It is estimated that more than 80 million Americans suffer from some form of venous disorder. Varicose veins differ from spider veins. Varicose veins are bulging veins that are larger than spider veins, typically 3mm or more in diameter. Moreover, varicose veins are deeper than spider veins. Varicose veins may be of primarily cosmetic concern, but can cause pain, leg heaviness, fatigue, itching, night cramps, restless legs at night and leg swelling. Moreover, severe varicose veins can compromise the nutrition of the skin and lead to eczema, inflammation or even ulceration of the lower leg. In addition, varicose veins increase the risk for infection.

Varicose veins are often caused by an underlying problem. A painless noninvasive ultrasound test is usually done to determine if an underlying source exists. Sclerotherapy and ambulatory phlebectomy may be used to treat the visible, bulging varicose veins. Ultrasound guided sclerotherapy, endovenous laser ablation may be used to treat the condition.

Normal veins have one-way valves that allow blood to flow upward only to return to the heart and lungs. A varicose vein has valves that are not functioning properly. The blood can flow upwards, but tends to pool in the vein because of valve dysfunction. The valves themselves may be abnormal or the vein walls may be dilated such that the valve leaflets are too far apart. The varicose veins bulge because they are filled with pooled blood.

Symptoms are often worse at the end of the day because more pooling has occurred. Other things which increase pooling and therefore symptoms also include prolonged standing and sitting, exposure to heat (summertime, hot baths) and hormonal factors (pregnancy, around the time of the menses).

Heredity is the number one contributing factor causing varicose and spider veins. Women are more likely to suffer from abnormal leg veins. Statistics show that up to 50% of American women may be affected. Hormonal factors can affect the disease. It is very common for pregnant women to develop varicose veins during the first trimester. Pregnancy causes increases in hormone levels and blood volume, which in turn cause veins to enlarge. In addition, the enlarged uterus causes increased pressure on the veins. Varicose veins due to pregnancy often improve within 3 months after delivery. However, with successive pregnancies, abnormal veins are more likely to remain. Other predisposing factors include aging, standing occupations, obesity and leg injury.