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Varicose veins -- dark, gnarly veins snaking down legs -- aren't pretty. A recent issue of Mayo Clinic Women's HealthSource covers the cause of these enlarged and twisted veins and what can be done about them.

Varicose veins can occur anywhere, but most commonly occur on the legs and feet. They develop when the valves in a vein weaken, causing the blood to pool. This pressure changes the size and shape of a vein.

Varicose veins can be quite noticeable. Usually, they look worse than they feel. They can cause achy or heavy feelings in the legs. Rarely, varicose veins can contribute to serious complications such as a blood clot in the vein.

Lifestyle changes can help reduce discomfort from varicose veins. Options include avoiding long periods of sitting or standing; being physically active; and, if needed, losing weight. Compression stockings, available over-the-counter and by prescription, can help keep blood from pooling.

Several surgical procedures are options when varicose veins don't respond to lifestyle changes.

Sclerotherapy: Doctors inject a chemical into a varicose vein, causing irritation and scarring. The treatment may need to be repeated several times. The result is a closed vein that will fade from view.

Laser therapy: Strong bursts of light are directed at a vein. The vein will slowly fade and disappear. This approach is mainly used on smaller veins.

Endovenous thermal ablation: Heat from lasers or radio waves is used to injure the vein and scar it shut. The therapy is applied via a small tube (catheter) that is inserted into the vein.

Vein stripping: Large varicose veins are tied shut and removed through small cuts in the skin. Doctors commonly used this procedure in the past. Now, it's mostly recommended when endovenous thermal ablation is not a good option.

Ambulatory phlebectomy: Doctors make tiny cuts to remove small veins close to the skin's surface. This procedure is often done in conjunction with endovenous thermal ablation or vein stripping.

Endoscopic vein surgery: Small cuts are made in the skin. A tiny camera positioned at the end of a thin tube (endoscope) is inserted and moved through the vein. A surgical device at the end of the camera is used to close the vein, which is then removed through the tiny cuts.

Most of these procedures are done on an outpatient basis. While they are effective, it's possible for varicose veins to recur or require several treatments. Insurance companies typically cover procedures used to relieve pain, swelling or other problematic symptoms. Most policies don't cover procedures done for strictly cosmetic reasons.

www.bookstore.mayoclinic.com. 

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