Varicose Veins
Varicose veins: they’re unsightly, sure—but do they constitute a serious condition? Where do they come from? Can you get rid of them?
Dr. Hei Jin Chung, MD, FACS, RVT, is a vascular surgeon and vein specialist in Phillipsburg, New Jersey who answered these questions—and many others—about this common condition.
Lehigh Valley Marketplace: Dr. Chung, we’ve all heard of “varicose veins.” What are they, exactly?
Hei Jin Chung: Our veins have one-way valves for proper blood flow. But when those valves don’t work right, blood can leak back through them. That blood can pool in your legs, putting more pressure on the valves and on the veins. When those veins swell, they create pain or tenderness. Although the veins are very small, they dilate enough that we can see them through the skin.
LVM: What about “spider veins”—are they the same thing?
HJC: Yes, but they are finer veins and don’t protrude. You can still see them through the skin; they resemble spider webs.
LVM: Do varicose veins display any other symptoms besides swelling?
HJC: Some patients experience pain, tenderness, or throbbing; others are pain-free. The symptoms can be worse near the end of the day, especially if you’ve been standing all day.
LVM: Are there any particular causes of varicose veins?
HJC: The tendency to develop them is mostly hereditary. There’s no guarantee of this, but if one or another of your parents have varicose veins, you’ll probably have some degree of it. That is, you can have a very mild case, or one that’s very serious. They’re also often part of the aging process.
LVM: So there’s a range of severity. What can you tell us about that?
HJC: Varicose veins fall into six general categories, or classes. Class 1 indicates spider veins; class 2, varicose veins with no other symptoms. In class 3, patients will exhibit symptoms like pain or swelling.
People in class 4 will experience some skin damage, such as discoloration. The internal pressure can lead to further skin damage, even skin infection. At class 5, patients will have a healed venous ulcer, and class 6 indicates an active ulcer.
LVM: Are there any general groups of people who might be more prone to varicose veins?
HJC: Yes, there are. Caucasians are more likely to develop them, followed by Hispanics and Asians. African-Americans have the lowest incidence.
Women experience them more than men, often because of the hormonal changes associated with pregnancy. Varicose veins often emerge around the age of 40, and are more likely as you grow older. In fact, about two-thirds of the female population will experience some degree of varicose veins.
LVM: Can varicose veins lead to any other health hazards?
HJC: Yes, they can. The biggest problem we see is at class 4 and 5, which involves skin ulcers. These can easily lead to various skin infections.
In addition, clots have a slightly better chance of forming in the smaller veins, and superficial veins can be prone to phlebitis [inflammation], which can be painful.
Because the walls of varicose veins are weak, they sometimes rupture and cause significant bleeding. A little nick in your skin can be enough to cause it, and you might need to visit the ER.
LVM: What can people do to avoid varicose veins, or at least lessen the severity?
HJC: Weight control is a big factor. So is exercise, like walking. Strong calf muscles will help push blood in the right direction.
You can consider wearing some type of compression stockings. If you’re looking for only a little support, you can get some from a medical supply store or online without a prescription. And many of them have fashionable looks, ranging from sporty to dressy.
If you need more compression, you’ll need a prescription to get those stockings. Your primary care physician can evaluate your needs.
LVM: What are the options for treating varicose veins?
HJC: For varicose veins that fall into classes 1 through 3, it can be as simple as wearing some type of compression stockings.
But in classes 4 and 5, I recommend treatment by a physician.
LVM: What sorts of treatments are there?
HJC: There are several. One is phlebectomy, which is the removal of veins that are close to the skin. In sclerotherapy, a salt solution injected into the vein causes it to collapse and eventually turn to scar tissue.
We can also use ablation to close off the veins. The process uses a probe that emits radio waves or a laser inside the vein. In some cases, we can use Trivex [transilluminated powered phlebectomy]; a rotating blade cuts the vein, which is then removed by suction.
Of course, the proper treatment depends
on the size and location of the veins, and a vein specialist is the best person to determine that.
