As if being ugly weren't bad enough, those big blue bulges can really hurt. We're talking about varicose veins, the bane of more than 25 million Americans, the majority of whom are women. Until recently, some of the options for getting rid of varicose veins seemed worse than the condition itself. But a new technique called "closure" makes banishing the blue meanies a lot easier.

Where Do Varicose Veins Come From?

What goes down must come up, in our circulatory systems anyway. Varicose veins can occur anywhere in the body, but they're most common in the legs. Normally, blood that has traveled all the way down to the feet returns toward the heart, in defiance of gravity, with the aid of a system of valves in the veins. But if a valve is defective or a portion of the vein wall is weak, de-oxygenated blood accumulates in that area, creating the familiar blue bulge.

"Most people don't realize that varicose veins are formed because of a defect in the way the vein is made initially, during our development, so that it is too stretchable," explains Dr. Robert Weiss, Assistant Professor of Dermatology at Johns Hopkins University School of Medicine. "Once it stretches beyond where the valves can meet, the blood is free to flow backwards in the wrong direction."

But you don't have to see the tell-tale bulge to suspect you have a varicose vein. Symptoms sometimes include minor swelling, a feeling of heaviness in the legs, or a dull aching in the affected area. In some cases, the pain can become intense as the distended vein pushes against surrounding nerves.

No one is sure what causes the initial malformation, but vulnerable veins may be partially hereditary. Hormones also seem to contribute to the problem, which may account for the fact that women are nearly twice as likely as men to develop varicose veins. An injury, or added pressure due to pregnancy or obesity can also make a good vein turn ugly.

While varicose veins are mostly just unsightly and uncomfortable, they can occasionally cause more serious problems. When a swollen vein doesn't allow adequate drainage of fluid from the surrounding tissue, an ulcer can form on the nearby skin. Within the vein itself, painful inflammation called phlebitis can develop, and in some cases, dangerous blood clots can form, called thromboses. The American Academy for Dermatologic Surgery estimates that nearly 100,000 Americans are completely disabled by varicose veins.

Common Treatment Options for Varicose Veins

There is no fix for the fatally flawed vein, so current treatments are designed to destroy or remove the offender. Most have excellent success rates, but some are no walk in the park. With all of these methods, side effects can include bruising, swelling of the leg or foot, itching, and minor scarring.

Sclerotherapy

A "sclerosing" (hardening) solution such as saline is injected into the vein, causing it to collapse. The "dead" vein slowly becomes scar tissue that is eventually reabsorbed into the body. While the procedure can be performed in a doctor's office and the injection is relatively painless, in many cases, it must be performed several times before the vein or veins are eliminated. Treatments must be separated by at least 4 to 6 weeks, and following each session, the patient has to wear compression bandages or support hose for two days to three weeks.