When to Treat Varicose Veins

When to Treat Varicose Veins

The majority of the more than 30 million Americans who suffer from venous disease, including varicose veins, don’t seek treatment for the condition. However, those enlarged veins on your leg may be more than a simple cosmetic issue.

It all comes down to blood flow. One-way valves inside your veins keep blood flowing to your heart. When the valves in your legs become weak or damaged, blood can back up and pool in your legs, causing the veins to swell. This can lead to varicose veins. If left untreated, varicose veins can progress to a more serious condition called chronic venous insufficiency (CVI), with symptoms that worsen over time.

“Typically, we work to slow the progression,” says Jarrod Buresh, DO, of St. Luke’s Pavilion Surgical Associates. “With this condition, progress never gets better, it only gets worse. If we can find ways to control symptoms and swelling, that’s better for the patient.”

According to the National Heart, Lung and Blood Institute, signs and symptoms of varicose veins include:

  • Large, visible vein just under the surface of your skin
  • Mild swelling in your ankles and feet
  • Painful, achy, or "heavy" legs
  • Throbbing or cramping in your legs
  • Itchy legs, especially on the lower leg and ankle (sometimes incorrectly diagnosed as dry skin)
  • Discolored skin in the area around the varicose vein
  • Clusters of red veins under the surface of your skin
  • Red or blue veins that form a web or tree branch pattern (spider veins)

While the condition affects both men and women, women are more likely to develop varicose veins. “For women, it’s often because of pregnancy,” says Dr. Buresh. “Pregnancy increases pelvic congestion, and increased pressures can translate down the leg.” Other risk factors for varicose veins include obesity, family history, older age, inactivity, and jobs that require standing a lot on hard surfaces.


Lifestyle changes such as exercise, weight loss, keeping the legs elevated and avoiding standing or sitting for long periods without a break can help relieve symptoms. Treatment options for varicose veins and CVI include minimally invasive treatments and surgical treatments to either remove the affected veins or close them.

Most insurance companies require a three-month trial of conservative, non-invasive therapy first, which involves wearing prescription-strength compression stockings. “Nobody likes compression stockings, but they are the best non-invasive way to treat varicose veins,” says Dr. Buresh.

If medical treatment is right for you, be realistic about the results. “It’s important to manage expectations. Sometimes after surgery for varicose veins, people can have more varicose veins,” says Dr. Buresh. “The venous system is complex, and there are a lot of veins. If the pressure is not relieved, the body compensates.”

For more information, visit the Rethink Varicose Veins website, where treatment options are described and you can take a self-assessment to see if you should talk to your doctor about seeking treatment.

Categories: Vascular Services

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