Varicose veins are veins that have become enlarged and tortuous. The term commonly refers to the veins on the leg,[1] although varicose veins can occur elsewhere. Veins have leaflet valves to prevent blood from flowing backwards (retrograde). Leg muscles pump the veins to return blood to the heart, against the effects of gravity. When veins become varicose, the leaflets of the valves no longer meet properly, and the valves do not work. This allows blood to flow backwards and they enlarge even more. Varicose veins are most common in the superficial veins of the legs, which are subject to high pressure when standing. Besides cosmetic problems, varicose veins are often painful, especially when standing or walking. They often itch, and scratching them can cause ulcers. Serious complications are rare. Non-surgical treatments include sclerotherapy, elastic stockings, elevating the legs, and exercise.

Complications :

Most varicose veins are relatively benign, but severe varicosities can lead to major complications, due to the poor circulation through the affected limb.
1. Pain, heaviness, inability to walk or stand for long hours thus hindering work
2. Skin conditions / Dermatitis which could predispose skin loss
3. Skin ulcers especially near the ankle, usually referred to as venous ulcers.
4. Severe bleeding from minor trauma, of particular concern in the elderly.
5. Blood clotting within affected veins. Termed superficial thrombophlebitis. These are frequently isolated to the superficial veins, but can extend into deep veins becoming a more serious problem.
6. Acute fat necrosis can occur, especially at the ankle of overweight patients with varicose veins. Females are more frequently affected than males.

Stages

1. C0 no visible or palpable signs of venous disease
2. C1 telangectasia or reticular veins
3. C2 varicose veins.
4. C3 edema.
5. C4a skin changes due to venous disorders: pigmentation, eczema.
6. C4b skin changes due to venous disorders: lipodermatosclerosis, atrophie blanche.
7. C5 as C4 but with healed ulcers
8. C6 skin changes with active ulcers (venous insufficiency ulceration)

Varicose veins are more common in women than in men, and are linked withheredity[6]. Other related factors are pregnancy, obesity, menopause, aging, prolonged standing, leg injury and abdominal straining. Less commonly, but not exceptionally, varicose veins can be due to other causes, as post phlebitic obstruction and/or incontinence, venous and arteriovenous malformations[7] See also for differential diagnosis- 1. Klippel-Trenaunay syndrome, 2. Parker-Weber syndrome.