Varicose Veins: A Painful Condition That’s Not Just Cosmetic

Free Community Screening on July 20^th

Nature has a sense of humor; while our hair becomes white, our legs become more colorful. It often begins with clusters of bright blue or red spider veins. But no one is laughing when purple, rope-like veins twist down our legs.

Varicose veins are tortuous, swollen veins that appear just below the surface of the skin, usually on the legs. Since most people keep them concealed, the general population is unaware just how common they really are. Varicose veins occur in 1 in 2 people over the age of 50 — affecting more than 30 million Americans.

The Vein Center, a South Central Clinic, is offering a free vein screening for the community on Thursday, July 20^th from 2 p.m. – 5 p.m. The screening will be held at 1410 Jefferson Street in Laurel, located behind South Central Urgent Care.

Here are some surprising stats about varicose veins:

• 30 million: The number of Americans with varicose veins.
• 90 percent: Your risk of developing varicose veins if both parents had them.
• 62 percent: Your risk if one parent had them.
• 20 percent: Your risk if neither parent had varicose veins.
• 25 percent of all women have varicose veins.
• 15 percent of all men have varicose veins.

While varicose veins are often misunderstood as simply a cosmetic problem, realistically many create symptoms of pain such throbbing, aching, fatigue and burning.

“A lot of people believe that varicose veins are not dangerous, which is not always true,” said Hossein Nasajpour, MD. “If left untreated for years, venous disease can progress and cause ankle swelling, skin discoloration, ulcerations, bleeding and blood clots.”

Blood Flow and Faulty Valves

The first step in evaluation is a duplex ultrasound, a study that assessed blood flow through the patient’s veins.

The underlying cause of varicose veins is often faulty valves in the superficial leg veins, particularly the greater saphenous vein in the thigh. Veins drain blood from the leg against gravity by using a system of one-way valves. When defective valves do not close properly pressure builds up in the venous system. Vein walls are thin, and in response to this pressure, they enlarge and twist, becoming varicose.

Definitive treatment of varicose veins aims at removing or destroying the long defective segments of the saphenous vein using surgery or new endovenous techniques. Traditionally, the vein was removed surgically by a method called “stripping.” This procedure, which had a long list of complications, required general anesthesia, a hospital stay and six weeks of recovery time.

Less Invasive Treatments, Faster Recovery

Over the past decade, stripping has been replaced by new less invasive, safer techniques. Endovenous, meaning in the vein, is a newer technology that has revolutionized varicose vein treatment. Instead of removing the vein, surgeons seal it shut from the inside. A thin catheter, about the size of a strand of spaghetti, is inserted into a vein near the knee and threaded up the thigh into the greater saphenous vein. Heat, in the form of radiofrequency energy or laser, is released from the tip of the catheter, sealing the vein.

The endovenous closure techniques, which have a success rate greater than 90 percent after two years, are done in an outpatient setting under local anesthetic. Usually Motrin and Tylenol are sufficient for pain control.

Post-operatively, patients are encouraged to walk frequently, and asked to wear compression stockings for seven days.

The Facts about Varicose Vein Treatment

• It’s not about being vain. “90% of patients present to me for symptoms, 10% for cosmetic,” said Dr. Nasajpour. The most common symptoms are heaviness, pain, aching, fatigue and burning.
• Men are affected too. About 25% of people with varicose vein are men. They often delay seeking treatment until their symptoms are severe.
• Duplex ultrasound is the first step. This non-invasive, painless test assesses blood flow in the leg veins. Most people with varicose veins have normal deep veins and valve reflux in the large superficial veins.
• Don’t sweat the procedure. With newer technologies, most vein surgeries are done under local anesthetic with a mild sedative in an outpatient setting.
• One size doesn’t fit all. Many times, a combination of treatments will be used, such as endovenous closure followed by sclerotherapy injections or external laser treatment of the smaller spider veins.
• Insurance often contributes. Insurance carriers have their own guidelines for varicose vein treatment coverage. Most require the presence of symptoms, such as pain and aching, and a duplex ultrasound. Some require a trial of compression stockings for two to three months.
• Research your provider: It is always encouraged to research the doctor and facility prior to your procedure. Call the facility and ask questions.

Lifestyle Remedies for Varicose Veins

You may not be able to prevent varicose veins, but you can slow their progression with the following:

• Exercise: Be active. Brisk walking, swimming, cycling and other exercises keep leg muscles strong and improve circulation.
• Avoid prolonged standing and sitting. Change your position every 30 minutes to encourage blood flow.
• Control your weight. Extra pounds put pressure on veins and can speed the development of varicose veins.
• Elevate your legs while sitting or sleeping. Take regular 10 minute breaks to elevate your legs above the level of your heart.
• Wear compression stockings. If you have symptoms, your doctor may prescribe graduated compression stockings, which prevent blood from pooling in the veins and decrease swelling.
• Avoid tight-fitting clothes. Clothes that constrict your waist, legs, or groin increase pressure in leg veins and can worsen varicose veins.

Are You at Risk for Varicose Veins?

These factors increase your risk of developing varicose veins:

• Family history
• Female gender
• Increasing age
• Multiple pregnancies
• Prolonged standing and/or sitting

Dr. Hossein Nasajpour is Board Certified in Cosmetic and Plastic Surgery. His office is located at the Cosmetic and Plastic Surgery Center in Laurel at 1410 Jefferson Street. To schedule an appointment for a Free Vein Screening on Thursday, July 20^th, please call 601-425-7522.