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" What is the difference between veins and arteries?  The heart pumps blood through the arteries to all parts of the body \u2013 the vital organs, the head, arms and legs. The blood is then spread through tiny vessels called capillaries which form a network . Later it is returned in increasingly large vessels \u2013 veins \u2013 which complete the circulation of blood back to the heart. The arteries are rather thick and elastic and their size constantly changes due to the fluctuating pressure which varies with the heartbeat. The veins, on the other hand, have very thin walls and have no elastic fibres. They are therefore unable to contract and push the bloodflow onwards.  The veins are completely dependent on the functions of the surrounding muscles and the valves inside the veins helping the blood to flow in the right direction towards the heart. What are varicose veins? Varicose veins are permanently dilated (widened) and twisted veins. Although this can occur in any part of the body, it usually develops in the legs.  Veins contain one-way valves every few inches to help the blood return to the heart against gravity. If these valves leak, then the increased pressure prevents the blood from draining properly.  The valves may leak and fail because of previous vein disease, eg thrombophlebitis, pressure on the veins in the pelvis from pregnancy or other causes of raised pressure within the abdomen. Varicose veins come on with advancing age and are often no great inconvenience apart from being unsightly. Who develops varicose veins? The risk of developing varicose veins increases with:  pregnancy a family history of the condition an occupation that involves prolonged periods of standing  menstruation \u2013 the symptoms worsen before and during menstruation.  How do I tell if I am developing varicose veins?  heaviness and tiredness in the legs particularly after standing they appear as enlarged, snake-like, blue veins and are most easily seen under the skin while standing they are most commonly seen in the back of the calf or on the inside of the leg between the ankle and the groin there may be a creeping sensation across the skin and possibly night-time cramps in the legs the legs may become swollen, sore and painful as the condition progresses. This is due to incomplete blood circulation (oedema or accumulation of fluid in the legs).   When do I seek help? Help should be sought when varicose veins cause irritation during the day; if fluid accumulates in the legs; if working standing up causes discomfort; or the legs become agitated at night (and sleep is interrupted).  In these cases consult a doctor about the possibility of receiving treatment. How are varicose veins treated?  Light to moderate physical activity, whilst avoiding factors that are known to make your symptoms worse if possible. When resting keep your legs elevated where possible.  In mild cases, lightweight elastic compression stockings should ease the discomfort but they will not remove the varicose veins. A loss of weight, if obesity is a problem. For further advice on weight loss, see the article How to lose weight the healthy way.   If the varicose veins are allowed to worsen there is a risk of developing:   phlebitis (inflammation of the wall of the vein) eczema  leg ulcers \u2013 it is estimated that 3 to 6 per cent of people who have varicose veins in their lifetime will develop venous ulcers  deep vein thrombosis (DVT).  To avoid these complications, an operation may be required. There is no definitive system for identifying which people will benefit the most from interventional treatment and no established framework within the NHS for the diagnosis and management of varicose veins.   This has resulted in wide regional variations in the management of varicose veins in the UK. It is recommended for your GP to refer you to a specialist if you have any of the following.  Bleeding from the veins (requiring immediate referral).  Veins found in association with troublesome lower limb symptoms (typically pain, aching, discomfort, swelling, heaviness and itching).   Lower limb skin changes, such as pigmentation or eczema, thought to be as a result of the varicose veins.  Superficial vein thrombosis (characterised by the appearance of hard, painful veins) and suspected venous incompetence.  A venous leg ulcer (a break in the skin below the knee that has not healed within 2 weeks).   A healed venous leg ulcer.  Interventional treatments of varicose veins in the leg can involve a number of different types of intervention, listed below in the order of preference, depending upon the severity and location of the veins.   Radiofrequency ablation of varicose veins. This involves heating the wall of the vein using a bipolar generator and catheters with sheathable electrodes.  Endovenous laser treatment of the long saphenous vein, which runs up the inside of the leg from the ankle to the thigh.  Ultrasound guided foam sclerotherapy \u2013 the injection of a sclerosing solution into the vein, which will close it.   If the veins are unsuitable for any of the above treatments, a complete removal of the vein from ankle to groin may be necessary (ligation and stripping).  For cosmetic improvement, small, localised &amp;#039;spider veins&amp;#039; (idiopathic telangiectases), which may be extensive, can be treated with injections using a needle with a very fine bore.  Several treatments may be required before a satisfactory resolution is achieved.  Laser treatment can also be effective for these small veins.  For most cosmetic cases however, this treatment tends to be available privately rather than on the NHS. Your doctor will be able to advise you as to the situation in your area. Can varicose veins develop in places other than the legs? Varicose veins can develop, for example, in the oesophagus (gullet or food pipe), pelvis, uterus (womb), vagina, scrotum and rectum (back passage). Haemorrhoids (piles) can be regarded as varicose veins around the anus. The majority of people with varicose veins manage by using simple non-surgical treatment measures.  Varicose veins are not a disease in themselves although they can cause daily irritation and worry. People with this problem should consult their GP to discuss whether treatment is necessary. Other people also read: Deep vein thrombosis (DVT): Why is DVT at greater risk of occurring on long-haul flights? Phlebitis: Why does phlebitis happen? Leg ulcers: What can trigger or worsen arterial leg ulcers? Haemorrhoids: How are haemorrhoids treated?  References Nice guidance on: Varicose veins in the legs (CG168), Radiofrequency ablation of varicose veins (IPG8), Endovenous laser treatment of the long saphenous vein (IPG52), Ultrasound-guided foam sclerotherapy for varicose veins (IPG440)   Based on a text by Dr Per Grinsted  Last updated 12.05.2014 "^^<http://www.w3.org/2001/XMLSchema#string>
<http://www.netdoctor.co.uk/conditions/heart-and-blood/a1145/varicose-veins/>