Varicose veins

Enlarged, tortuous veins just beneath the skin. Varicose veins most often occur in the legs but can also occur in the anus (see haemorrhoids), oesophagus (see oesophageal varices), and scrotum (see varicocele). A defect of the valves in the leg veins causes blood to pool in the veins near the surface of the skin, causing them to become varicose. Contributing factors include obesity, hormonal changes and pressure on the pelvic veins during pregnancy, hormonal changes occurring at the menopause, and standing for long periods of time. Varicose veins are common, tend to run in families, and affect more women than men. Varicose veins may not cause any problems but may ache severely; swollen feet and ankles and persistent itching may occur. These symptoms may worsen during the day and can be relieved only by sitting with the legs raised. In women, symptoms are often worse just before menstruation. In severe cases, leg ulcers may occur. Thrombophlebitis may be associated with varicose veins. Usually, support stockings, regular walking, and sitting with the feet up as much as possible are the only measures required. In more severe cases, sclerotherapy may be carried out. Varicose veins may require surgical removal if they become painful or ulcerated, but they may later develop elsewhere.