Varicose veins (Varicosity; Varicosis) are the largest ropy veins seen especially in the legs and ancles. varicose veinThey may appear as swollen, twisted clusters of blue or purple veins. Varicose veins are the result of normal veins being exposed to high pressure over a prolonged period of time. In normal veins, valves in the vein keep blood moving forward toward the heart.

Varicose veins, which are normally a clearly visible veins, develop when you have faulty valves in your veins and weakened vein walls. When these valves do not function properly (inhibit the re-circulation of the blood back to the heart), the blood cannot overcome gravity’s effects and begins to flow backward and pool in the veins.

Because of that pressure builds up and the veins become enlarged, weakened and twisted. As a result the veins become more visible under the skin. Once a vein becomes varicose, it usually does not return to normal. Varicose veins caused by a problem in deeper veins may be due to a more severe blood circulation problem called chronic venous insufficiency (CVI).

Aproximately 40 million people in the United States have varicose veins. They become more prevalent with age and have been reported to affect from 30-60% of the adult population. Varicose veins primarily affecting women. It is estimadted that more than 20% of women develop some form of varicose vein. In some women, the enlarged veins first occur during pregnancy, possibly because of hormone changes and physical pressure caused by the growing baby.

Signs and symptoms of varicose veins

  • Aching pain
  • Legs that tire easily
  • Leg swelling (usually feet and ancles)
  • Redness and heat in the irritated area
  • Heaviness in legs
  • Skin darkening
  • Tingling or burning sensations
  • Muscle cramps
  • Itching skin

Varicose veins are relatively easy to identify and can be a cosmetic nuisance for many people. Most people identify varicose veins by the appearance of twisted, swollen, bluish veins just beneath the skin. If you experience above mentioned symptoms and if you delay treatment, your symptoms may progress onward to more serious complications such as inflammation (phlebitis), blood clots (e.g., DVT), ankle sores or skin ulcers (ulceration), bleeding and Chronic Venous Insufficiency (CVI). Some people may have no symptoms at all. For most people, varicose veins are mainly a cosmetic problem. But is good to know that even if the veins are not causing symptoms, they have the potential of becoming progressively larger and developing complications over time. Varicose veins will not go away without treatment.

Causes of varicose veins

  • heredity
  • hormonal factors
  • pregnancy
  • ageing
  • obeseness
  • leg injury

Heredity, pregnancy, prolonged standing and obesity all act to cause valves to break down and leak. When treating varicose veins, the veins containing the bad valves must be eliminated for long lasting results. People who are overweight or people who are working while standing for a longer time might get varicose veins. Pregnancy, pre menstruation, and menopause are some of the factors in women that influence varicose veins. During pregnancy, hormones relax the veins and more blood travels through the veins. Varicose veins often develop during pregnancy and resolve shortly after childbirth. Lack of exercise, prolonged constipation, and sitting with legs crossed can compound the problem.

Diagnostic procedure

  • visual observation
  • phlebography (a painless procedure in which a solution called a radio-opaque contrast medium is introduced into the bloodstream to detect the abnormalities in the blood flow and venous pressure)
  • use of ultrasound to examine the blood flow in the major arteries and veins. This procedure is also known as Doppler’s ultrasonography.
doppler ultrasonography Doppler ultrasonography can detect the direction, velocity, and turbulence of blood flow. Because it is non-invasive and uses no x rays, doppler ultrasongraphy is widely used for numerous diagnostic procedures.
llustration: Electronic Illustrators Group

Varicose veins treatment

Surgical treatments for varicose veins are usually performed by general and vascular surgeons. Sclerotherapy is performed by dermatologists, family practitioners, internists and some general, vascular and plastic surgeons. The treatment of varicose veins varies per patient. It depends upon the results of an ultrasound examination. The most common surgical treatment includes stripping of the long and/or short saphenous veins. Treatment programs such as sclerotherapy, laser surgery, surgical vein stripping, ambulatory phlebectomy and endoscopic vein surgery are tailored to each individual. Patients may receive a combination of treatments, and most patients participate in some self-care therapies as well. Self-help measures – such as wearing elasticised compression stockings, regular exercising, controlling and if necessary your losing weight, not wearing tight clothes, avoiding long periods of sitting or standing – can ease pain and prevent varicose veins from getting worse. Varicose veins will not get better by themselves but are likely to get worse. That’s why is recommended to be treated as early as possible. The earlier you receive specialist treatment the better the long term clinical and cosmetic results. If left untreated, irritation of the skin around the ankles with swelling of the feet (worse at the end of the day) and discolouration may occur. Finally, eczema, phlebitis (inflammation of the vein) and ulceration may occur.

Side effects of varicose vein treatment

  • The side effect of surgery under anesthesia may include nausea, vomiting and a slight risk of infection in the incision. Surgery may cause bruises and areas of hardening near the scars in the operated leg. Bruising usually goes away during the first several weeks after the treatment.
  • The side effects of sclerotherapy may include allergic reactons. Sclerotherapy can cause small blood clots in the injected veins. The other possible side effects of Sclerotherapy are: temporary stinging or painful cramps, red raised patches of skin, small skin sores, and temporary bruises where the injection was made.
  • Laser and pulsed light treatments also may cause scarring. Poorly performeded laser surgery may cause rarely burns and scars.

Above mentioned side effects are normal and are expected after a successful treatment procedure. Most treatments have minimal side effects and recovery time.

What can be done to prevent varicose veins?

  • maintaining a normal weight
  • wearing support or compression stockings
  • avoiding long periods of standing or sitting
  • don’t cross your legs when sitting.
  • exercise regularly – walking
  • eat high-fiber foods like bran cereals, whole grain breads, fresh fruits and vegetables

As we mentioned surgical treatment is available to avoid varicose veins. But as we know it is always healthier and less expensive to prevent, rather than treat most health problems. Prevention for varicose veins initially begins with the wearing of support hosieryor compression stockings. They can significant improve circulation of blood. Wearing properly fitted therapeutic compression hosiery, especially during pregnancy, may help lower the risk of thromboembolic disease. Healthy diet is also appreciated if you like to avoid the occurrence of varicose veins. Weight reduction in patients with obesity may reduce valvular incompetence by reducing intra-abdominal pressure. Regular exercising such as walking, bicycling, and swimming are recommended for varicose veins. Limiting excessive standing or sitting may be helpful in alleviating symptoms. Since the above measures do not treat the underlying cause of the disease, varicose veins will usually enlarge and worsen over time. Many people with varicose veins also have spider veins, which are enlarged capillaries.