Love Your Legs
Take steps to get back legs that look and feel good.
If you've spent most of the summer wearing pants to hide your varicose or spider veins, you've got lots of company. An estimated 40 percent of all women have some vein problems in their legs, compared with 10 to 25 percent of men.
Pregnancy, birth control pills and aging, along with obesity and spending long periods sitting or standing, are believed to contribute to those ropy, blue veins. But the biggest risk factor is probably your mother; heredity seems to be the best predictor. Varicose veins appear when the valves that are meant to keep blood flowing in just one direction-back to the heart and lungs-begin to fail, causing blood and fluid to pool.
When Should I Worry?
Varicose leg veins often are only a cosmetic concern. But they can produce burning sensations, pain, fatigue and swelling. You may find you cannot stand for a long time. Fritz Angle, M.D., an interventional radiologist at the University of Virginia Health System, says you may be able to improve symptoms and prevent worsening of varicose veins by regularly elevating your legs, getting more exercise, losing weight and wearing support hose. If that doesn't help, Angle says, there are a number of good options. He usually begins with an ultrasound exam to determine the extent of the problem. Angle often recommends a technique called endovenous laser therapy that requires only an office visit. After numbing the area, he inserts the laser 
through a tiny incision in the calf. In just two minutes, the laser burns the lining of the vein, causing it to collapse. Most patients go back to work the same day. The benefits generally last five years, although new veins do sometimes surface.
In some cases, sclerotherapy may be recommended. This involves injecting a solution into the veins that cause the vein walls to collapse and disappear. Usually, this takes several treatments and can cause some bruising that lasts two or more weeks. Except for wearing a compression bandage or hose for several days, activity is not restricted.
When to Consider Surgery
For big veins (3 mm or larger), the best option is usually surgical removal, says Nancy Harthun, M.D., a UVa vascular surgeon. In a procedure called vein stripping, a large vein is removed from the leg through a couple of small incisions. It is usually performed on an outpatient basis, and most people return to work in four to 11 days. Deeper leg veins take over the function of the removed vein.
Standing Tall Again
Diane Cole, a UVa Health System patient educator, suffered with painful varicose veins for 16 years before she consulted Harthun and chose the surgical option. "It was the best thing I've ever done for myself," Cole says. Before the surgery, jogging had become painful and a day spent baking Christmas cookies was no longer a joy. "I really suffered at the end of any day I spent on my feet," she recalls.
The vein stripping required Cole to spend a day at the hospital, spend a few days with her legs wrapped and use pain medication for a day or two. "My legs don't get tired and painful anymore-even while jogging," she says. "And I am no longer embarrassed to wear shorts."
Take Steps to Lovelier Legs
Don't hide your legs or ignore pain. Most insurance plans will pay for treatment if considered medically necessary. Call 888-882-9892 to make an appointment with a cosmetic or medical specialist at UVa Health System.