Q. I have unsightly varicose veins on my legs. Is there any way to get rid of them? And can I prevent new ones from forming?
A. Varicose veins are very common, and as in your case, they're usually found in the legs. They can look blue, swollen or stretched out, kinked or twisted.
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It sounds like your varicose veins are not causing any symptoms -- such as aching, swelling or itching. In most people, they rarely cause symptoms; they're just unattractive.
What are they, and what can you do about them? Veins are the blood vessels that return blood to the heart. Varicose veins occur when veins just below the skin's surface get damaged. They become swollen and fill with too much blood.
They get swollen because their valves get weak. Veins in the legs are designed to carry blood upward from your legs to your heart. Here's the problem: We're on our feet a lot of the day. Whenever we are standing, the blood in our leg veins -- the blood that wants to go up to the heart -- is being pulled down by gravity. To counteract that, we are born with valves in our veins that let blood flow through them in just one direction -- upward to the heart. When those valves get weak, gravity pulls blood downward, making the veins swell.
Varicose veins run in families. They're more common in women in general, pregnant women and obese people. They are more common in pregnant women and obese people because both conditions cause pressure to rise in the leg veins. In pregnancy, the uterus and the fetus inside it often press against the veins carrying blood from the legs to the heart. That makes it harder for the blood to go upward, and so causes the veins to swell.
If your occupation requires uninterrupted standing (a waitress or a nurse, for example), this also increases your risk of varicose veins.
There aren't many things you can do to prevent varicose veins. Maintaining a normal weight and avoiding standing for long periods will help. But you may still develop varicose veins if they run in your family.
If you already have varicose veins, you can help to prevent symptom flare-ups. Periodically lie down or sit down with your legs raised above chest level. You can also wear support stockings or compression stockings when you walk or stand for long periods of time. The stockings prevent blood from pooling in the veins.
If you experience mild swelling, itching or aching around your varicose veins, the treatment is the same as prevention: Elevate and support your legs periodically throughout the day and wear compression stockings.
There are two treatment options that can help make your varicose veins less noticeable. One option is sclerotherapy, which involves (strange as it may sound) injecting an irritating substance into the affected vein. This causes the vein to scar and shut down.
Your other option is laser therapy, which can remove small, superficial, spider-like veins, and is effective for even the smallest varicose veins. Lasers placed inside very large varicose veins also can be effective. A vascular medicine specialist can determine the best treatment for you.
• Dr. Komaroff is a physician and professor at Harvard Medical School. Go to his website to send questions and get additional information: AskDoctorK.com.