PATIENT TEACHING AID Varicose

More Common in N O I T A R O

F the Legs and Feet R E P G N Varicose veins are veins that have become O L A dilated with blood, often bulging out of R A

E the skin’s surface. The twisted, enlarged T appearance of a varicose is due to blood pooling, a result of the dilated vein’s inability to return blood to the heart. Varicose veins are found most commonly in the legs and feet, since these veins have the most difficult time fighting gravity and push- ing the venous (blue) blood back to the main circulatory system. Varicose veins in the rectal area are known as . Although varicose veins are simply a cosmetic problem for most people, some become so enlarged they cause an aching, throb- bing, or burning sensa- tion when standing or sit- 5 0

0 ting for long periods of time.

2 Normal vein

N In patients who suffer from symp- O J E tomatic varicose veins, self-care steps to relieve these symptoms Z R A can help. In more severe cases, these enlarged and painful veins are M

T removed by one of several techniques, including (injec- Varicose vein D N

A tion of the vein with a scar solution that causes it to collapse), laser sur- N I E gery (laser beams destroy the vein), catheter procedures (catheter destroys the vein through heat or W N

E radio waves), or (removing the vein through a small incision). T S I To some extent, varicose veins can be prevented by keeping the circulation and muscles strong in R K : the lower extremities. By avoiding standing or sitting for long periods of time and situations that N O I

T cut off circulation such as crossing the legs or wearing tight socks or pants, while maintaining a A R

T healthy weight and exercise schedule, you can help to prevent the formation or aggravation of vari- S U

L cose veins. L I L A C I Copyright Jobson Publishing L.L.C., 2005

D continued E M U. S. Pharmacist PATIENT TEACHING AID

Varicose veins are found most commonly in the legs and feet, since these veins have the most difficult time fighting gravity and pushing the venous (blue) blood back to the main circulatory system. Nor- mal blood flow is shown on the left, and blood flow in varicose veins is shown on the right.

Symptoms Often Self-Treatable Varicose veins are a common complaint, affecting over half of all Americans. They are more likely to be a problem in women and those over age 50. Although varicose veins, and a milder version of tiny surface veins known as “spider veins,” are somewhat unsightly, for most people they are not a significant medical problem. In some cases, though, varicose veins become so enlarged that they cause pain, throbbing, and burning symptoms. Serious varicose veins can lead to ulcers in the skin that signal vascular (circulatory) disease requiring treatment. Varicose veins that form deep within the leg can cause swelling of the ankle or leg and should be examined by a doctor. Any swelling of the lower extremity may be a sign of a more serious condition, such as a blood clot. Varicose veins form when the tiny valves in the veins that normally return the blood up to the heart become weakened, causing the blood to pool in the vein and dilate or stretch the vein wall. This condition can be a result of aging, , genetic factors, , or standing for long periods of time. Hormones may play a role in the development of varicose veins in women, since these hormones may cause veins to relax, making it more difficult to return blood from the lower extremities up to the heart. Many women first develop varicose veins or hemorrhoids while they are pregnant. In addition to the hormonal changes at this time, the mother’s blood volume increases and blood flow slows from the legs to the abdominal area due to the pressure of the uterus on leg veins. Varicose veins are simple to diagnose; patients with severe varicose veins complain of classic symptoms such as burning, itching, swelling, and a feeling of heaviness, aching, or throb- bing in the affected legs or feet. Steps a patient can take to relieve the symptoms of varicose veins: Avoid standing for long periods of time, do not sit in positions that cut off circulation such as crossing the legs, do not wear tight clothing, lose excess weight, and do sensible exercise. Elevating the legs for short peri- ods throughout the day can relieve pain and swelling. The doctor may recommend to lessen symptoms of varicose veins. These stockings should be fitted properly and worn as directed to help move the blood from the lower legs to the heart, relieving the workload on the varicose veins. When these self-care steps are not enough to relieve the symptoms of varicose veins, there are several outpatient treatments available. Sclerotherapy involves injection of solution into the vein that causes it to collapse. It can be done in the doctor’s office without anesthesia. In some cases, sclerotherapy requires repeated treat- ments. This therapy is often used for spider veins as well as small-to-medium-sized varicose veins. New laser technology has improved procedures to remove spider and varicose veins. In this procedure, a laser beam of light destroys the vein, so no needles are required. Catheter closure procedures are used for larger varicose veins, in which a tiny catheter tube with a heated tip is inserted into the varicose vein and the end of the vein is sealed shut as the catheter is removed. The vein collapses and eventually disappears. This procedure is also done using radiofrequency energy waves to seal the vein. The classic procedure known as ligation and stripping, or “stripping the vein,” involves a small incision through which large surface veins are tied off, then removed. It is usually outpatient surgery and requires local or general anesthesia. A less invasive procedure known as uses a light to locate the vein, and a small hook removes the vein through a tiny incision. Your pharmacist can help you select the correct compression stockings for symptom relief.

U. S. Pharmacist