Varicose Veins - Office Visit

These are enlarged, twisted veins that are frequently found just under the surface of the skin. They are usually found in the legs.

These are enlarged, twisted veins that are frequently found just under the surface of the skin. They are usually found in the legs.

Veins are blood vessels that carry blood to the heart. In the legs, veins have one-way valves that stop blood from flowing backward and pooling in the legs. Varicose veins develop when the valves in the veins do not work properly.

  • Varicose veins are enlarged, twisted veins that are frequently found just under the surface of the skin. They are usually found in the legs.
  • Veins just under the surface of the skin are more likely to become varicose veins. This is because they are not surrounded by muscles that help keep the blood moving in the direction of the heart.
  • Varicose veins can also occur in deeper veins when a valve is weak. They can also occur when there has been an injury, blood clot or inflammation in the vein.

Varicose veins are more frequently seen in women, especially women who have been pregnant. They are more commonly seen in people:

  • Between the ages of twenty and seventy
  • With a family or personal history of varicose veins
  • Who are overweight or obese
  • Who sit or stand for a prolonged period
  • Who wear restrictive clothing

Most people who have varicose veins notice enlarged, deformed, bluish veins under the skin. Most people with varicose veins have no symptoms or minor symptoms. However, some people experience:

  • Aching and fatigue of the affected muscles
  • Itchy skin near the veins, especially on the lower leg and ankle
  • Brownish-gray skin or skin ulcers near or on the ankle
  • Swelling and heavy feeling in the affected leg

Contact your healthcare provider if you have varicose veins and they are causing you pain or other symptoms.

  • In most cases, diagnosis is based on your medical history and a physical exam.
  • A Doppler ultrasound may be recommended to check the blood flow in the vein(s).

Conservative therapy is typically recommended first and will relieve symptoms in some people. Conservative therapy includes:

  • Resting and elevating your legs at the end of the day or when aching occurs
  • Wearing compression stockings during the day to keep blood moving
  • An exercise program as recommended by your healthcare provider
  • Losing weight if you are overweight
  • Avoiding standing or sitting for long periods of time
  • Avoiding crossing your legs when sitting
  • Avoiding tight clothing - especially around your waist, upper thighs and legs
  • Avoiding wearing high-heeled shoes for long periods of time

If conservative treatment does not ease your symptoms, there are procedures that may be helpful. However, in some cases, varicose veins may reappear after surgical treatment. Some of the procedures to treat varicose veins include:

  • Procedures that irritate or damage the wall of the varicose vein. This causes the vein to collapse and seal shut. Some examples are sclerotherapy, radiofrequency ablation and laser treatment.
  • Procedures to remove and/or tie off the damaged vein. This is known as vein stripping and ligation.
  • Procedures to remove a varicose vein through an incision. This is known as a phlebectomy.
  • Endoscopic vein surgery, which is only considered in severe cases that have caused leg ulcers. The surgeon repairs a weak valve through small incisions and an endoscope (a thin, flexible tube equipped with a camera lens and light).

In some cases, procedures on varicose and spider veins are done for purely cosmetic reasons and may not be covered by insurance. Please review your coverage documents and/or call the number on the back of your ID card for more information. The estimates shown apply when the service is determined to be a covered service, eligible for in-network reimbursement.

Make an appointment with your healthcare provider if you have symptoms of varicose veins.

  • Bring a copy of your medical history (past illnesses, surgeries, and hospitalizations).
  • Make a list of your medications (including over-the-counter).
  • Write down any questions, symptoms or concerns you want to talk about.

Here are some questions to ask your healthcare provider.

  • What is my causing my symptoms and what treatment are you recommending? Are there any alternatives?
  • When might I start to see improvement in my symptoms?
  • What tests do I need? What is the reason for those tests? Will the test results change my treatment plan?
  • Will my medical and surgical treatment for varicose veins be covered by my insurance?
  • What are my follow-up plans and what symptoms should I report before my next appointment?

Make sure you understand your treatment plan, any possible alternatives, and what medications are recommended (including possible side effects). If surgery is recommended, you should understand why that recommendation was made. Seek a second opinion if necessary.


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Varicose Veins - Office Visit
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