James M. Salander, MD, FACS
Vascular Surgery and Varicose Vein Treatment

5513 Connecticut Ave. Suite 210
Washington, DC 20015
Phone: 202-966-1228
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Varicose Veins

Arteries bring blood into the leg, and veins take it back to the heart. Vein problems usually affect the legs and can result in many problems. Varicose veins are the most common problem, affecting 40% to 60% of men and 60% to 80% of women. These can be the result of heredity, pregnancy, obesity, or blood clots (phlebitis). Occupation can be a contributing factor to symptoms. At times, hot weather, exercise, pregnancy, and menstrual cycle can create or increase symptoms.

There are two systems in the leg: deep and superficial. Varicose veins only occur in the superficial system. Clots, called phlebitis, can develop in either system. Deep clots are referred to as deep vein thrombosis (DVT) and can be dangerous. The superficial system clots are referred to as superficial thrombophlebitis (SVT) and are usually not dangerous but can be painful. Either type of clot can cause symptoms immediately or later on as the body begins to heal the problem. Each type of clot results in scar tissue in and around the vein that can damage or block the vein and create problems. The skin can become discolored, and the tissue under the skin can deteriorate.

Veins get bigger or smaller depending on activity: walking, sitting, standing, pregnancy, and so forth. The muscle in the wall of the vein stretches to accommodate this change in flow. In some people for many different reasons, these muscle fibers break, and the veins get stretched out and baggy. Small valves in the vein help keep the blood moving back out of the legs towards the heart. When the muscle fibers break, the valves lose their support and leak. Then the blood returns inefficiently. Problems from varicose veins and old blood clots are referred to as chronic venous insufficiency. You cannot prevent varicose veins, but you can reduce the symptoms and avoid the problems associated with them.

Spider veins (telangiectasias) are blue, red, or black veins seen just under the skin. They may cause local pain and occasionally can bleed. More often, they are without symptoms and are simply unsightly.

How can you prevent problems from varicose veins and old blood clots?

  • Walk regularly for exercise
  • Elevate legs when sitting
  • Use skin lotion to prevent dryness
  • Adopt a low-sodium diet
  • Increase your water intake
  • Do not scratch
  • Avoid antibacterial soaps
  • Lose weight
  • Wear support stockings
  • Do not brush or rub vigorously in the bath or shower
  • Contact your doctor at the first sign of problems - do not delay!

What are the symptoms of varicose veins and other vein disorders?

  • Bulging or ropey veins
  • Spider veins
  • Aching
  • Pain
  • Swelling - edema
  • Itching
  • Redness
  • Dry, cracked skin
  • Discoloration of the skin - red, brown, or black
  • Open Wounds
  • Blood clots - phlebitis
  • Superficial vein thrombophlebitis (SVT)
  • Deep vein thrombophlebitis (DVT)
  • Thickened, lumpy skin
  • Scarred skin
  • Bleeding (uncommon)

What tests may be ordered?

In order to determine the cause of your condition and help direct the best treatment, an ultrasound or venogram may be ordered.

What treatments are available?

  • Patient education
  • Lifestyle changes
  • Dietary changes
  • Exercise
  • Compression stockings
  • Weight loss
  • Sclerotherapy to dry up poorly functioning small veins
  • Endovenous laser treatment (EVLT). Click here for more information on this technique
  • Surgery