Varicose Veins

Enlarged, twisted veins that are visible under the skin’s surface are called varicose veins. They most commonly appear in your legs as blue or purple clusters. They’re sometimes surrounded by tiny veins (often red) known as spider veins.

Varicose veins can range from a mild, cosmetic issue to a more serious condition with painful aching. In rare cases, varicose veins can lead to complications such as skin sores (ulcers), bleeding or deep vein thrombosis, blood clots in deep veins.

Leg veins work against gravity to send blood up to your heart, helped by contractions in your leg muscles. Valves inside the veins open to send blood toward the heart and close to prevent it from flowing backward.

Varicose veins develop when weak or damaged valves allow blood to back up in the veins, causing them to stretch, twist and swell. Several factors can increase your risk of varicose veins, including:

• Congenital (present since birth) valve defects in veins
• Family history of varicose veins
• Lack of movement, such as standing in one spot or sitting for long periods of time
• Obesity or excess weight
• Older age
• Pregnancy
• Trauma to vein valves, such as previous blood clots in your legs

The most common signs and symptoms of varicose veins are:

• Visible, swollen veins that resemble twisted cords
• Veins that are blue or dark purple

If the condition worsens, you may experience:

• Cramps or throbbing in your legs, often at night
• Fullness, heaviness or aching pain in your legs
• Itching or burning, especially in the lower leg and ankle
• Mild swelling of your ankles and feet
• Pain that worsens after long periods of sitting or standing
• Skin discoloration around the varicose veins
• Spider veins, clusters of small veins just under the skin’s surface on your legs or face

Varicose vein complications

In some people, varicose veins can lead to more serious symptoms, such as:

• Blood clots
• Dry, irritated skin that cracks easily (dermatitis)
• Ulcers that do not heal easily

Our vascular medicine specialists usually diagnose varicose veins during a physical exam, looking for signs such as swelling or discoloration. We also ask you about your symptoms and your personal and family health history.

Sometimes, we use additional testing to understand the size of the area affected or check for issues such as:

• Blood clots
• Leg vein valves that don’t work properly, allowing blood to leak downward

Imaging for varicose veins

We may need to take scans to help us make a diagnosis. If so, you work with certified imaging technologists in our nationally accredited vascular testing labs.

Our technologists have advanced training and experience in the latest equipment, offering:

• Doppler waveform analysis: We use specialized ultrasound (sound waves) to measure your ankle-brachial index, a ratio of the blood pressure in your ankle to that in your arm. This analysis can confirm a diagnosis of blocked blood vessels and determine the severity.
• Duplex ultrasound: Combining traditional and Doppler ultrasound, this imaging study checks for vein valve problems that lead to pooled blood or clots in legs. We also use duplex ultrasound in the abdomen to check the pelvic veins and inferior vena cava (IVC) for blockages or clots. The IVC is the large vein that runs from the lower body to the heart.
• Intravascular ultrasound: Using a minimally invasive procedure, we insert a catheter (thin tube) through a small skin puncture into the affected vein. The catheter is tipped with a miniature ultrasound probe to provide images of blockages anywhere along the vein.
• Venography: We take X-rays after injecting a dye that outlines veins so they show up better on the scans. Although we rarely use this scan, it can provide another look at blood flow when needed.

The vascular disease experts at Henry Ford offer the full range of treatments for varicose veins. Whether your case is mild or severe, our vascular surgeons and vascular medicine specialists tailor a treatment plan just for you. Find out more about the Henry Ford Vein Center.

Lifestyle changes and self-care for varicose veins

Most people who have mild symptoms see our vascular specialists for ongoing management. Lifestyle changes and self-care can relieve symptoms, keep varicose veins from getting worse and help prevent possible complications.

Recommendations for healthy lifestyle habits

Small changes can slow the progress of varicose veins and improve your symptoms. Our vascular specialists have years of experience helping people develop realistic goals to:

• Eat a nutritious, low-sodium diet to help lose weight and prevent swelling from water retention
• Stay physically active to help lose weight and maintain good blood circulation in the legs
• Maintain a healthy weight

Self-care for varicose veins

You can take steps on your own to improve the way you feel. Self-care for varicose veins includes:

• Wearing compression stockings to relieve swelling and help move blood up to the heart
• Changing your position about every hour to avoid sitting or standing in one position for too long
• Raising your legs above your heart three to four times per day for 15 minutes each time
• Avoiding tight clothes, especially on the waist and lower body
• Wearing low-heeled shoes to help tone your calf muscles to improve blood flow to the heart
• Taking proper care of any wounds, with instructions from your care team
• Moisturizing dry, cracked skin on your legs, using lotions recommended by your care team

Noninvasive and minimally invasive varicose vein treatments

For more severe varicose veins that cause pain or other symptoms, our vascular doctors offer the latest noninvasive and minimally invasive treatments. Your care team has extensive expertise with these outpatient procedures, developed from helping thousands of people. We use safe, effective treatments with little or no downtime.

Minimally invasive and noninvasive procedures close off varicose veins, which then fade. These therapies don’t disrupt blood circulation because blood goes to other, healthy veins.

Noninvasive treatments

Our noninvasive treatment options include:

• Sclerotherapy: Your vascular specialist injects liquid or foam chemicals into the affected veins, causing them to collapse and gradually fade. We typically use liquid for small to medium varicose veins and foam for larger veins. About 90 percent of veins receiving sclerotherapy go away in just two to three treatments.
• Surface laser therapy: Your specialist applies a handheld laser to the affected surface of your skin. Bursts of light break down the wall of the varicose vein, which gradually fades. We typically use this procedure to treat small varicose veins.
• Vein sealing: Using the VenaSeal™ system, we inject special medical glue to close the problematic vein. Blood continues to flow through other nearby veins, relieving symptoms.

Minimally invasive treatments

Many of our minimally invasive treatments take an endovascular approach, with work done inside the vein. Minimally invasive options include:

• Endovenous ablation: This endovascular procedure for larger varicose veins uses a tiny incision. Your vascular surgeon inserts a catheter (thin, flexible tube) into the vein and heats it using energy from light (laser) or radio waves (radiofrequency). As the surgeon slowly pulls the catheter out, the heat seals the vein shut.
• Microphlebectomy: Also known as ambulatory phlebectomy, this procedure removes small varicose veins through several tiny incisions.
• Incompetent perforator vein treatment: This endovascular procedure treats veins whose valves no longer work properly. Your doctor uses ultrasound-guided sclerotherapy and ablation, with the heat coming from laser or radiofrequency energy.
• Endovenous stenting: This minimally invasive procedure relieves ulcers on legs or ankles caused by nearby vein blockages. Your vascular surgeon uses special X-rays (fluoroscopy) and intravascular ultrasound to guide the work. The surgeon places a stent (tiny metal mesh tube) in the blocked or narrowed area as a scaffold to keep the vein open.

Varicose veins typically respond well to treatment, but they can recur (come back). You can see our vascular specialists for long-term management after undergoing a procedure.