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Varicose veins

Diagnosis of varicose veins

When you see your doctor about varicose veins, they are generally easy to diagnose because they are so visible. Your doctor will also want to talk with you about your medical and family history, your symptoms, and your lifestyle. You will be able to discuss any pain or aches you have.

Your doctor will do a physical exam, which will include an examination of your legs. They will view your legs while you are standing to look for signs of swelling. In addition, your doctor may order an ultrasound of your legs to get an image of how the valves are functioning and to ensure there are no blood clots present.

Treatment

If your varicose veins are not causing uncomfortable symptoms and their appearance does not bother you, it is not necessary to treat them. However, you might consider medical treatment to relieve discomfort, prevent complications, and improve appearance.

Varicose vein treatment will depend on a variety of factors, including your age and health status, the severity of the veins, your symptoms, and personal preference. In addition to the preventive measures listed above, treatment options include:

  • Sclerotherapy – A procedure in which your doctor injects a foam or solution into affected small- or medium-sized veins to close off the vein. There is also a foam treatment for large varicose veins.
  • Laser surgery – An in-office procedure that uses light to improve the appearance of smaller varicose veins.
  • Ablation therapy – An in-office procedure using local anesthesia so a thin tube can be inserted into the leg. Once inserted, lasers or radio waves produce heat that is used to close off the vein as the tube is being removed.
  • Ambulatory phlebectomy – A number of skin punctures are made, through which smaller veins are removed.
  • Endoscopic vein surgery – A type of varicose vein surgery that involves the insertion of a video camera into the leg to view and close off varicose veins. Typically used when ulcers are present.
  • Vein stripping – The surgical removal of large varicose veins while you are under general anesthesia. The vein is tied off and then removed via small incisions.

Preparation

There is nothing special you need to do before an appointment with your doctor, other than being prepared to discuss your symptoms, medical history, and lifestyle, and asking any questions you have.

When it comes to preparing for varicose veins treatment, your care team will meet with you beforehand to answer any questions and tell you what to expect. Prior to the procedure, you will need to:

  • Drink lots of water
  • Take a sedative, if it has been prescribed
  • Ensure you have someone to drive you home after the procedure
  • Bring a pair of compression stockings
  • Wear loose-fitting pants, a skirt, or shorts
  • Bring a change of underwear, as they may get stained during the procedure

In addition, do not shave or wear any makeup or scented products on the area to be treated prior to the procedure.

Recovery

After the procedure, you may experience bruising, swelling, pain, and/or discoloration of the area. Your recovery time will depend on the procedure. Noninvasive procedures take about two weeks, and invasive surgery, such as vein stripping, takes as long as four weeks. With vein stripping, the amount of recovery time will ultimately depend on how many veins you have removed.

With noninvasive procedures, you can get back to your regular activities right away. However, it is recommended that you wait a week to 10 days before resuming heavy physical activity, such as running, cycling, or strength training. With vein stripping, you will have an incision and will need to take it easy for the first week to 10 days, after which you can slowly begin to resume normal activities.

Overall, you will find that the symptoms of your varicose veins and the aesthetic appearance of them will improve or disappear after the procedure. Then it is up to you to continue to take preventive measures to ensure new varicose veins do not form.

Complications

While most cases of varicose veins remain benign and harmless, there are potential complications that can develop. These include:

  • Blood clots – The veins deep within the leg can become enlarged, and blood clots can form, causing pain and swelling in the leg.
  • Bleeding – An enlarged vein can burst, causing minor bleeding.
  • Ulcers – These can form on the skin near varicose veins, particularly around the ankles, and can be painful.

Each of these complications requires medical attention. This is particularly the case with blood clots because the clot can travel to your lungs, heart, or brain, causing a life-threatening health issue.

The information contained in this article is meant for educational purposes only and should not replace advice from your healthcare provider.