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Thick veins: Bulging Veins | NIH News in Health

Bulging Veins | NIH News in Health

August 2019

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What to Do About Varicose Veins

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Are there bluish-purple or red lines popping out on your legs? Those could be varicose veins. Varicose veins are swollen, twisted veins that lie just underneath the skin’s surface. They aren’t just a cosmetic issue. If they aren’t treated, they can also cause health problems.

“By the age of 50, nearly 40% of woman and 20% of men will have some significant leg vein problem,” says Dr. Cheryl McDonald, a physician at NIH.

Varicose veins are caused by blood pooling in the veins. This makes them bulge out. Varicose veins most often occur in the legs, but they can appear other places too.

The veins farthest from your heart have the toughest job. They must move blood a long distance back to your heart—and work against gravity to do it.

Your heart pumps oxygenated blood out through arteries to your organs and other tissues. Once your body uses the oxygen, the blood makes its way back to the heart through your veins. Then it’s pumped to your lungs to pick up oxygen before being sent around your body again.

Veins have one-way valves that let blood flow forward. The valves then close to keep blood from leaking backward. When a valve doesn’t function properly, blood can flow back down the vein. This can cause the blood to pool in the vein and keep it from going back to the heart. Blood pooling in the veins stretches them out—creating the swollen, twisted veins that can be seen and felt through the skin.

Blood can pool in both large and small veins. When this happens in small blood vessels, or capillaries, they’re called spider veins. Spider veins usually appear on your face or legs. They’re very thin—like a spider web—and can be red or blue. Spider veins don’t usually bulge out like larger varicose veins. They can be a cosmetic issue, but don’t normally cause bigger problems like varicose veins can.

“If not treated, larger varicose veins can become problematic,” explains McDonald. They can cause symptoms like itching, achiness, heaviness, and swelling in the legs. If left untreated, the pressure inside the vein can further weaken the valve’s functioning. That can lead to chronic changes in the skin and tissues, including open sores or ulcers and hard, thickened skin.

Varicose veins are a treatable medical condition. Your health care provider can usually diagnose them with a physical exam. They may also order an ultrasound or other tests to more fully evaluate the problem.

Treatment depends upon the severity of the vein problems. They range from lifestyle changes to medical procedures.

Losing weight can help combat varicose veins. Being overweight or obese adds pressure on the veins that can make it even harder for the blood to get back to the heart. Getting active and moving your muscles can help push blood back up towards the heart.

If lifestyle changes aren’t enough, surgical methods may be used. Talk with your health care provider about your options.

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Causes of Bulging Veins – Delaware Vein Center

Our blood moves through the body via blood vessels with the goal of reaching our heart. But when blood has a hard time being transported, it can pool up in our veins. This can manifest itself as bulging in legs, hands, and feet. These swollen veins can look unappealing and really show off our age.


The good news is most bulging veins aren’t actually a sign of poor health. But there are instances where they may arise from an underlying disease. Whatever the cause or effect, let’s discuss everything you need to know about bulging veins.


8 Common Causes of Bulging Veins 


Bulging veins can be identified by their rope-like shape and bluish-green tone. While they’re not an inherent health threat, none of us want to have them on our skin. So why are my veins popping out? Here are some of the reasons why they appear:


  • Aging: As we age, our skin gets thinner and less elastic, making our blood vessels more visible. While not particularly desirable, it’s all part of the aging process.
  • Genetics: Having family members with bulging veins increases your chances of getting them.
  • Hot Weather: Heat can make veins more prominent and enlarged. Because they have to work harder in high temperatures, veins become more visible.
  • Hormone Imbalance: Pregnancy or menopause can lead to a hormone imbalance. One of the symptoms is bulging veins. Pregnancy may also put pressure on veins, making it harder for blood flow to get back to the heart.
  • Exercise: Heavy lifting for long periods of time can make blood flow increase. The muscles harden, causing more visible blood vessels. Over-stretching can also play a role in making veins pop out.
  • Blood Clots: Also known as thrombophlebitis, this condition can cause swollen veins that feel tough.
  • Body Fat Loss: Our skin has a layer of fat that serves as an insulator. When you lose weight, that layer thins, making veins more visible.
  • Health Conditions: Underlying heart problems can cause a chronic increase in blood pressure. This weakens the veins and can cause popping.


The causes of bulging veins differ from that of varicose veins. Varicose veins are often caused by damaged or weakened valves. Not all bulging veins are varicose veins, deeming them generally harmless. But if they cause pain and discomfort, it may be an underlying problem from untreated varicose veins. Let’s explain.


Are Bulging Veins the Same as Varicose Veins?


There are a few ways to tell the difference between a regular bulging vein and varicose veins. The first is where the vein is located. Bulging veins can pop up in various places. But varicose veins usually show up on your legs. This is where blood has to work the hardest to travel back to your heart.


Though similar in appearance, varicose and bulging veins have a slightly different look to them. They both have a rope-like structure. But varicose veins are generally larger and more twisted. Bulging veins are smaller with a green-blue hue. Varicose veins have a more purple-blue color.


Symptoms can help you identify whether you’re dealing with bulging or varicose veins. Bulging veins can be purely aesthetic and may have no real symptoms. Varicose veins; however, come with pain, discomfort, swelling, changes in skin texture, and even ulcers.


Can Bulging Veins Go Away?


Usually, bulging veins will go away on their own. Especially ones that are caused by exercise or hot weather. But if popping veins run in your family or come from underlying conditions, you may need treatment to help them go away. Here are some options:


  • Over-the-counter anti-inflammatory drugs can help decrease the swelling of bulging veins.
  • Sclerotherapy injects a chemical solution into targeted veins and makes them close.
  • Ambulatory phlebectomy is the removal of the targeted veins via small incisions. While you’re under general anesthesia, your doctor will make an incision, tie off the vein, and remove it. The blood that used to run in the vein is automatically shifted and the closed vein eventually fades away.


What Can You Do To Prevent Bulging Veins From Forming?


As we’ve learned, bulging veins often have genetic causes. So while we can’t always stop them from forming, there are things we can do to lessen the appearance of bulging veins or prevent new ones from popping up.


Improve Your Heart Rate, Reduce Your Weight


Routine exercise improves circulation, prevents blood from pooling in veins, and helps with weight loss. Being overweight puts extra pressure on your veins. This increases your chances of developing bulging veins. So maintaining a healthy diet and workout routine is an advantageous step in treating or preventing bulging veins.


Sport a Pro-Vein Wardrobe


Wearing tight clothing could actually be the cause of your vein problems. Overly fitted garments restrain blood flow, which can then cause bulging veins to form. Sporting a loose-fitting, free-flowing wardrobe can help. And to further reduce your risk, compression socks can even out the pressure on your veins and prevent blood pooling.


Switch up Your Position


Refrain from standing, sitting, or crossing your legs for extended periods of time. Doing so can cause blood to pool in your veins. Elevating your legs to a position higher than your heart can also improve blood flow. Taking periodic breaks and stretching are both helpful ways to prevent and lessen bulging veins.


Trade Bad Habits for Healthy Ones


We all know that smoking is bad for us. It damages our blood vessels and restricts blood flow. This enlarges your veins and can cause them to bulge out. If you don’t want this to happen, stop smoking and start drinking—water that is. Getting lots of hydration keeps the blood flowing. This reduces pressure on your veins and can even help with skin elasticity.


When All Else Fails, Bulging Veins Can Be Fixed


Bulging veins are not a serious medical issue for the majority of people. But if you’re concerned that your popping veins are something serious (or if you just don’t like the way they look) make an appointment with a vein doctor.


If there’s a serious problem with your veins, a doctor can recommend treatment. And if you want them removed for cosmetic purposes, they can also make a suggestion for the best procedure. If bulging veins are a sign of a more serious condition, your doctor will offer specific medical treatments.

causes, treatment, consequences · Vascular Center. T. Toppera

What are veins?

Veins are the vessels that carry blood from the organs of the body towards the heart.

In the lower extremities there are superficial, deep, as well as their connecting – the so-called perforating – veins.

What is phlebology?

Phlebology is a branch of medicine related to the diagnosis and combined treatment of acute and chronic venous diseases. Phlebology is, along with arteriology and lymphology, a section of general angiology. Doctor specializing in this section – phlebologist

What are varicose veins?

Varicose veins (colloquially varicose ) are overstretched, irregularly shaped, tortuous blood vessels that have lost their elasticity. They are enlarged in length and width and look like thick, twisted blue plaits, translucent under the skin. Veins become so when the venous valves are absent or, for some reason, cannot perform their functions. If the valves do not work as they should, the blood flows through the veins in the opposite direction, down, accumulates in the lower sections of the veins and bursts their walls. As a result, the veins lose their natural shape, and a pathological chain of various complications begins.

What do varicose veins look like?

Varicose veins in different patients and even on different legs in the same patient are very different – both in appearance and in quantity. In some patients, varicose veins are not visible at all. In others, they bulge under the skin with writhing bundles and knots. But we must not forget that the severity of the disease rarely corresponds to the severity of such external manifestations.

How common is varicose veins?

Varicose veins are one of the most common diseases of the vascular system. According to some statistical estimates, up to a third of the entire population of Western countries suffers from varicose veins. The number of people who have varicose veins increases with age, with women being affected much more often than men. According to statistics, in the age group up to 25 years, only 8% of women suffer from varicose veins, and in the older age group – from 55 years and older – 64% of women are affected by varicose veins.

How can you recognize varicose veins?

The most common symptom of varicose veins is fatigue, dull pain, feeling of heaviness and fullness in the legs after sitting or standing for a long time. Often these symptoms appear or worsen in the evening. In this case, it is usually impossible to determine exactly where it hurts. And if these unpleasant symptoms – fatigue, heaviness, pain – disappear after resting with raised legs, then they are really caused by varicose veins (unless some other reason has been reliably identified).

However, do not rush to blame everything on varicose veins, especially if there are no external signs in the form of dilated veins. The same symptoms can manifest and some other painful conditions.

Varicose veins may be the only manifestation of chronic vein diseases or be accompanied by the presence of subjective symptoms: pain (aching, dull, buzzing), feeling of pulsation, throbbing pain, feeling of tightness, pressure, heaviness in the legs, fatigue of the legs, feeling of swelling, convulsions, skin itching, feeling of restlessness in the legs, a tingling sensation, a feeling of heat or burning. Often, varicose veins are accompanied by the presence of vascular “asterisks” (telangiectases) and “nets” (reticular veins). These vascular elements are a purely aesthetic problem and are widespread even in the absence of varicose veins in healthy people. A complication of varicose veins is chronic venous insufficiency, which is manifested by edema and trophic disorders, up to the formation of a venous trophic ulcer.

Leg cramps

In case of varicose veins, painful nocturnal leg muscle cramps (in other words, “leg cramps”) can indeed occur. Most often, cramps appear in the calf muscles and can sometimes be so painful that the patient wakes up. Moreover, night cramps are usually after a hard day, when the patient had to stand or sit a lot.

Where do varicose veins usually appear?

Varicose veins most often appear on the superficial leg veins, just under the skin. The great saphenous vein, which runs along the inside of the leg from the ankle to the groin, is usually affected.

Is varicose veins hereditary?

Varicose veins are not genetic diseases. For its occurrence, it is necessary to influence environmental factors, which include, first of all, lifestyle. The onset and progression of the disease is associated with the influence of such provocative factors as prolonged static loads in a standing or sitting position, weight lifting, pregnancy, childbirth, taking estrogen-containing drugs, etc. The incidence increases with age, however, a significant number of cases of varicose veins are observed in individuals under 30 years old.

Varicose veins in pregnancy

Pregnancy does not cause varicose veins, but is often the trigger for varicose veins in women who are predisposed to them. For example, in people with congenital insufficiency of venous valves or even their absence. This fact has already been established quite definitely, because many pregnant women do not have any varicose veins. Sometimes varicose veins appear only during the fourth, fifth or tenth pregnancy.

And in some women, they appear during pregnancy and disappear immediately after the birth of the child. Pregnancy acts as a trigger factor for varicose veins due to the fact that during pregnancy the blood levels of a woman’s sex hormones – estrogen and progesterone – rise sharply. These hormones in high concentrations contribute to the softening of the venous walls, the veins are stretched, and the valves cannot close normally because of this.

Maybe it will go away on its own?

Varicose veins are a steadily progressive disease that, if not treated promptly, can lead to complications. It has been established that in the presence of varicose veins, the annual probability of the appearance of new varicose veins reaches 25%, the probability of edema and trophic disorders reaches 5%, the probability of trophic ulcers is up to 1%, and the risk of thrombophlebitis is up to 1.3%.

Types of varicose veins

Varicose veins are divided into two main groups:

  1. The first group includes primary varicose veins due to hereditary predisposition to varicose veins.
  2. The second group includes varicose veins that appeared after damage to the venous walls as a result of trauma with the formation of blood clots in the veins or thrombosis.

When a clot or thrombus passes through a vein, the integrity of the venous valves is disrupted and secondary varicose veins are formed.

Varicose veins

Varicose veins are tufts of thin purple or red veins that appear around the knees or ankles. (Sometimes these spider webs can appear on the face, near the nose.) These vessels cannot be called varicose veins because, by definition, varicose veins are veins that are enlarged in length and diameter. In fact, these are slightly dilated venules (vessels connecting the capillaries to the veins themselves), which are located close to the surface of the skin.

These dilated venules are due to increased levels of female sex hormones in the blood and are not uncommon in women taking oral contraceptives. But venules can also expand in the presence of varicose veins of larger veins that have not manifested outwardly. However, women with varicose veins often have symptoms that are very similar to those of varicose veins.

COVID infection

COVID infection is known to negatively affect the blood coagulation system. After a viral illness, the risk of deep vein thrombosis increases several times and is characterized by a more aggressive course. In addition, coronavirus infection has a direct negative effect on the venous wall, the weakening and thinning of which can trigger the process of varicose vein transformation and ultimately lead to complications such as the development of trophic ulcers and varicothrombophlebitis of the dilated vein. To assess the risk of a negative impact from the past disease, a consultation with a cardiovascular surgeon is recommended, who will prescribe the necessary studies.

Treatment of varicose veins

Treatment depends on the severity of the disease. If the disease is not too severe, then conservative treatment is best:

  • regular rest with legs raised,
  • elastic bandage (or special elastic stockings),
  • physical exercises for leg muscles.

These measures are often not enough, the disease progresses, and the veins affected by varicose veins must be surgically removed. Formed varicose veins can only be eliminated by surgical removal, thermal obliteration or sclerosing. To date, there are no non-surgical methods for the elimination of varicose veins. Any methods of non-surgical treatment are aimed only at eliminating the subjective symptoms that may accompany the presence of varicose veins. Elimination of varicose veins is necessary to prevent further progression of the disease, reduce the risk of possible complications, improve venous outflow, reduce the severity of subjective symptoms and improve appearance.

For the treatment of varicose veins of the lower extremities in the initial stages of the disease (spider veins, intradermal varicose veins) and on small veins in the Center for Vascular Surgery. T. Topper uses the method of sclerotherapy, which is very effective and inexpensive. The procedure is not surgical in nature, it consists in the introduction of special drugs directly into the affected vein using a syringe with a very thin needle, that is, the introduction of sclerosing substances into the places of expansion, which causes clogging of the pathological vein. The procedure is unique in providing an instant visual effect. Blood returns to the heart through normal veins.

Various methods and their combinations can be used to remove sources of pathological blood shedding and varicose veins: removal, endovasal laser ablation (EVLA), radiofrequency ablation (RFO), sclerobliteration (sclerotherapy). All methods are effective and the choice of a specific method of treatment is based on the experience and preferences of the doctor, as well as the technical equipment of the medical institution.

Endovasal laser coagulation

Specialists of the Vascular Center use the possibility of treating varicose veins using laser ablation without anesthesia and incisions.

The technique of laser coagulation allows you to quickly, easily and effectively get rid of swollen leg veins. The main advantage of laser treatment of varicose veins is an excellent cosmetic result with minimal trauma. A reliable result is ensured by the possibility of conducting an ultrasound examination directly during and immediately after the procedure.

Unlike open surgery, laser photocoagulation:

  • does not require anesthesia;
  • performed without incisions;
  • possibility of carrying out under local anesthesia;
  • it is possible to treat both legs at the same time;
  • the patient experiences minimal pain;
  • no need for long-term hospitalization, no disability.

For complex and advanced cases, there is always the possibility of surgical removal of veins (combined phlebectomy) with an acceptable cosmetic effect

Who is the operation for

In most cases, it is not possible to cure varicose veins with conservative methods or the results are not always encouraging. Time is lost and the disease begins to progress. The goal of surgery is to eliminate the pathological blood flow through the veins and eliminate venous congestion.

The procedure is prescribed for the following symptoms:

  • bulging and varicose vein transformation;
  • heaviness and soreness in the lower extremities;
  • soreness in the feet;
  • redness, induration of the skin of the legs;
  • frequent subcutaneous hemorrhages;
  • swelling of the lower extremities;
  • rapid onset of fatigue in the legs after physical activity;
  • convulsions.

Compression hosiery must be worn after any of the above interventions. Terms and rules of wearing are discussed with the attending physician.

Complications of treatment

The main danger of conservative treatment (elastic stockings, exercise and rest with legs raised) is its possible ineffectiveness.

Surgical treatment of varicose veins of the lower extremities must now be performed by experienced vascular surgeons and phlebologists . Often complications and relapses after surgical treatment are caused by the fact that the operation was performed by a non-specialist of the phlebology center.

With sclerotherapy, the main trouble is small dark spots that can remain at the injection sites for several months, in some cases forever.

Dilated veins after surgical treatment

If varicose veins have been removed, varicose nodes will no longer appear in their place. However, sometimes varicose veins are also found after surgery – in veins that were not previously affected, or in small veins that were not identified during the preoperative examination. Varicose veins after surgery appear because the blood is forced to find new ways to outflow. At the same time, a larger volume of blood is redistributed to the remaining veins than before, and if there were any defects in the valves or walls in them, then new problems arise. New varicose veins, as a rule, bring cosmetic inconvenience and are easily eliminated by a phlebologist using modern sclerotherapy techniques.

Complications of varicose veins

The most common complications are thrombophlebitis. With the ascending nature of thrombophlebitis, when inflammation passes to the thigh. There is a danger of a life-threatening condition of pulmonary embolism. With severe stagnation (chronic venous insufficiency), the skin of the limb becomes dense, pigmented at the slightest injury, non-healing trophic ulcers open.

Vascular surgeons of our center have been successfully fighting both the disease itself and its complications for many years.

treatment, symptoms, causes, prevention · Diseases of the veins · Vascular Center.

T. Toppera

The Center for Aesthetic Phlebology and Laser Technologies has started its work at the Department of Vascular and Endovascular Surgery of the Clinical Hospital 122 named after LG Sokolov. Today in our center it is possible to treat not only serious diseases of peripheral arteries and veins, but also solve a whole range of aesthetic problems of the skin and its appendages.

Laser Aesthetic Phlebology Center deals with the treatment of the entire spectrum of vein diseases at the highest level. Having the capacity of a multidisciplinary hospital and the autonomy of an outpatient center, our doctors in a short time carry out highly informative diagnostics and low-traumatic treatment of all types of varicose veins, venous thrombosis and their consequences, as well as help in solving a variety of cosmetic problems of the vascular profile.

A complete treatment of all forms of varicose veins today is unthinkable without a combination of modern techniques: microsurgical techniques, sclerotherapy, phlebological and transcutaneous laser. It is the use of these methods that allows you to remove not only the cause of the appearance of varicose veins, but also the smallest cosmetic problems, incl. vascular networks and pigmentation.

Our department has at its disposal the latest American laser platform, Cutera Xeo, equipped with a neodymium laser using Vascular and Genesis technology and a short wavelength laser – LimeLight.

How the vascular removal procedure works

After examination, photographic fixation and, if necessary, ultrasound examination of the problem area and identification of indications for the use of laser therapy or a combination of laser coagulation and sclerotherapy, the affected area is treated with an antiseptic solution, sclerotherapy is performed through micropuncture, after which it is applied a transparent gel on which the doctor works with a laser.

Before the flash of the laser, the patient’s skin is strongly cooled to reduce pain. If necessary, an anesthetic gel is used. Compression stockings are not required but may be helpful if the lesion is large.

The average duration of the procedure is 20-40 minutes.

Restrictions after the procedure

There are no strict restrictions in sports and physical activity after laser photocoagulation and sclerotherapy.

If a laser is used for fine meshes (diffuse redness), do not sunbathe for 1-2 months before and after the procedure.

Expected effects

After vascular treatment with laser and sclerotherapy, the skin may turn red, a slight swelling may appear, which, with proper care, disappear after 1-4 days.

After the laser vascular removal procedure, the vessels will become more visible for a while due to the coagulation of the vascular wall. But do not be afraid! This means that the blood flow through them has stopped and after 1-3 months they will disappear.

Modern treatment of vein diseases is a combination of high efficiency and safety of the methods used, which is possible only due to the introduction of the latest technical developments and the rich clinical experience of our continuously trained specialists.

Upon contacting our center, a full-fledged vascular diagnosis can be carried out already at the first appointment and an individual plan for your treatment can be drawn up.

All treatment procedures carried out in our center are performed in compliance with the principles of high efficiency, low trauma and aesthetics, which in many cases allows us to reduce the time or completely avoid hospitalization, and the latest laser equipment available makes the treatment process quick and painless.


The results of our work speak for themselves.

The result of treatment of unaesthetic veins of the temporal region with Cutera neodymium laser The result of the use of transcutaneous laser and sclerotherapy The result of the treatment of unaesthetic foot veins by sclerotherapy The result of the treatment of perforant veins by endovenous laser coagulation

However, the main success criterion for a doctor is not just a beautiful picture, but first of all, satisfaction patient treatment.