Varicose Veins

About Varicose Veins

Varicose veins are enlarged bulging veins that appear just below the surface of the skin. They are larger than spider veins, and the color of the veins is not usually visible. Sometimes the veins are present and do not bulge through the skin. They are most commonly found in the legs and ankles because standing and walking increase pressure in the legs. These veins enlarge as the normal valve system in the veins fails and blood pools in the veins.


There are a variety of symptoms of this condition including tingling, aching, burning, pain, muscle cramps, swelling, throbbing, leg heaviness, itching, restless legs, leg tiredness, and fatigue. Symptoms are usually worse with heat, and with periods of standing or sitting. Symptoms usually worsen during the course of the day. Typically these symptoms get better with rest, leg elevation, and elastic compression stockings.


Varicose veins are caused when the normal valves in the veins fail. This results in pooling of blood, increased pressure, and enlargement of the veins. As the veins get larger, they also get longer and become tortuous, and this gives the veins their bulging and twisted appearance. Research suggests that the most common cause for veins to fail are problems with the vein wall which lead to vein dilation and then valve failure. There is a strong genetic component to vein disease, and many people inherit their vein problems from their parents. Pregnancy, weight gain, and prolonged standing can also contribute to the formation of varicose veins. Other causes of varicose veins include deep blood clots (DVT), superficial blood clots (thrombophlebitis), obstruction of the veins, and vein malformations.


Evaluation and diagnosis of varicose vein disease begins with a consultation including a patient history and physical examination. If signs and symptoms of varicose vein disease are present, an ultrasound examination is performed. This is the standard test to diagnose venous insufficiency. The ultrasound also provides a detailed roadmap for any needed treatments. If other causes of venous insufficiency are suspected, additional tests such as CT or MRI exams may be performed.

Treatment Options

Treatment for varicose veins is customized to each individual.

Varicose vein treatment options include:

  • Radiofrequency Ablation (Thermal Ablation)
  • Varithena (Chemical Ablation)
  • Ambulatory Phlebectomy
  • Sclerotherapy
  • Endovenous Laser Ablation (EVLA)
  • Venaseal