When people hear about varicose veins they most often think of a disease that affects women. One reason that varicose veins are more prevalent in women is that pregnancy is an additional risk factor for varicose veins. Of the more than 4 million people in the United States with varicose veins, it is estimated that 25 to 30 percent of them are male. Risk factors include family history of varicose veins, obesity, sedentary lifestyle, smoking, and prolonged standing.
Our veins have one-way valves that keep blood moving toward the heart. Varicose veins develop because these valves deteriorate and become ineffective, causing blood to pool in the veins. Over time, this causes the veins to enlarge and become more visible. In the early stages of venous disease the veins appear as small visible vessels but don’t cause pain or discomfort. Having these “spider veins” is considered mainly a cosmetic problem. Insurance companies usually don’t even cover treatment; however, treatment is available and includes injecting the veins with a solution that may make them fade.
Venous disease can get worse over time. The veins enlarge further, protrude and become more visible. Eventually, this can lead to swelling, pain, blood clots, skin damage and leg ulcers. The best prevention for this progression is generally to maintain a healthy lifestyle including exercise. When we walk, our leg muscles essentially act as pumps to help move the blood toward the heart. Elastic compression stockings are also beneficial for patients with venous disease and have come a long way in terms of style and comfort. I highly recommend them to school teachers, machine operators, factory workers, and other people with jobs that require them to stand for long periods of time.
Surgical options for treatment of varicose veins are usually indicated when conservative measures such as exercise, leg elevation, and stockings fail to relieve symptoms and the disease continues to progress. This treatment is generally covered by insurance. Surgery has become much less invasive and is generally done in the outpatient setting of the hospital. Recovery is typically swift and very little (if any) time out of work is necessary.
Men (and women) who have visible varicose veins should consider having them evaluated. Ultimately they may not just be a cosmetic issue. Even if no surgical intervention is necessary, a physician familiar with varicose veins can help you understand the disease and the options available to make your legs look and feel better!
Gregory Gadowski, MD is a board-certified surgeon practicing at Brattleboro General Surgery, which is part of BMH Physician Group. He can be reached at 802-254-5510.