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Varicose Veins and Treatment

Varicose veins are superficial veins that have become stretched, dilated and twisted. Smaller, bluish veins just under the skin's surface are called spider veins, because they look like spiders. Spider veins are dilated small veins and most often appear on the legs. It is estimated that up to 25 percent of women and 15 percent of men suffer from varicose and spider veins. Although varicose veins are common, they are almost never a serious problem. Blood clots rarely develop in varicose veins.

Risk Factors

The exact cause of varicose veins is not known. If vein valves become stretched and do not close tightly, blood can pool in the lower legs. Pooling of blood further increases the pressure against the vein walls. This increased pressure may also cause the veins to stretch further and bulge. Little muscle support in the superficial veins and weak vein walls may be contributing factors. Additional factors that may include:

  • Congenital vascular malformations
  • Family history
  • Faulty or absent venous valves (inherited or acquired)
  • History of blood clots (deep vein thrombosis)
  • Hormonal factors in females
  • Obesity
  • Pregnancy


Symptoms of varicose veins depend on the type and size of the veins. They may include:

  • Bleeding
  • Bulging, purplish or bluish veins near the surface of the skin
  • Heaviness or aching discomfort of legs when standing, relief with elevation
  • Itching/rashes
  • Leg swelling
  • Skin discoloration and skin changes
  • Superficial blood clots (superficial phlebitis)


Certain tests are done to detect the cause and extent of varicose veins.


The purpose of treatment for varicose veins is to relieve pain and discomfort, improve the appearance of the legs, and prevent bleeding and superficial clots. Treatment may be conservative medical therapy, open surgical intervention or minimally-invasive therapy. The majority of patients receive treatment for varicose veins at the Center for Vascular Disease in the Northwestern Vein Center.

Medical Therapy

One or more of the following treatment options may be recommended:

  • Avoidance of prolonged standing
  • Daily exercise
  • Leg elevation periodically
  • Pain relief, over the counter
  • Prescription compression stockings
  • Weight loss, if needed

Open Surgery

Surgical vein ligation and stripping: The varicose veins just under the skin are tied off and removed. Several small incisions are made along the leg to remove the veins. When the varicose veins are tied off and/or removed, blood flows through the deep veins and back to the heart.

Minimally-Invasive Therapy

Endovenous laser ablation: Guided by ultrasound, a thin tube (catheter) is inserted through an incision in the vein. A laser device is then inserted into the catheter and threaded through the vein. Once in place, the doctor activates the laser and slowly withdraws it over approximately two minutes. The heat generated by the laser causes the vein to close and seal off.

Microphlebectomy: The veins are removed in segments through tiny incisions that, once healed, leave small scars that are barely visible in most cases.

Sclerotherapy: Chemicals are injected into the veins to make them disappear. Sclerotherapy is performed on spider veins only.

Superficial laser therapy: This procedure is used to treat small spider veins with lasers directing energy below the skin. Although many lasers have been highly effective in the treatment of facial spider veins, laser treatment of the veins on the legs has proven to be less successful.

Clinical Trials

Ongoing clinical research trials at the Center for Vascular Disease are investigating new treatment options for venous disease to ensure that our patients continue to receive the most innovative care in the country. For more information regarding these clinical trials, please view the Clinical Trials Unit of Northwestern, send an e-mail or call 312-926-4000.

Contact Us Today

For more information regarding varicose veins and the treatments available, please contact the Bluhm Cardiovascular Institute at 1-866-662-8467. To schedule an appointment, please call 312-695-4965 or  request a first time appointment online.

Last UpdateNovember 20, 2012