Varicose Veins
A comprehensive guide

Varicose veins are enlarged, twisted veins that appear just beneath the skin—usually on the legs, ankles, or feet. They often look like bulging, rope-like cords and may cause discomfort, aching, or swelling. You may also notice smaller red or blue veins near the surface of the skin—these are called spider veins.

While often seen as a cosmetic issue, varicose veins can progress and lead to serious conditions like skin ulcers or blood clots if untreated.

How do I prevent new varicose veins from forming after treatment?

While treatments like laser ablation, radiofrequency closure, sclerotherapy, or VenaSeal™ effectively eliminate existing varicose veins, new veins can still develop over time. Recurrence often stems from ongoing vein weakness, lifestyle factors, or underlying circulatory issues.

To support long-term results and maintain healthy veins, patients often ask how to adjust their lifestyle. Here's how to reduce your risk of recurrence:

1. Exercise Regularly
Low-impact activities such as walking, swimming, or cycling improve blood flow in your legs and strengthen the calf muscles that help push blood upward toward the heart. Walk daily and stretch your legs during breaks.

Avoid high-impact or straining exercises like heavy weightlifting or prolonged squats that can increase venous pressure.

2. Manage Your Weight
Excess body weight puts additional pressure on your leg veins, accelerating valve dysfunction. Lose excess weight if overweight. Maintain a healthy weight to reduce long-term stress on your circulatory system.

3. Elevate Your Legs
Raising your legs above heart level helps blood flow back toward the heart and reduces pressure in the leg veins. Rest with legs elevated for 15–20 minutes, several times a day. Use pillows or cushions to prop them up while lying down or reclining.

4. Avoid Prolonged Sitting or Standing
Staying in the same position for too long—whether standing or sitting—can cause blood to pool in your lower legs. Move around every 30–60 minutes during work, travel, or long meetings. Shift positions often and flex your ankles to keep blood circulating.

5. Wear Supportive Clothing
Compression stockings gently squeeze the legs to support blood flow and reduce swelling. Use medical-grade compression stockings, especially during travel or standing work. Avoid tight clothing around your waist, legs, or groin that may restrict circulation.

6. Eat a Healthy Diet
Nutrition plays a role in vein health and circulation. High-fiber, low-salt diets help reduce bloating and water retention. Include foods rich in flavonoids (like citrus fruits, berries, and dark chocolate), which may support vein function and reduce inflammation.

7. Additional Tips
Stay hydrated to promote smooth blood flow. Consider herbal remedies (e.g., grape seed extract), but only under medical supervision. Follow up with your vein specialist for routine scans or check-ups to detect early signs of recurrence.

While no method guarantees full prevention, these strategies can significantly reduce the chance of new varicose veins and help you preserve the results of your treatment.

Can varicose veins be a sign of a deeper circulatory problem?

Yes. While most varicose veins are superficial, in some cases they may signal an underlying issue such as chronic venous insufficiency (CVI) or perforator vein reflux. In rare but serious instances, symptoms may overlap with deep vein thrombosis (DVT)—a condition involving clots in the deep veins.

Warning Signs to Watch For:

• Persistent swelling in one or both legs
• Skin discoloration, itching, or thickening near the ankles
• Slow-healing sores or ulcers
• Constant aching, heaviness, or night cramps
• Sudden calf pain with redness or warmth (requires urgent medical attention)

At your consultation, your doctor may recommend duplex ultrasound to assess deeper vein function and rule out significant venous disease.

Untreated venous insufficiency can lead to serious complications including:

• Vein damage and bleeding
  Swollen veins can weaken the skin over time, leading to leakage, itching, or even spontaneous bleeding from minor trauma.
• Superficial thrombophlebitis
  Small clots in superficial veins cause pain, swelling, and warmth. Though not as dangerous as DVT, this condition still requires medical treatment.
• Deep vein thrombosis (DVT)
  A large clot in a deep vein can dislodge and travel to the lungs, causing a pulmonary embolism—a life-threatening emergency.
• Skin ulcers
  CVI can result in painful leg ulcers, especially around the ankles. In diabetics, over 80% of lower-limb amputations begin with an infected venous ulcer.

What’s the difference between cosmetic spider veins and veins that need medical treatment?

Spider veins are small, dilated capillaries located near the surface of the skin. They are usually painless and treated for cosmetic reasons. In contrast, varicose veins are larger, deeper, and often symptomatic, with potential to worsen over time if not addressed.

Feature	Spider Veins (Telangiectasias)	Varicose Veins
Appearance	Fine, red/blue web-like lines	Bulging, rope-like veins
Symptoms	Usually asymptomatic	Heaviness, aching, swelling, itching
Health Risk	Low	Moderate to high (if untreated)
Treatment Indication	Cosmetic	Medical necessity

Will pregnancy cause varicose veins to return after treatment?

Yes, pregnancy can increase the risk of recurrence or worsening of varicose veins, even after successful treatment. This is a common concern for women planning future pregnancies or considering treatment between pregnancies.

Why Pregnancy Affects Veins:

• Increased blood volume: Blood volume increases by up to 50% during pregnancy, placing added pressure on leg veins.
• Hormonal changes: Pregnancy-related hormones relax vein walls, making them more prone to bulging.
• Uterine pressure: The growing uterus compresses veins in the pelvis, impeding blood return from the legs.

Recurrence After Treatment:

• Existing treated veins may reopen under increased pressure and hormonal influence.
• New varicose veins may form, even if previous ones were removed or sealed.
• The risk increases with multiple pregnancies due to cumulative vascular stress.

Managing Veins During and After Pregnancy:

• Delay elective treatment until after your final planned pregnancy, when possible.
• Use compression stockings during pregnancy, especially in the third trimester.
• Stay physically active and elevate your legs regularly to reduce venous pressure.
• Consult a vascular specialist to create a pregnancy-safe management plan.
• Follow up postpartum to monitor for new vein formation or recurrence.

Treatment between pregnancies may be appropriate depending on symptoms and personal goals. Your care team will guide you based on your health, timing, and family plans.

How often should I follow up after treatment, and what signs should I watch for?

After varicose vein treatment, ongoing surveillance is key to maintaining results and identifying any early signs of recurrence or complications.

Typical Follow-Up Schedule:

• Initial post-procedure check: Within 7–14 days to assess healing and immediate outcomes
• Imaging follow-up (if indicated): At 3–6 months to evaluate vein closure and rule out residual reflux
• Annual monitoring: For patients with chronic venous insufficiency or a strong family history of recurrence

Signs That Warrant Evaluation:

• Reappearance of bulging veins or visible swelling
• Return of aching, heaviness, or cramping
• New skin discoloration or dryness near the ankles
• Slow-healing wounds or skin ulcers

Early intervention is more effective and less invasive than waiting until symptoms progress. Routine follow-up allows your provider to track your vascular health and intervene proactively if needed.

RIVEA Vascular Institute for advanced varicose veins care

At RIVEA, our commitment to cutting-edge vascular care ensures that every patient receives a personalized treatment plan. Our vascular team is led by American-board certified vascular specialist, Dr. Karthik Mikkineni. We utilize the latest minimally invasive techniques to restore circulation, preserve limbs, and improve quality of life.

RIVEA can help you with comprehensive vein care, whether it’s managing early symptoms or treating advanced complications. We are Hyderabad’s premier centre for advanced vascular care.