The Berks-Mont News (

Getting control over Varicose Veins

By Hermine Stein, DO, Guest Columnist

Wednesday, January 9, 2013

Pottstown, PA- January, 2013 - Warm weather and shorts season are well underway, and unless you’re a teenager, your legs may sport some of the telltale signs of aging; namely, varicose veins. Varicose veins can range from small spider veins to swollen, bulging and rope-like veins. Aside from their unattractive appearance, varicose veins can also cause discomfort and, in severe cases, health problems ranging from skin ulcers to blood clots.
Symptoms of varicose veins include:
• Enlarged veins visible just under the surface of the skin
• Mild swelling of the ankles and feet
• Painful, achy or heavy-feeling legs
• Throbbing or cramping in the legs
• Itchiness, particularly on the lower leg and ankle
• Discolored skin in the area surrounding the varicose vein
Varicose veins are very common. Around 55 percent of women and 45 percent of men in the U.S. suffer from some type of vein problem. These enlarged veins – caused by weak or damaged valves in the veins – most often appear in the legs, due to body weight and the force of gravity. Because the veins in the legs carry blood the longest distance from the lower extremities of the body back up to the heart, they also bear the greatest pressure. This pressure can sometimes damage the valves in the veins, and cause blood to back up and pool in the leg veins – a condition known as venous insufficiency. Over time, this overfilling of the superficial veins closest to the surface of the skin causes the veins to stretch, bulge and become prominent.
Half of people over age 50 have varicose veins. The primary causes are heredity, advancing age, pregnancy, being overweight or obese, and being sedentary. People who sit or stand for a large part of the day or engage in heavy lifting as part of their occupation have an increased risk of varicose veins. Women have a greater risk than men due to hormonal changes during puberty, pregnancy, and menopause, as well as increased pressure on leg veins during pregnancy.
Spider veins are a smaller, milder form of varicose veins, and involve the capillaries – the smallest blood vessels in the body. Often red or blue, spider veins can appear on the legs or face, closer to the surface of the skin than varicose veins, and look like a spider web or tree branch. This type of vein is usually only a cosmetic concern.
Varicose veins that need medical attention are those that become swollen, red, warm or tender to the touch, or begin to bleed. Also, watch for sores or a rash in the ankle area; thick or discolored skin in the area around the affected vein; or if leg pain and discomfort begin to interfere with daily activities.
Varicose veins can cause complications such as leg pain; dermatitis, an itchy rash that can cause bleeding or skin ulcers when scratched or irritated; or a condition known as superficial thrombophlebitis, a blood clot in a vein. This type of blood clot can cause pain in the affected area.
Varicose veins are typically diagnosed through a physical exam and an ultrasound imaging test to look for blood clots or other blockage, and to determine if the valves are working properly. Treatment depends on the severity and can include lifestyle changes, compression or support hose, or surgery. Techniques for eliminating or closing off varicose veins include laser therapy, sclerotherapy (the injection of saline solution into the vein to cause it to collapse), or radiofrequency or endovenous laser ablation – a minimally invasive procedure which uses intense heat to close off and destroy the vein from the inside. Sclerotherapy and topical laser treatments are most effective for smaller spider veins.
Depending on the severity of your varicose veins, your doctor may refer you to a dermatologist, a vascular medicine doctor/surgeon, or a phlebologist, a vein specialist, for treatment. You should check with your health insurance plan to determine coverage for treatment, as many plans only cover varicose vein therapies that are considered medically necessary, rather than cosmetic.
Dr.Hermine Stein, DO, is an independent member of the medical staff at Pottstown Memorial Medical Center, department of family medicine. She is a graduate of University of Osteopathic Medicine & Health Sciences. Dr. Stein completed an internship at Metropolitan Central Division, Philadelphia, and a residency at Bryn Mawr Hospital. She is board certified by the American Osteopathic Board and practices with Brookside Family Practice & Pediatrics, 1555 Medical Drive, Pottstown.