Understanding Varicose Veins

Causes, Prevention, and Treatment Options

Varicose veins are more than just a cosmetic concern—they can be a sign of underlying venous disease that affects how blood circulates through the legs. These enlarged, twisted veins often appear blue or purple and are most commonly seen in the legs and feet. While they can cause discomfort or swelling, they are also a very treatable condition with the right medical care.

Veins carry blood back to the heart, and one-way valves inside the veins keep blood flowing in the right direction. When these valves weaken or fail, blood can pool in the veins instead of moving upward toward the heart. This backup of blood causes the veins to stretch, bulge, and become twisted — resulting in varicose veins.

Erica Salinas, MD, a vascular surgeon at Boone Health Vascular Surgery, explains that both genetics and lifestyle play roles in who develops varicose veins. “When trying to prevent varicose veins, a lot of it depends on the type of job you have, as well as your genetics,” Dr. Salinas said. “Wearing compression stockings from a young age, especially if you’re in a job where you’re sitting or standing still for long periods of time, can be very helpful to treat symptoms early or prevent varicose veins and venous reflux before it even starts.”

Certain factors increase the likelihood of developing varicose veins:

• Genetics – A family history of venous disease is one of the biggest risk factors.
• Prolonged standing or sitting – Jobs that require long periods on your feet or at a desk can increase pressure in the leg veins.
• Pregnancy – Hormonal changes and increased blood volume can cause veins to enlarge.
• Age – As we age, vein walls and valves naturally weaken.
• Obesity or lack of exercise – Extra weight and inactivity can add pressure to veins and slow circulation.

While many people first notice varicose veins because of their appearance, others experience physical symptoms that can worsen over time. Common signs include:

• Aching, throbbing, or heavy sensation in the legs
• Swelling around the ankles or calves
• Itching or skin changes near the veins
• Cramping, especially at night
• Large, bulging veins visible beneath the skin

Dr. Salinas emphasizes that these symptoms shouldn’t be ignored. “Sometimes patients think it’s just a cosmetic issue, but varicose veins can indicate poor vein function that can get worse without treatment,” she explains.

A key contributor to varicose veins is venous reflux, which occurs when the valves inside the veins don’t close properly, allowing blood to flow backward. Dr. Salinas notes that there are two main types of venous reflux: deep and superficial.

“There are two different types of venous reflux,” she explains. “You have deep veins and superficial veins. For deep venous reflux, compression therapy is the only treatment available; no surgical option exists. But if you have superficial venous reflux, there are surgical treatments that can help.”

Superficial venous reflux affects the veins closer to the surface of the skin — the ones most likely to become visible and symptomatic. Fortunately, these can often be treated with minimally invasive procedures that require little downtime.

Boone Health Vascular Surgery offers several effective treatments for varicose veins, depending on the severity and type of venous reflux. One of the most common is endovenous laser therapy (EVLT).

“EVLT uses a laser fiber to cauterize the inside of the vein,” Dr. Salinas said. “That causes the vein to scar down and close off, and over time, your body naturally absorbs it. The blood then reroutes through your healthy veins, which restores proper circulation and provides symptom relief.”

For patients with larger, bulging veins, Dr. Salinas and her team may perform ambulatory phlebectomy, a minor surgical procedure that physically removes those visible veins through tiny incisions.

While some risk factors like genetics and age can’t be controlled, certain habits can help reduce the likelihood of developing varicose veins or slow their progression:

• Wear compression stockings – They help improve blood flow and reduce swelling.
• Move regularly – Avoid long periods of sitting or standing. Get up and walk around every hour.
• Maintain a healthy weight – Extra weight adds pressure to your veins.
• Elevate your legs – Raising your legs above heart level can help blood flow back toward the heart.
• Exercise – Activities like walking, cycling, or swimming promote strong, healthy circulation.

Dr. Salinas also stresses the importance of early evaluation. “If you notice leg pain, swelling, or visible veins that seem to be getting worse, it’s best to get checked sooner rather than later,” she advises. “The earlier we evaluate your veins, the more options we have for treatment and prevention.”

If varicose veins are causing pain, swelling, or affecting your quality of life, it’s time to consult a vascular specialist. At Boone Health Vascular Surgery, patients can expect a thorough evaluation including ultrasound imaging to assess vein function and determine the best course of treatment.

“Varicose veins are extremely common, and the good news is that there are safe and effective ways to manage them,” Dr. Salinas said. “Whether it’s through lifestyle changes, compression therapy, or minimally invasive procedures, we can help patients get back to feeling comfortable and confident.  By Madison Loethen

Boone Health Vascular Surgery provides comprehensive evaluation and treatment for varicose veins and other vascular conditions. To learn more or to make an appointment, call 573-815-2970 or visit boone.health/vascular-surgery.