varicose

Varicose veins are enlarged, tortuous veins that develop when the veins' valves fail to function properly, allowing blood to pool and the vein wall to dilate. They most commonly involve the superficial veins of the legs and feet and can have a cosmetic and symptomatic impact.

Causes include age-related vein wall weakness, pregnancy, obesity, prolonged standing or sitting, injury, and genetics. The underlying mechanism is venous insufficiency: incompetent venous valves produce retrograde blood flow, increasing venous pressure and vein dilation.

Symptoms range from cosmetic concerns to aching, heaviness, swelling, throbbing, cramps, itching, and skin changes. Severe cases may lead to eczema, ulcers near the ankle, or superficial thrombophlebitis. Varicose veins can occur in both sexes but are more common in women.

Diagnosis: clinical examination; duplex ultrasound may assess valve function and reflux, and rule out deeper venous disease.

Treatment: many cases require only reassurance and lifestyle modification, such as leg elevation and compression stockings. Weight loss and regular exercise help. For persistent symptoms or complications, options include sclerotherapy, endovenous thermal ablation (radiofrequency or laser), foam sclerotherapy, ambulatory phlebectomy, and vein stripping in selected cases. Post-treatment compression may be recommended.

Prevention and prognosis: maintaining a healthy weight, regular activity, and avoiding prolonged standing or sitting can reduce risk. Varicose veins are generally not life-threatening but can worsen over time. Complications include dermatitis, ulcers, and superficial thrombophlebitis.