When to Worry About Varicose Veins

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When to Worry About Varicose Veins

Varicose veins, the colored, ropy protrusions that appear on your thighs and calves, are unquestionably an eyesore, but are they something you need to worry about medically?

At Advanced Surgical Associates of Northern Minnesota, Dr. John Bollins and his team recommend not just treatment but early treatment for varicose veins because of their potential to lead to more advanced stages of vein disease, ones that can jeopardize your health. Here’s what the team wants you to know about this common circulatory system condition.

Your veins’ role in circulation

Your circulatory system is a closed loop, delivering oxygen-and nutrient-rich blood from your heart to your body’s tissues and returning deoxygenated blood to the lungs and heart. Arteries perform the outgoing function, while veins perform the incoming. 

Veins, though, have the harder task because they have to move blood against the pull of gravity. To assist with the task, the body has developed two strategies. First, the calf and thigh muscles contract, squeezing the elastic vein walls and forcing the blood forward. Second, the veins contain a series of small, one-way valves that snap shut once blood flows through, preventing backflow. 

The walls and the valves can be damaged, though, by injury or by consistently high blood pressure. When that happens, the valves can’t shut completely. Blood flow in the area becomes sluggish, and some can flow back toward the legs and feet, where it pools around the weakened or damaged area. The superficial veins become engorged, and you end up with varicose veins.

If you don’t correct the damage, the condition becomes chronic and is termed chronic venous insufficiency (CVI) because blood flow is insufficient to meet the body’s needs. It affects about 40% of adults in the United States. While CVI’s manifestations can be cosmetic, they can be the first stage of developing vein disease, putting your health and life at risk.

Vein disease stages: why you should worry

If not treated early, vein disease can become a chronic problem with multiple, increasingly serious scenarios. Here are the stages it goes through.

Chronic venous insufficiency

As we’ve mentioned, vein disease starts with damaged valves that allow blood that should be heading to the heart to pool around the damaged area.

Varicose veins

As the pressure grows and the larger veins become affected, small spider veins give way to varicose veins. Though these may be mostly an eyesore, they can produce symptoms like pain, itchiness, swelling, and aching heaviness in the legs. And because they have stagnant blood flow, they can also lead to deep vein thrombosis, which is much more serious.

Deep vein thrombosis (DVT)

Varicose veins affect surface veins, but DVT affects veins deep in the leg tissue. When blood flow is sluggish, the blood is more likely to clot. Two things may happen: the clot grows big enough to completely block blood flow in the vein, causing a crisis, or the clot can break free of the vein wall and travel to the lungs. If it lodges in an airway, it may cause a life-threatening pulmonary embolism (PE).


DVT can lead to leaky veins, which cause edema (swelling) in the area around the weakened vein. If you press on the skin, you’ll notice an indentation from the fluid buildup, and you may experience pain and stiffness in the affected leg.

Venous stasis dermatitis

In this next stage, you’ll see a brown or red discoloration around your lower legs and ankles, which derives from hemosiderin deposits, a breakdown product of hemoglobin, the molecule that transports oxygen. Your skin may also appear shiny, scaly, thickened, or scarred.

Venous ulcers

Venous ulcers are easy to identify — they’re slow-healing open sores surrounded by discolored or thickened skin on the lower leg or ankle. Because they heal slowly, they’re easily infected, especially in people with diabetes. While the sore is relatively painless, people experience pain from related edema or infection. If the infection becomes too advanced, the doctor may need to amputate the lower leg.

Treating varicose veins

The earlier the stage of vein disease, the easier it is to treat it successfully. For varicose veins, there are several treatment options:

  • Sclerotherapy: The doctor injects an irritating solution into the vein that makes the vein walls collapse; your body flushes out the diseased tissue
  • Venous ablation: uses heat from a laser or radiofrequency energy to close the vein; the body reroutes blood flow and flushes out the diseased tissue
  • VenaSeal®: The doctor injects a medical-grade adhesive into the vein that makes the walls stick together; the vein isn’t eliminated, but the varicose veins disappear

Got varicose veins and wondering what to do about them? Come into Advanced Surgical Associates of Northern Minnesota, where we can stop vein disease. To schedule, call us at our Hibbing, Duluth, or Ely, Minnesota, office or book your appointment online.