The groups at higher risk for varicose veins include:

• Family History: Genetics can increase the risk of varicose veins, though people with no family history can also develop them.
• Women: Hormonal changes make varicose veins more common in women.
• Women Who Have Given Birth: Especially those with two or more childbirths are at higher risk.
• Overweight Individuals: Being overweight, especially for women, increases the risk of varicose veins.
• Professionals Who Stand or Sit for Long Periods: Those whose jobs require prolonged standing or sitting are more prone to developing varicose veins.

Varicose veins primarily occur when the valves in the veins fail to function properly. Normally, blood in the leg veins flows in one direction—from the feet back to the heart. When these valves are insufficient, blood flows backward and pools in the legs, causing the veins to widen, leading to varicose veins over time.

The symptoms of varicose veins include:

• Pain: Intense pain below the knee is the most common symptom.
• Pain in the Varicose Vein: Women may feel increased pain in the varicose veins, especially during menstruation.
• Swelling: General swelling is observed, especially around the ankles.
• Fatigue and Heaviness: Legs may feel heavy and fatigued.
• Burning or Warmth: A burning sensation in the lower leg is common, especially in warm weather.
• Cramps and Itching: Night cramps and localized itching in varicose areas are possible.

• Symptoms are mild in the morning but worsen as the day progresses.
• Symptoms are usually concentrated below the knee.
• Elevating the legs at night provides relief.
• Wearing compression stockings reduces discomfort.
• Symptoms are worse in hot weather and less severe in cold weather.
• Walking alleviates symptoms, whereas standing or sitting for prolonged periods exacerbates them.
  Young individuals, especially young women, may experience these symptoms without visible varicose veins. A Color Doppler Ultrasound can help identify underlying venous issues in the legs.

Advanced varicose veins, although rarely, can cause bleeding. Since varicose veins are close to the skin surface, bleeding can occur suddenly. Applying pressure can help stop the bleeding, and medical treatment should be sought afterward.

In large, twisted varicose veins, poor blood flow can lead to clot formation. The clot typically remains in a specific part of the varicose vein, causing it to harden and lead to pain and sensitivity. Although clots do not spread, they still require treatment.

Severe varicose veins can cause thinning and discoloration of the skin around the ankle area. Untreated, this may lead to hard-to-heal ulcers called stasis ulcers.

• Pain from varicose veins is milder in the morning and worsens throughout the day.
• Pain is typically concentrated below the knee.
• There is a tendency to elevate the legs in the evening to relieve discomfort.
• Leg elevation and compression stockings alleviate pain.
• Pain is more pronounced in warm weather and less in cold.
• Walking reduces pain, while prolonged standing or sitting worsens it.
  If your leg pain matches these symptoms and varicose veins are visible, treating the varicose veins may reduce or eliminate the pain and visible veins.

Large varicose veins are visible to the naked eye. However, deep-seated varicose veins require diagnosis through Color Doppler Ultrasound, which is essential for accurate diagnosis and proper treatment planning.

Prevention tips for varicose veins include:

• Exercise: Activities like walking, swimming, and cycling that engage the leg muscles reduce varicose vein risk.
• Avoid Prolonged Standing or Sitting: If sitting for long periods, perform ankle exercises to promote circulation.
• Elevate Your Legs: Elevating your legs at the end of the day promotes blood flow.
• Avoid High Heels: Wearing high heels for prolonged periods can impair leg muscle activity.
• Weight Control: Maintaining a healthy weight, especially for women, helps prevent varicose veins.
• Stay Active During Pregnancy: Remaining active and using compression stockings during and after pregnancy is beneficial.

Hormonal changes, weight gain, and pressure from the uterus on blood vessels increase the risk of varicose veins during pregnancy. Women with prominent varicose veins before pregnancy should consider treatment beforehand. During pregnancy, varicose vein treatment is not recommended; however, wearing compression stockings and light walking are helpful.

Restless Leg Syndrome (RLS) is a neurological condition. Symptoms of RLS may resemble those of varicose veins, so it is crucial to distinguish between the two.
RLS manifests as an uncomfortable sensation in the legs, often requiring movement to relieve it. To diagnose RLS, two of the following criteria should be met:

• A sensation like water flowing, tingling, or pins and needles in the leg, relieved only by movement. This sensation occurs primarily at night but may also appear during the day.
• A family history of restless leg syndrome.
• Symptoms improve or disappear with medication prescribed by a neurologist.
  RLS often disrupts sleep and can gradually reduce quality of life in severe cases. While there is no cure, certain medications may relieve symptoms. Walking exercises are also recommended for RLS.

A small percentage of varicose vein patients (around 1%) experience symptoms similar to RLS. This is called a "Restless Leg-Like Condition" rather than true Restless Leg Syndrome. Treating varicose veins in patients with venous insufficiency and varicose veins can reduce or eliminate these symptoms.

Foam or RF ablation therapy is not recommended for pregnant women, individuals with vein blockages, or those allergic to the sclerosing agent used.

If combined with larger varicose vein treatment, no additional preparation is needed. However, if performed alone, bring compression stockings or bandages as advised by your doctor.

Foam or RF ablation therapy is quite comfortable and lasts about 30-45 minutes. Relaxing medications may be provided before the procedure.

Foam therapy is a low-risk procedure, but potential side effects include:

• Temporary skin discoloration (pigmentation)
• New spider veins in the treated area
• Rarely, temporary chest tightness, cough, or headache
• Very rarely, clotting in normal veins

No hospitalization is necessary. Patients can walk in and walk out after the procedure.

Most people can return to daily activities the same day. Light walking is recommended after the procedure, and work can typically resume the next day. Pain levels vary; pain relievers are prescribed if needed.

Your doctor may schedule follow-ups at regular intervals after the procedure.

• Inform your doctor if you experience leg pain or swelling.
• Continue using elastic bandages or compression stockings as directed.
• You may shower the day after the procedure.
• The number of sessions required depends on the extent of varicose veins. Extensive cases may need 4–5 sessions.

Foam therapy has a success rate of approximately 60-70% for spider veins and 90% for medium-sized veins. Although foam therapy may not remove all varicose veins in a single session, it is especially effective for treating medium-sized, greenish veins.
RF ablation is a highly effective method for treating spider veins with a success rate of 90%.

Non-surgical options like laser, radiofrequency, or glue (adhesive) treatments are highly effective, with success rates of 95%.

After the procedure, the treated leg is bandaged. Patients are given a medical treatment plan, including antibiotics and pain relievers, before going home. Bandages may be removed the next day.

• Avoid bathing and strenuous exercise on the first day after the procedure. Mild pain, redness, and firmness are normal and generally resolve within 1–2 weeks. Pain relievers can be used if needed.
• Regular follow-ups are conducted to monitor the treated veins and overall progress, using clinical evaluation and color ultrasound.