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Varicose Veins: Are They More Than Just Cosmetic?

Your veins are your body’s highways, and your blood is constantly flowing against gravity to get to the heart. At the heart, your blood picks up more oxygen to bring it to your organs, like filling your car up with gas to keep it moving.

But sometimes the heart valves — the highway’s on- and off-ramps that keep traffic flowing properly in your veins — don’t function the way they need to. This causes blood to pool, which can eventually lead to traffic jams. This is called varicose veins.

You have two types of veins in your legs: superficial and deep. Your valves are supposed to help the transfer blood from the superficial veins back to the deep veins, and then back to the heart.

But when the valves don’t work as they should, the blood can actually be forced back into the superficial veins instead of the deep veins, causing it to pool and create a varicose vein.

  1. 25 to 35% of people have varicose veins
  2. 1 in 8 teenagers have early signs of varicose veins
  3. Men and women are equally affected
  4. 98% reported success rates for treated patients after 1 year
  5. Overweight can increase the risk of developing varicose veins.

Varicose Veins vs Spider Veins

Varicose veins are more severe versions of spider veins (also called telangiectasia). True to their name, spider veins look like spider webs. They usually are not painful and don’t require medical treatment. Varicose veins, however, look like large, twisting, rope-like veins in the legs.

Varicose veins are lumpy and can sometimes appear to be swollen or bulging. They may have a purple or blue tinge to them. Normally, they are found on the backs of the calves and on the inner leg.

Sometimes, varicose veins do not cause any noticeable symptoms. Other times, you may have:

  • Pain and discomfort
  • Swelling
  • Itching
  • Burning
  • Skin discoloration
  • Legs that feel heavy, stiff, or tired

You may also feel self-conscious about your varicose veins, possibly avoiding wearing certain clothes and feeling uncomfortable about others seeing your veins.

Varicose Veins the Risk of Blood Clots

It’s rare, but blood that pools from a varicose vein can create a blood clot (called phlebitis). When phlebitis occurs in the surface veins, it is not a cause for concern. This type of blood clot usually gets better without medical treatment in about 2 to 3 months.

However, when phlebitis occurs in a deep vein — referred to as deep vein thrombosis (DVT) — it can become dangerous, especially if the clot travels to the heart or the lungs, causing difficulty breathing or heart failure.

When To See Your Physician

If you notice any of the following symptoms, seek medical help:

  • Skin ulcers or open sores near the ankle that are not from an injury and do not seem to be healing on their own
  • Major swelling in the leg
  • Reddened veins that feel painful, warm, or hard
  • Bleeding from or near the varicose veins

Varicose veins can be treated to resolve cosmetic or urgent medical issues. In either case, many treatment options are available.

Treating Varicose Veins

Compression Socks – to relieve aching and swelling

Compression socks — which provide a tight fit and typically go up to your knees — are used to relieve aching or swelling. They compress the veins so that blood can’t travel downward and pool in your legs. Wearing compression socks may be used as the first step in varicose vein treatment or as follow-up after a different procedure, like ablation therapy, sclerotherapy, or thrombolytic therapy. Some socks can be purchased over-the-counter, but some may require a prescription.

You should talk to your physician to see if wearing compression socks is a treatment option for you, especially if you have another health issue affecting blood flow, such as diabetes.

Ablation Therapy – closes off the affected vein using a laser

If you and your physician determine compression socks aren’t working for you, you may be a candidate for ablation. Ablation therapy uses a laser or radiofrequency to close off the affected vein.

The procedure is done in your physician’s office and usually takes about 20 minutes to complete. Though you are awake for it, ablation therapy is generally painless.

Because your veins must be straight enough for this to be an option, your physician may first perform an ultrasound to see your veins more clearly.

During the procedure:

  1. Your physician will numb the injection site and all of the surrounding skin up to the affected area.
  2. Your physician will insert a catheter — or thin tube — into your vein and guide it up to the varicose vein.
  3. An ablation catheter, which emits laser energy or radiofrequency energy, will be threaded through the catheter to reach the affected vein.
  4. The ablation catheter will be used to cauterize (burn using a heated instrument) and close the vein.
  5. Within about a week, your physician will perform a follow-up ultrasound to confirm that the vein has successfully closed.

Preparing for — and recovering from — ablation therapy:

  • You may need to stop taking certain medications — like aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), and blood thinners — prior to the procedure.
  • You should wear loose, comfortable clothing on the day of the procedure.
  • You should plan to have someone available to drive you home afterward.
  • Most patients are able to resume normal activities the same day.

Sclerotherapy – causes the body to break down the pooled blood in the vein

If your veins are not straight enough for ablation therapy, your physician may recommend sclerotherapy. Sclerotherapy uses a chemical called sclerosant to make the vein spasm and clot.

This type of clot is not dangerous, and your body actually breaks it down itself, causing the varicose vein to disappear. Sclerotherapy is successful in treating varicose veins about 50% to 80% of the time.

During the procedure:

  1. Using an ultrasound, your physician will use a very fine, thin needle to access the affected vein.
  2. Your physician will inject sclerosant into the vein, causing it to clot. You may feel small needle sticks or a slight burning sensation while the chemical does its job.
  3. The number of veins your physician will treat in one session will depend on the size and location of the veins.
  4. Using an ultrasound, your physician will be able to tell if it was a success immediately, but you may be asked to come in for a follow-up visit to confirm.

Preparing for — and recovering from — sclerotherapy:

  • You may need to stop taking certain medications — like aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), blood thinners, and iron — prior to the procedure.
  • You should wear comfortable clothing on the day of the procedure.
  • You should not use lotion anywhere on your legs the day before or after the procedure.
  • Larger injected veins may feel lumpy or hard for a few months as the clot breaks down.
  • Brown lines and spots may appear on the skin at the injection sites. These may disappear within 3 to 6 months, but in about 5% of cases, they can be permanent.

Phlebectomy – removes varicose veins with small incisions

Phlebectomy is used primarily for veins that are just below the surface of the skin. It’s a minimally-invasive procedure that uses a small needle or scalpel to create several very small incisions to remove varicose veins. More than 90% of people experience long-term success with a phlebectomy.

During the procedure:

  1. Your physician will administer local anesthesia just on and surrounding the affected vein. Because the area will be numbed, you typically will remain awake for the procedure.
  2. After cleaning the surrounding area, your physician will create a series of small incisions — no larger than a pencil eraser — right next to the varicose vein.
  3. Using a small tool with a hook on the end, your physician will remove the vein through the small incisions.
  4. The incisions are small enough that you will not need stitches, and the incisions will be covered with small bandages.
  5. This usually takes 30 minutes to an hour. It is typically done on an outpatient basis, meaning you are allowed to return home the same day.

Preparing for — and recovering from — ablation therapy:

  • You should wear loose-fitting clothing on the day of the procedure.
  • It is unlikely you will experience any pain during the procedure, as the area has been numbed.
  • Afterward, your leg will be wrapped in a compression wrap that is comfortable but snug.
  • For about 2 to 3 weeks after the procedure, you will need to wear graduated compression stockings — elastic garments that will go around your leg.
  • You should be able to resume daily activities after 24 hours, though you should avoid strenuous activity for about 2 weeks.

Vein Stripping – removes the entire affecting vein by tying, dividing, and often removing it.

Because of the advancements in other procedures, vein stripping has become a less common way of treating varicose veins. The aim of this procedure is to remove the entire affected vein by tying, dividing, and often removing it. This doesn’t affect the blood flow because when one is removed, the others will take over its job. Vein stripping is usually done for larger varicose veins.

During the procedure:

  1. You will be given a general anesthetic, meaning you will not be awake during this procedure. Local anesthetic will also be put around the incision areas to avoid pain when you awaken.
  2. Your physician will make an incision about 4 to 6 centimeters long at the top end of the vein.
  3. A wire will be inserted into the vein at the top end and passed through to knee- level.
  4. Your physician will make another incision of the same size at knee-level, and the vein will be pulled out using the wire.

Preparing for — and recovering from — vein stripping:

  • In most cases, you will be able to return home the same day, though you should have someone available to drive you home.
  • Pain is not usually strong on the day of the procedure, but it typically increases steadily over the next week and is at its strongest about 8 to 10 days after. Any discomfort usually subsides about 2 weeks after.
  • You will be able to drive and bathe within 48 hours of the procedure.
  • Light, regular exercise (walking, using an exercise bike) is recommended following the procedure to avoid developing blood clots. There are usually no limitations for heavy lifting.

Deep Vein Thrombosis: Treating Varicose Veins When It’s Serious

Varicose veins can become very serious if they lead to a blood clot. If a solid clot forms in a deep vein — as in deep vein thrombosis (DVT) — it requires immediate medical attention. This is because if a piece of the clot breaks off and travels to the heart or lungs, it can cause difficulty breathing or even death. DVT is usually treated with medication.

Blood Thinners

The most common way of treating DVT is by taking blood thinners, also known as anticoagulants. These medications — which require a prescription — prevent blood clots from growing by decreasing your body’s ability to clot.

Over time, your body and the blood thinners will work together to break down any existing clots by decreasing their size and consistency.

Blood thinners may be taken in the form of a pill, as an injection, or intravenously (using an IV). Because blood thinners thin all of your body’s blood, your chance of bleeding elsewhere may increase while taking these medications. It is important to use caution to avoid injuries while taking blood thinners.

Thrombolytic Therapy

While blood thinners thin the blood throughout the body, thrombolytic therapy is site-specific. Your physician will use X-ray imaging and a catheter to guide medicine to the location of the clot. This is often done if blood thinners are not successful in dissolving the clot.

During the procedure:

  1. You will be given medicine to relax you, and your physician will numb the area that will be treated.
  2. Your physician will make a small puncture in your skin and insert a catheter (small, thin tube).
  3. Medicine will be infused through the catheter to the clot.
  4. Your physician may also use a small machine inserted through the tube to break up the clot.
  5. The catheter will be removed, and pressure will be applied to stop bleeding. No sutures will be needed.
  6. Using an ultrasound, your physician will be able to tell you if the procedure was a success immediately, though you may require additional treatment at a follow-up visit for any tissue that was damaged from the clot.

Preparing for — and recovering from — thrombolytic therapy:

  • You may need to stop taking certain medications — like aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), blood thinners— prior to the procedure.
  • You may be given medicine immediately after to ensure the clot dissolves.
  • You may be hospitalized for several days afterward so that your physician can monitor the location of the removed blood clot.
  • You will likely be asked to take blood thinners for 3 to 6 months following the procedure.

Why Choose Stormont

Located in Topeka, Kansas, Stormont Vail Health is a community-driven organization. It offers close to home care and with limited travel requirements, it will be easier for you to get the care you need close to home.

In 2009, Stormont Vail achieved Magnet designation, one of the highest awards given to organizations with excellent nursing teams and high-quality patient care. Only 9% of US hospitals have earned this recognition.

The Joint Commission — with more than 50 years of accrediting hospitals in high quality standards — has accredited Stormont Vail Hospital. Stormont also achieved additional accreditations in many areas related to cardiovascular health, including Advanced Primary Stroke Center and Chest Pain.

With over 200 employed physicians and 33 working specifically in Cardiology, Stormont Vail has an experienced and skilled physician to help you treat varicose veins.

Next Steps

Make an Appointment

To make an appointment at the Cotton O’Neil Heart Center, call (785) 270-4000.

See a Primary Care Provider

  • Call (785) 270-4440 to schedule an appointment with your Stormont Vail primary care provider.
  • Not a Stormont Vail patient? Call (785) 270-4440 to set up your first appointment with one of our primary care providers.