Varicose Veins

Varicose veins are enlarged veins that are swollen and raised above the surface of the skin. They can be dark purple or blue, and look twisted and bulging. They develop when valves in the veins that allow blood to flow toward the heart stop working properly. As a result, blood pools in the veins and causes them to get larger. Varicose veins affect 1 out of 2 people over age 50.

Although most common in the legs, there are a number of places on the body varicose veins can appear. The Vein Center of San Diego can treat all areas of the body for varicose veins.

Legs
Leg veins present in multiple sizes shapes, and depths. The main approach to treating leg veins is to treat the veins starting from groin and progressing to the toes and treating from the largest to the smallest veins. It is important to treat the highest, largest area of backflow before treating the lower dilated (diseased) veins, otherwise the lower veins will continue to come back despite proper treatment. Large varicose veins, and the diseased main trunks that cause them, are treated with Radiofrequency or Laser . Sclerotherapy is the primary treatment for spider, small, and medium size leg veins. Learn more about Treating Leg Veins >>.



Foot
Varicose veins on the top of the foot can lead to pain, swelling, non-healing ankle ulcers, and an ugly appearance. Although Sclerotherapy is an effective treatment of foot varicose veins, a duplex ultrasound needs to be performed to make sure arteries are avoided. Ambulatory Phlebectomy (surgical removal) is sometimes a better option for treating these varicose veins.

Hand
Bulging hand veins are rarely the result of damaged valves and venous backflow. Abnormally large hand veins may be the result of an obstruction to venous flow in the upper arm; however, they are merely the result of loss of fat around the veins due to the aging process. These veins can be treated by Sclerotherapy or by transferring fat from one area of the body to the hands. Ablation of the hand veins by any technique will often cause several weeks of hand swelling while alternate pathways for venous return are developing.

Breast
Prominent veins on the chest and breast result from multiple causes. They may be spider veins from genetics, from trauma, as a result of pressure from breast implants, the result of venous obstruction in the armpit or neck, and they more visible from thinning of the skin that occurs during the aging process. These veins can be treated with Sclerotherapy and Laser . Good compression is difficult after treatment; however, a tight-fitting brassiere and sleeping in the supine for 48 hours to reduces inflammation and helps to insure a favorable result. Bruising is common after the treatments.

Abdomen
Abdominal varicose veins (caput Medusae) are almost always the result of serious disease in the deep veins of the body. Liver disease (cirrhosis) is the most common cause of abdominal varicose veins. By the time abdominal varices are present, individuals usually have esophageal varicose veins as well. These varicose veins are usually asymptomaic until they rupture and bleed. It is rarely appropriate to treat abdominal varicose veins with sclerotherapy. The esophageal varicose veins need to be treated and Sclerotherapy may be used to treat them.

Scrotum
The scrotal veins form a complex of vessels known as the pampiniform plexus. Varicose veins of the scrotum are often referred to as “a bag of worms”. These varicose veins usually causes no symptoms; however, they can cause infertility as a result of increased temperature that reduces sperm count and activity of the sperm. The traditional treatment requires open surgery under local or general anesthesia. Laparoscopic surgery is an alternate approach. Scrotal Sclerotherapy is gaining favor but is not yet considered the standard of care.

Small, round, and red spots called angiokeratomas are often seen on the scrotum. Laser or intense pulse light are the best treatments for these vascular lesions.

Vulva
Vulvar varicose veins arise from damaged valves and backflow in the superficial or deep veins of the upper thigh or pelvis. They often appear after pregnancy or clots in the thigh deep veins (deep vein thrombosis-DVT). They tend to be more painful immediately before and during menses. Early treatment with Sclerotherapy of the end-branch vessels is preferred because over time these vessels become progressively more painful, disfiguring, and prone to bleeding. Compression is accomplished with padding, tight underwear, and close fitting girdle or Lycra bicycle shorts. A device known as the “Prenatal Cradle V2 Supporter” is made expressively for vulvar varicose veins during pregnancy and after sclertherapy treatment.

Hemorrhoidal
Hemorrhoids are essentially perirectal varicose veins. Individuals with liver disease causing obstruction to venous flow develop abdominal, esophageal, and perirectal varicose veins. The cause of hemorrhoids needs to be established prior to treating them because they may play a role in routing blood back to the heart. Treatment can be done by surgical removal, sclerotherapy, infrared or laser ablation, and rubber band ligation. Compression of internal hemorrhoidal varicose veins is neither possible or necessary. Compression of external hemorrhoidal varicose veins will reduce postsclerotherapy inflammation and pain.