Varicose veins are enlarged, tortuous veins just beneath the surface of the skin. Varicose veins most commonly occur in the legs but can also occur in the anus (haemorrhoids), oesophagus (oesophageal varices), and scrotum (varicocele).
A defect of the valves in the leg’s perforating veins (which lie between the superficial veins (those near the skin’s surface) and the deep-lying veins) causes blood to pool in the superficial veins. The buildup of pressure in these veins causes them to become varicose. Factors that contribute to varicose veins include obesity, hormonal changes and pressure on the pelvic veins during pregnancy, hormonal changes occurring at the menopause, and standing for long periods of time. Varicose veins are common, tend to run in families, and affect more women than men.
Varicose veins may not cause any problems, but they may ache severely and the feet and ankles may be swollen; persistent itching can also occur. These symptoms may worsen during the day and may be relieved by sitting with the legs raised. In women, symptoms are often worse just before menstruation. In severe cases, leg ulcers may develop. Thrombophlebitis (inflammation and clotting of blood in the veins) may be associated with varicose veins.
Usually, support stockings, regular walking, and sitting with the feet up as much as possible are the only measures required. In more severe cases, sclerotherapy may be carried out. Varicose veins may require surgical removal (by an operation known as stripping) if they become painful or ulcerated, however, they may later develop elsewhere.