Varicose veins are abnormal, enlarged, and twisted blood vessels on the legs and feet. If left untreated, they may cause discomfort, pain, ulcers, and clots.
Varicose veins (or varicosis) occur when blood vessels just beneath the skin become large, twisted, bulging, increasingly visible, and dark purple or bluish. The condition typically affects the legs and feet. It occurs in 20% of the adult population and becomes more common with age. After 50, one out of two people has varicose veins. Women, overweight people, and those who must stand still or sit at a desk for long periods are more likely to develop varicosis.
Spider veins are a milder form of varicose veins. These are capillary varices, usually red and less than 1 mm in diameter. They may resemble a spider web on the skin’s surface.
A varicose vein develops when the small valve inside stops working properly. The blood is not pumped to the heart effectively; it accumulates inside the vein and deforms the valve further. The increased pressure makes the vessel’s wall weaker, and the vein expands and becomes visible: varicosis occurs.
Estrogen can relax the vein walls and trigger the formation of varicose veins, which is why varicosis is more common in women. Pregnancy and the use of birth control pills may also contribute to the formation of enlarged vessels. The risk is higher for those who have a family member with varicosis than for those with no family history. Risk factors include a sedentary lifestyle, overweight, hot climates, exposure to heat, constipation, and wearing accessories such as knee pads, knee bands, or high-heel shoes.
Swollen veins have a distinctive look, and, therefore, the most common complaint is the deterioration of the appearance of the legs. In addition to the visible symptoms, common symptoms of varicose veins are:
Varicose vein symptoms may vary from one person to another. They are usually more intense during hot weather or longer periods of inactivity.
Doctors use the universal CEAP scale to evaluate the problem and determine the varicose veins treatment. The stages are classified as follows:
C0: No visible or palpable signs of venous disease
C1: Telangiectasias (spider veins) or reticular veins begin to appear
C2: Large venous varicose veins now appear
C3: Swelling of the feet and ankles (edema)
C4a: Discoloration of the feet
C4b: Skin changes
C5: unhealed wounds
C6: Active varicose wounds that have not healed
In the early stage, the symptoms of varicose veins can be controlled with lifestyle changes, such as a healthy diet, regular exercise, and compression stockings.
Varicose veins are a common condition, and for many people, they do not cause problems other than aesthetic concerns. However, they can cause symptoms such as pain, swelling, or discoloration of the skin, in which case a doctor should be consulted. The longer the problem is left untreated, the higher the risk of complications.
Varicosis is one of the most neglected diseases by both physicians and patients. It is typically ignored until it reaches a severe stage. Varicose veins are much more than a cosmetic problem. If left untreated, leaking valves may cause clotting and inflammation (thrombophlebitis) in the vein. This condition can lead to vascular occlusion and respiratory failure, ranging from occlusion in the lungs (pulmonary embolism) to death by clot rupture.
Nowadays, open surgery is often replaced by minimally invasive methods to treat varicose veins. Some surgeries are performed as outpatient procedures and do not require a hospital stay. Thanks to the new techniques we perform at Acıbadem, we achieve good cosmetic results with maximum comfort for the patient.
To determine the right treatment, a vascular surgery specialist will examine the patient and identify the source of the varicosis. Color Doppler ultrasound is the best tool for diagnosing varicose veins and visualizing blood flow through the valves. Vessel mapping helps evaluate which vessels require intervention. Based on these findings, the specialist may recommend surgery or another procedure, including: