Varicose veins are an unavoidable condition resulting from human upright walking. Historical records trace varicose vein treatments back to ancient Egyptian papyrus texts, Hippocrates' medical writings, depictions in Greek sculptures, and even accounts of surgery performed on Roman General Gaius Marius.
Today, varicose veins remain a common condition observed in the legs, where veins become enlarged, twisted, and swollen due to blood pooling caused by venous reflux. The primary causes include prolonged standing, tight clothing that restricts blood circulation, hormonal changes, aging, and other contributing factors.
The most noticeable sign of varicose veins is the visible protrusion of veins in the legs, often appearing as spider veins or reticular veins. Patients may experience symptoms such as heavy legs, swelling, and fatigue, with frequent leg cramps occurring especially at night. For individuals with varicose veins, these symptoms manifest more frequently in daily life, causing discomfort and inconvenience.
If left untreated, varicose veins with reflux can lead to complications such as skin ulcers on the ankles, feet, and calves due to tissue damage. Diagnosis of varicose veins is primarily conducted using Doppler ultrasound imaging, and in some cases, CT scans may be performed for further vascular assessment.
Varicose vein treatment is broadly categorized into three approaches:
Conservative Treatment – For mild cases, symptoms can be alleviated by taking venous circulation medications to improve blood flow.
Sclerotherapy – This involves injecting a special solution into the veins to close them. This method is particularly effective for treating telangiectasia (spider veins) and reticular veins, which cannot be eliminated through surgery or conservative treatments.
Surgical Treatment – Various surgical procedures are available, including traditional saphenous vein stripping, endovenous laser ablation (EVLA), radiofrequency ablation (RFA), and VenaSeal closure. However, surgical intervention should only be performed on veins diagnosed with reflux, making accurate diagnosis essential for selecting the most appropriate treatment method.
Varicose veins are an inevitable condition for individuals who walk and stand upright. Due to its common occurrence, many people tend to overlook early symptoms and delay treatment. However, even in mild cases, consulting a specialist and receiving appropriate care is highly recommended.
While professional diagnosis and treatment are crucial, adopting a healthy lifestyle to prevent varicose veins is equally important.
Maintaining an optimal weight and strengthening the calf muscles, which function as the "heart of the leg veins," through regular ankle stretching and walking exercises can be beneficial. Additionally, quitting smoking is essential for those with varicose veins. If you work in an environment that requires prolonged sitting or standing, wearing medical-grade compression stockings can aid in both prevention and symptom relief.
Written by: Dr. Min-Soo Kim, Department of Surgery, Seoul Metropolitan Seonam Hospital
