These are defined as tortuous dilated veins. They affect 5% or more of the adult population of western countries. Any vein may become varicose, but the veins most commonly affected are those in your legs and feet. That's because standing and walking upright increases the pressure in the veins of your lower body resulting in incompetence of venous valves

Symptoms

• Aching, heavy legs (often worse at night and after exercise).
• Appearance of spider veins (telangiectasia) in the affected leg.
• Ankle swelling, ankle swelling, itching, bleeding, superficial thrombophlebitis, eczema, lipodermatosclerosis and ulceration.
• Cramps may develop especially when making a sudden move as standing up.

Causes

• chronic heart valve conditions, which are usually congenital
• pregnancy
• menopause
• standing for long periods of time
• pressure on the midsection of the body, especially the abdomen
• obesity, which adds weight to the body and increases the pressure on the legs

Complications

• Pain, tenderness, heaviness, inability to walk or stand for long hours
• Skin conditions / Dermatitis which could predispose skin loss
• Skin ulcers especially near the ankle, usually referred to as venous ulcers.
• Development of carcinoma or sarcoma in longstanding venous ulcers.
• Severe bleeding from minor trauma, of particular concern in the elderly.
• superficial thrombophlebitis

Treatment

Treatment can be either conservative or active. Active treatments can be divided into surgical and non-surgical treatments.
Injection sclerotherapy

Ultrasound-guided foam sclerotherapy

Surgical : invasive saphenous stripping