Varicose veins are abnormally large veins visible beneath the skin of the legs. They develop as a result of increased internal pressure within the veins accompanied by a genetically inherited weakness in the wall of the veins. Some people develop varicose veins after an episode of phlebitis (deep venous blood clot) when the superficial veins enlarge to accomplish more of the work of draining blood from the leg. However, most people with varicose veins simply have inherited the tendency from their parents, and under conditions of increased internal pressure with the veins, the vein walls stretch somewhat like a wet sweater, never to return completely to normal. The veins of the leg have internal valves which promote flow uphill against gravity back to the heart when we are standing up. When these valves do not function well however, the pressure within the veins below the valves will increase, causing the problem to worsen further downstream. Any increase in pressure can promote the stretching process in susceptible people. Varicose veins are most common in people with a positive family history, and a job requiring lots of standing, lifting or straining, and of course, during and after pregnancy.

   Mild varicose veins may cause no symptoms at all and need no treatment other than support hose to diminish the tendency of the veins to stretch further. Patients with advanced cases complain of leg fatigue, swelling and congestion particularly as the day wears on. After years, complications such as painful blood clots in the vein (superficial phlebitis), bleeding from eroded veins near the skin surface, and nonhealing ankle sores (venous stasis ulcers) may develop. Also, many people find varicose veins unsightly.

   Because of the serious and common long-term complications of varicose veins, proper treatment is important, and the best results are obtained before complications have already developed.

TREATMENT OPTIONS:
1. Sclerotherapy
2. Endo-venous ablation and ambulatory phlebectomy
3. Ligation and stripping