Varicose Veins Concerns

Question: I am 42 years old and have varicose veins in my left leg. Will they present a problem in the future?

Dr. Hibberd's Answer:

Occasional superficial varicosities are very common in both sexes at your age, and they generally do not reflect a tendency to developing vascular problems later. Superficial veins rarely cause the creation of clots, and varicose veins are usually more a nuisance than anything else to most people.

While superficial varicosities do not disappear by themselves, we have many very simple techniques from local sclerosing injection to removal surgically or by a laser that is customized to each individual's medical need.

Some of us have genetic predispositions or weight issues that predispose to superficial varicosities, and aside from the cosmetics of the varicosities, many patients have nothing done if they are small, isolated, and not cosmetically unacceptable. If these superficial varicosities become inflamed or associated with swelling, redness, or edema, or if they seem to extend superficially or deep into the tissue toward the deep veins, then we may have concerns and may recommend intervention.

If a clotting process extends from the superficial veins into the deep veins, we then have concerns about blood clots and the risk of a clot or embolus reaching the lungs. Emboli are not innocuous and can plug the vessels of sensitive lung tissue and impair proper oxygenation of the blood. When large or multiple, they may be immediately life-threatening. Superficial varicosities may clot, but they rarely, if ever, organize into the deep-vein plexus to pose any risk for pulmonary embolus .

Most superficial varicosities occur because of damage or injury to the valves in our low-pressure venous system that prevent backflow and swelling. Muscle contraction in the vicinity of the veins, especially the deep veins, assists with venous blood return. Blood return within veins is in a one-way direction thanks to built-in valves. For example, gently stroke the blood vessel along a distended vein in the back of your hand, and you will see how the valves within each vein serve to limit backflow of blood. This is especially easy to see in the superficial veins of the hand and forearm.

Removal of superficial varicosities does not improve your health risk but may improve your appearance and your self-esteem.