Varicose veins for some women are a cosmetic concern. For others, however, they mean pain and swelling, and possibly other circulatory problems.

Who gets varicose veins? The number one risk for developing varicose veins is inherited from parents.

Varicose veins are due to weakening of the strength of the vein itself, which leads to dilation and malfunction. This leads to more dilation, which leads to pooling of blood in veins and acting as a poison to the leg — that's in extreme cases. Varicose veins can cause pain, leg fatigue, swelling and leg ulcers.

Other symptoms may include dry, scaling skin on the legs, feet or ankles, itching near the vein, dry or thinning skin, changes in color and burning.

Unfortunately, for some women there's a stigma associated with seeking help for varicose veins. They don't want to be viewed as complainers and they don't want to show anyone their legs when they have bulging veins, heaviness, fatigue and soreness.

Other risk factors include prolonged standing without breaks and support for legs, pregnancy, being overweight — it impairs functions of the veins in the legs — heavy lifting and lifestyle.

Women, for example, suffer needlessly with conditions such as severe superficial venous insufficiency, a condition in which the valves in the superficial veins begin to leak blood backwards towards the feet. This can lead to swollen, tired and painful legs.

Many patients are misdiagnosed because they're not seeing a physician who specializes in vein treatment.

See a physician if a vein looks red, swollen, painful or even feels warm. Check for sores or rashes on your legs near the varicose vein and be aware of any changes in circulation, like unusually cold feet.

Within the last 10 years, advanced doppler ultrasound has become the test of choice to detect bad veins. A doppler ultrasound only takes about 25 minutes.

Varicose veins usually become visible in a person's late 20s. Normally, these aren't serious, but sometimes can lead to other problems. Realize that you don't have to suffer. There are less invasive treatments available today.

Ricardo Rao, MD, FACS, general and vascular surgeon and medical director of the Vascular Laboratory, Missouri Baptist Medical Center. He is board-certified in general and vascular surgery and is on staff at Missouri Baptist Medical Center. For a referral, call 314-996-LIFE.