Our legs can sometimes be a neglected area when it comes to health and self-care. They work hard, and we often forget to take care of them until it’s too late!
One problem that can occur in our legs are varicose veins, particularly as we age, but not exclusively so. They’re an often misunderstood condition, with many sufferers failing to seek help to rectify the condition in a timely manner, whether due to fear, misinformation or simply not knowing what to look for.
In truth, they are a relatively simple condition to deal with and one that need not be a scary prospect if you seek help and advice on how to look after them, as soon as you can.
Frequently Asked Questions About Varicose Veins:
How Common Are Varicose Veins?
Varicose veins are a common problem. They are swollen, often over stretched veins which can be seen and felt underneath your skin. They usually form in the legs.
Most people who have them don’t experience any symptoms or problems with them. The main issue they cause for sufferers is embarrassment in terms of their appearance. This is completely normal and understandable. However, there are lots of ways they can be treated, and no-one need suffer from them in silence.
How Do Varicose Veins Form?
This condition develops when blood cannot flow properly through the veins in your legs. There are two different types of vein in the leg:
Superficial: These are near the surface
Deep: These are contained within the muscles
In a leg that has healthy and normal circulation blood should flow from the superficial veins to the deep veins and then back up to the heart.
When someone has varicose veins, it is usually a sign that there is high pressure in the veins of the leg. The valves inside your veins control the way the blood circulates and ensure that it goes in the right direction. When these stop working normally blood starts to collect in the veins of the legs. This in turn increases the pressure in the veins and makes them swell. Once this happens, varicose veins form.
There are certain health conditions which means some people are more susceptible to developing varicose veins, but equally they can occur in otherwise healthy people.
What Factors Cause Varicose Veins?
It’s not really clear why some people are more prone to varicose veins than others. However, the medical profession recognize that you’re more likely to develop them if you have other family members who have been susceptible to them in the past.
Other factors that may increase your risk are below:
- If you’re female. This is all down to hormonal changes and the fact that these fluctuations can make the walls of veins much more elastic.
- The ageing process – this is due to vein walls getting weaker as we age.
- Being very overweight or morbidly obese, as this puts more pressure on your veins.
You may also be more susceptible to varicose veins if:
- You’ve previously suffered from damaged leg veins or a blood clot.
- You have to stand for long periods of time, for instance, if you work in retail or any other profession that relies on standing all day at work.
- You’re pregnant – again, this is down to high levels of hormones in the bloodstream. The good news is that, if you get varicose veins during pregnancy they usually get better within a year of your baby being born.
Symptoms of Varicose Veins
These can vary person to person. The size of the varicose vein doesn’t necessarily dictate how bad the symptoms will be. Many who have them find they have no symptoms at all. However, some people do and they can include the following:
- Bulging, visible veins
- Feelings of aching or heaviness in the legs; This might worsen after standing for long periods of time.
- Restless legs or restless leg syndrome
- Patches of brown or purple skin on the lower legs, calves and ankles.
- Burning or itching sensations in the veins that worse after long periods of time standing up
- Swollen ankles and feet, again after spending long periods of time standing up
- Venous eczema skin ulcers on the lower leg
Some people can be susceptible to varicose veins which bleed but these are the exception, rather than the rule. If you do find this happening, contact a healthcare professional immediately.
Whilst these symptoms are all indicative of varicose veins, they may also be a sign of other underlying health problems. If you find you have one, or more of the symptoms described above, please contact your Doctor.
How are varicose veins diagnosed?
When you visit your Doctor they will ask about your medical history and any symptoms you think are concurrent with varicose veins. They will then give you an examination, part of which will need you to stand up.
If your symptoms are very bad or you are at risk of developing any complications, your Doctor might refer you straight on to a vascular surgeon. However, if you are largely symptom/pain free and in otherwise good health, but simply want to have them removed for aesthetic reasons you may be referred elsewhere.
It’s easy to spot varicose veins in your leg, and they’re relatively easy to diagnose. Sometimes, Doctors may suggest a special type of scan called a duplex ultrasound, to help diagnose and confirm cases of varicose veins.
A duplex ultrasound works by using sound waves to produce an image of he veins inside your leg and how blood flows through them.
They also show your veins in a lot more complex detail and can give an idea about how your varicose veins are positioned and how deeply they run. A duplex ultrasound can also help rule out the possibility of any other potential complications such as blood clots.
Treatments for Varicose Veins
Interim self-help treatments and suggestions for varicose veins
A good doctor will always offer suggestions on self-help measures that patients can take to decrease any symptoms brought about by varicose veins. These may include:
- Taking steps to lose weight if you’re obese or carrying a few extra pounds
- Encouraging light to moderate movement and exercise, including walking or swimming.
- Discouraging standing for long periods of time as this can increase pain and make symptoms worse
When sitting, making sure you sit with your legs raised and perhaps resting on a foot stool to keep them elevated and the blood circulating properly.
- Wearing compression stockings
- If you work in a job or have a profession that involves a lot of standing, then it’s imperative you alter your position as frequently as you can, and when you do so try to move your feet and legs as much as possible. Doing this will increase blood to the muscles and improve it’s flow.
- If you work in a job that is sedentary, do the same, and alter your position as much as possible. Try not to sit cross legged either, as this can hinder the flow of blood.
- Whenever you stop for a rest keep your legs raised.
- If you’ve been diagnosed with varicose veins during pregnancy, they can sometimes improve after the birth. Some Doctors will advise the wearing of compression stockings to relieve any swelling in the legs.
What are the different treatments for varicose veins?
A decent healthcare practitioner will discuss as many options as possible with you, once you’ve been diagnosed with varicose veins as different treatments are available that will suit the differing needs of the patient.
For instance, if you have been diagnosed with varicose veins, but they’re not causing you any pain or discomfort then you may decide, along with your Doctor that they can be left alone for the present moment. Regular check-ups may be advised, to make sure that your condition is monitored and not getting any worse. In the event it does, other options can then be explored.
Anyone suffering with varicose veins should be aware that even if they have been treated, they can recur. It’s important you talk to your Doctor about the likelihood of this happening, and the steps you can take to help yourself.
Options for non-surgical varicose vein treatment
For anyone who would like to consider non-surgical options to treat their varicose veins, there are a few options. These should always be undertaken in consultation with your Doctor or other healthcare practitioner.
Non-surgical treatments will simply block affected veins. Many patients worry that this will cause damage to the circulation, but this won’t happen as all the other veins in your legs take over to compensate.
It’s worth noting that non-surgical procedures, like the ones outlined below will require patients to wear compression stockings or bandages (or sometimes a combination of both) afterwards, for at least five days. After this period, you might then be advised to carry on wearing compression stockings for another week, only removing to bathe or shower.
In some cases of non-surgical treatment, Doctors offer an injection of anti-coagulation medicine, which will help stop the formation of blood clots anywhere in the body.
(video shows endothermal ablation for varicose veins – warning, graphic content)
This is a procedure which heats the varicose vein from the inside, forcing it to close off. It can be done with either a laser, or radio waves.
Although this sounds scary, it’s actually a much less invasive alternative to surgery to treat varicose veins, and it often results in a speedier recovery with far less pain and discomfort.
Endothermal ablation is normally carried out with a local anaesthetic, which is injected around the vein. This is the perhaps the only part of the procedure that will cause a little bit of discomfort.
(video showing how foam sclerotherapy for varicose veins works – warning graphic content)
In this form of treatment, a medical foam is injected into the varicose vein. It ‘damages’ the vein and forces it to close up.
It’s a simple, effective treatment though in some instances, patients may need more than one injection to block a vein off totally.
Just as endothermal ablation is done, this is also carried out with a local anaesthetic and you’re encouraged to be up, about and moving as soon as possible.
Your Doctor will make a very small cut in the vein and insert a catheter. Heat is passed along this and this is what seals off the problem.
The main advantage to this procedure is it’s quick, you can go home the same day and you’re encouraged to keep moving and mobile from the get-go.
(video shows ligation and stripping of varicose veins – warning, graphic content)
Sometimes surgery is the only option, if your varicose veins need more specialist attention.
Varicose vein surgery involves a surgeon removing superficial veins that have become varicose. The bigger veins in your legs than run deeper will then take on the role of making sure the blood flow isn’t impeded. This surgical technique is known as ligation and stripping. For this procedure, you’ll have a general anaesthetic.
Your surgeon will make an incision in your groin, and from here they’ll find the damaged vein. They’ll then tie this off (this is known as ligation) before safely removing it with a surgical wire (this is known as stripping).
Sometimes your surgeon might want to undertake a procedure called a phlebectomy. This is a technique that removes the veins on the surface of your leg.
(Video shows surgeon using phlebectomy to remove veins – warning, graphic content)
This involves making small cuts over the veins, and then using hooks to pull them out. Sometimes this can be done with a local anaesthetic, as a separate operation to ligation and stripping.
Even with this type of surgery, you’re often allowed to go home the same day, although some patients may have to have an overnight in hospital. Your leg might feel sore and uncomfortable for up to two weeks afterwards, so you should arrange to be absent from work for up to three weeks to give you time to get back on your feet properly.
Once a vein has been operated on, patients shouldn’t need any further treatment. However, if you’re susceptible to varicose veins you should be aware that others may form in different areas of the leg.
What Other Treatment Options are THere?
There may be times when non-surgical or surgical options are simply not right for you. Here are the other methods of treatment used to help control varicose veins.
Your doctor may simply advise that you use compression stockings to help keep your symptoms under control. This will simply and effectively relieve any swelling and aching in your legs. This method of treatment is usually advised if you are pregnant. If you’ve had either surgical or non-surgical treatment for varicose veins, you’ll also be advised to wear compression stockings for aftercare.
Can complications arise from varicose veins?
If left untreated it is possible that varicose veins can give complications. There are some patients who may notice that their skin changes color around the legs. It will usually turn brown or purple and might sometimes be accompanied by a rash, known as varicose eczema.
You should also be aware that the following complications can also arise:
If you have an accident and your leg is cut near the vein, the varicose vein can start to bleed. This will stop quickly if firm pressure is applied.
Wounds or small cuts near varicose veins can take longer to heal, and in some cases can form an ulcer of this nature which will require medical assistance.
Blood clots can form in the veins, making the varicose vein unusually red or painful.
Deep vein thrombosis (DVT)
Sufferers of varicose veins are more likely to be susceptible to DVT. If your calf swells or becomes very painful, consult your doctor straight away.
Is it possible to prevent varicose veins?
In short, no. There are no medically proven ways to combat them or stop them appearing. However, there are some suggestions below that might prove useful in helping reduce the chances of them appearing:
Don’t stand still or sit still for excessive periods of time. Keep moving
Exercise regularly, and include swimming and walking in your routine
Keep your weight healthy and look at ways of reducing it, if you’re carrying too many extra pounds
When resting, put your feet up properly.
Myths and Misconceptions About Varicose Veins
Support Stockings Will Completely Eradicate Varicose Veins
Unfortunately not. They can help to compress varicose veins and will aid in helping the other veins in your legs work better, but they will not eradicate the issue completely. They’re a temporary respite from the problem and will give symptomatic relief only.
You Absolutely Have to Have Surgery to Deal with Varicose Veins
No. As we’ve outlined above there are a range of different non-surgical and other options to help treat the condition and medicine has advanced in the last decade or so. There are techniques that can be used that mean full surgery is no longer necessary. This is definitely a myth. Up until a decade ago, surgery was the only solution for varicose veins.
Varicose veins will always come back no matter how much surgery you have
Not true. If veins like this do reappear, it’s more than likely down to a different vein going wrong, rather than one that has already been operated on. If you’re susceptible to them, you always will be and there’s little you can do, but many people have the issue once, have it treated and they never recur.
Medical insurance won’t cover varicose veins so there’s no point getting them treated
This can go either way. If the varicose veins are accompanied by valvular insufficiency and reflux then your insurance will cover you.
If this is the case and you have symptoms from the reflux, have tried treatment methods like support stockings, and they’ve failed to help, then you are eligible for treatment of the varicose veins under your insurance.
Only women suffer from varicose veins
For the most part, there will be more cases of women suffering from the condition, but it’s a myth to suggest only women can get them. Men will suffer from them too, and the numbers of them are on the increase.
You can treat varicose veins at home
You can help minimize the symptoms and use treatments such as support or compression stockings to help with pain and discomfort, but there are no other medically recognised or recommended treatments for getting rid of varicose veins that can be bought for use at home. Any online tutorials or videos professing to do so should be avoided. The best way to treat varicose veins is to visit a properly qualified healthcare practitioner who will be able to correctly identify and diagnose the condition, before recommending the right method of treatment for you. There are a lot of questionable sources of advice and treatment online, it is always best to seek professional help for any medical condition.
Varicose vein treatment is strictly cosmetic
Not true in the slightest. Varicose veins are caused by valvular insufficiency, which will often be shown up if a patient has a duplex scan. There are many symptoms including: pain, swelling, aching, cramping, itching, burning and restless legs.
If this is the case for you and you find yourself noticing these symptoms, then the resulting varicose veins are not cosmetic and are as a result of a defect in your valves. Once this is documented, at least with varicose veins, insurance companies frequently will cover their treatment.
References and Further Reading