Untangling varicose veins
Varicose veins cause texture that can be seen from the surface of the skin, appearing swollen and twisted. They typically occur in the legs and feet. In this article, a consultant surgeon and expert in vascular disease Mr Tom Browne explains why they occur and how they can be addressed.
Varicose veins are visible on the surface of the skin, looking blue or purple, and lumpy or bulging. Varicose veins are more likely to affect older people, pregnant women, and those with obesity.
What causes varicose veins?
Varicose veins occur due to dysfunction within the veins which carry oxygen-infused blood to the heart, where the blood starts flowing backwards, pooling together and creating obstructions.
What are the symptoms and possible complications of varicose veins?
They are primarily a cosmetic concern, but they can be accompanied by symptoms such as:
- Aching and heavy-feeling legs
- Burning or throbbing sensations
- Dry and itchy skin in the affected areas (in what is called varicose eczema)
- Cramping
- Swollen ankles and feet
- Rashes
These symptoms may worsen after long periods of standing. Varicose veins can worsen if they are not treated, and complications may arise such as phlebitis, which is the swelling of the veins, and blood clots superficially or deep within the leg (deep vein thrombosis).
How are varicose veins diagnosed?
Varicose veins have a distinctive appearance and may be identified by sight, but an official diagnosis is done with a Doppler ultrasound. This is an imaging scan that measures ultrasonic sound waves that bounce off the red blood cells, illustrating the movement of blood through the blood vessels. The ultrasound will show how the blood isn’t flowing as it should using colour coding.
How are varicose veins treated?
Conservative treatment for varicose veins includes compression socks and stockings, and elevating the legs above the heart for stretches of time to help with circulation.
If conservative treatment is ineffective, then more thorough treatments or procedures for varicose veins can be explored. These tend to be outpatient procedures such as:
- Sclerotherapy, which is where saline or chemical solutions are injected into the varicose veins to make them defunct, so the blood flow is redirected to other, non-varicose veins instead.
- Thermal ablation, which is where laser or radiofrequency energy, directed through a catheter that is inserted into the vein, destroys or ablates the varicose vein, sealing them and redirecting the blood to other, non-varicose veins.
- Vein stripping, which is a surgical procedure to physically remove the varicose veins.
- Micro-phlebectomy, another surgical procedure in which varicose veins are removed through small incisions.
Can varicose veins be prevented?
There is no guarantee to preventing varicose veins, but preventative techniques can help by maintaining good circulation – this can be achieved by exercising regularly, eating healthily, not wearing clothing that is too tight or restrictive, avoiding staying on your feet for extended periods at a time, and practising good sitting habits like putting up the feet and not crossing the legs when seated.
If you are struggling with varicose veins, you can consult Mr Browne via his Top Doctors profile.