard that you know it is likely to bruise, elevate your leg and apply ice or a cold pack as soon as you can for the next hour or two. This may help reduce the amount of bleeding under the skin and minimize bruising.
If you cut or scratch the skin over a vein, it may bleed a lot. Elevate your leg and apply firm pressure with a clean bandage over the site of the bleeding. Continue to apply pressure for a full 15 minutes. Do not check to see if the bleeding has stopped sooner. If the bleeding hasn't stopped after 15 minutes, apply pressure again for another 15 minutes. You can repeat this up to three times for a total of 45 minutes.
Signs of a small blood clot in a superficial varicose vein (superficial phlebitis) include tenderness and swelling over the vein. The vein may feel firm. If your doctor has told you how to care for superficial phlebitis, follow his or her instructions.

Often doctors will recommend that you elevate your leg and apply heat with a warm, damp cloth or a heating pad set on low (to prevent burns, put a towel or cloth between your leg and the heating pad).
Your doctor may also tell you to take a nonsteroidal anti-inflammatory drug (for example, two aspirin or ibuprofen tablets taken 3 to 4 times a day at first and less often as your symptoms go away).
Talk to your doctor if you are not sure that your symptoms are caused by a superficial blood clot or if you are not sure how to treat your symptoms.