3921
3.7 Minute

30-July-2024 Team Medicover Procedure

Understanding and Managing Varicose Veins

Varicose veins are enlarged, twisted veins that typically appear on the legs. They result from malfunctioning valves in the veins, causing blood to pool and veins to become swollen and visible. This comprehensive guide covers causes, symptoms, stages, risk factors, and when to seek medical advice for varicose veins.

What are Varicose Veins?

They are abnormally dilated, tortuous superficial veins. These are commonly formed in legs due to defective, incompetent venous valves and are widely observed in the legs of females aged 40 and rarely seen in males.

Varicose veins are enlarged, swollen, and distorted, often blue or dark purple. They occur when defective valves in the veins allow blood to flow or pool in the wrong direction. Varicose veins are believed to affect more than 23 per cent of all adults.

Spider Veins vs. Varicose Veins

Spider Veins: Spider veins are narrower than varicose veins and are located closer to the surface of the skin. They are primarily red or blue and can occur on the legs or face. Spider veins differ in size and often resemble a spider web.
Varicose Veins: Varicose veins are larger, twisted, and bulging veins usually found on the legs. They are dark purple or blue and can cause more severe symptoms, such as significant pain, discomfort, and skin changes.

Stages of Varicose Veins

Stage I - Small, thin, thready veins
Stage II - Large dilated visible veins
Stage III - Swelling in leg / Edema
Stage IV - Venous Ulcers, Discoloration of skin

Causes of Varicose Veins

Varicose veins occur when veins malfunction, allowing blood to pool instead of flowing back to the heart. This causes the veins to enlarge and become visible.

Key Causes

Valve Malfunction: One-way valves in veins fail, causing blood to pool.
Gravity: Veins in the legs are farthest from the heart, making upward blood flow difficult.

Contributing Factors

Menopause
Pregnancy
Obesity
Age over 50
Prolonged standing
Family history of varicose vein

Symptoms of Varicose Veins

Leg Discomfort: Muscles in the legs may feel tired, heavy, or sluggish, especially after physical activity.
Venous Ulcers: Severe varicose veins can cause venous ulcers on the skin.
Burning Sensation and Dry Skin: Burning sensation in the foot and skin dryness.
Pain and Itching: Many patients complain of pain, an itching sensation, soreness, cramps in the legs, and swelling legs.
Visible Veins: Highly noticeable, misshapen veins are the main signs of varicose veins, usually on the legs. Veins are dark purple or blue in color and appear twisted and bulging, resembling cords on the thighs.
Leg Discomfort: A tight or achy sensation in the legs, burning, throbbing, muscle cramping, and swelling in the lower legs.
Discomfort After Inactivity: Worsened discomfort after long periods of sitting or standing.
Skin Changes: Itching along one or more veins, changes in the color of the skin around a varicose vein, and possible swelling and discoloration. In extreme cases, the veins can bleed substantially, and ulcers can form.
Pelvic and Testicular Varicose Veins: Varicose veins can form in the pelvic area (pelvic congestion syndrome), especially in women who have had children. Varicose veins in the testicles (varicocele) can cause infertility.

Risk Factors of Varicose Veins

Age

The risk of varicose veins increases with age. Ageing in your veins induces wear and tear on the valves that help control the flow of blood. Ultimately, the wear causes the valves to allow some blood to flow back into the veins, where it pools instead of flowing to the heart.

Sex

Women have a higher risk of developing the disorder. As female hormones appear to relax vein walls, hormonal changes during pregnancy, pre-menstruation, or menopause can be a factor. Hormone therapies, such as birth control pills, can increase your risk of varicose veins.

For Pregnancy

The amount of blood in your body increases during pregnancy. This move helps the developing fetus, but it can also cause an unfortunate side effect: swollen veins in your legs. Hormonal shifts during pregnancy can also play a function.

Genetics

If other family members have varicose veins, there is a greater risk that you will, too.

Being overweight places extra strain on your veins.
Standing for extended periods or sitting. When you're in the same place for long stretches, the blood doesn't flow as well.

Complications of Varicose Veins

1. Vermin Ulcers

Painful ulcers can develop near varicose veins, particularly around the ankles. Initially, a discolored patch appears on the skin before an ulcer emerges.
If you suspect an ulcer has developed, see your doctor immediately.

2. Blood Clots

Widened veins deep inside the legs can cause pain and swelling. This condition, known as thrombophlebitis, requires medical attention.
Any recurrent leg pain or swelling should be evaluated by a healthcare provider.

3. Hemorrhages

Veins close to the skin may occasionally burst, causing mild bleeding.
Seek medical attention for any bleeding.

Complications if Left Untreated?

Non-Healing Ulcers: Ulcers that do not heal and may worsen over time.
Bleeding: Continued or severe bleeding from burst veins.
Skin Discoloration: Changes in skin color around the affected area.
Blood Clots: Risk of developing clots in veins.

Serious Complications

Superficial Thrombophlebitis: Inflammation of veins close to the skin.
Deep Vein Thrombosis (DVT): Blood clots in deep veins, usually in the legs.
Pulmonary Embolism: A blood clot that travels to the lungs, which can be life-threatening.

How are Varicose Veins Diagnosed?

Varicose veins are found near the skin's surface and can be diagnosed during a physical examination.

Ultrasound: It is a safe, painless test that shows blood clots and how your valves are working.

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Varicose Veins Treatments

Treatment for varicose veins has significantly advanced over the years, leading to better patient outcomes and reduced recurrence rates. Historically, treatment involved multiple incisions and had a high chance of recurrence. Today, Medicover Hospital offers state-of-the-art treatments with remarkable results and virtually no recurrence.

EVLT (Endovenous Laser Treatment)

A catheter and laser are used to close off damaged veins.
Benefits: Non-surgical; no incisions or scars; day-care procedure; minimal downtime.

Sclerotherapy (Foam Sclerotherapy)

A solution is injected into the vein, causing the vein walls to stick together, eventually fading away.
Benefits: Non-surgical; effective for smaller veins; minimal recovery time.

VENASEAL (Endovenous Glue Embolization)

Uses medical-grade adhesive to seal off the affected vein.
Benefits: Pain-free; patients can walk home within a few hours; no visible signs of treatment.

Outdated Techniques

Injection Therapy (Sclerotherapy)

Process: A solution injected into the vein causes the vein walls to stick together and turn into scar tissue, which eventually fades.
Benefits: Non-surgical; effective for treating smaller veins.

Laser Therapy (EVLT)

Process: A catheter and laser are used to close off a damaged vein.
Benefits: Non-surgical; precise; minimal recovery time.

Glue Treatment

Process: Medical-grade adhesive is used to close off the vein.
Benefits: Advanced and effective; completely pain-free; minimal downtime; no visible signs of treatment.

Traditional Vein Surgery (Surgical Stripping)

Process: This older method involves ligation (tying off the vein) and stripping (removing the vein), which is less commonly used today.
Disadvantages: It involves surgical cutting, a higher risk of scarring, and a longer recovery time.

Post-Treatment Care

Compression Stockings: Recommended for 4-6 weeks post-procedure.
Normal Activities: Patients can resume regular activities on the same day with no visible signs of the procedure.

Lifestyle Changes for Varicose Veins Prevention

While it's impossible to prevent varicose veins completely, you can reduce your risk by improving circulation and muscle tone. The same steps that help manage varicose vein pain at home can also help prevent new varicose veins. Consider these strategies:

Doing workout
Observing your weight
Eating a low-salt, high-fiber diet
The avoidance of high heels or any uncomfortable sandals and tight trousers
Uplifting your legs
Regularly modifying your sitting or standing position.

When to Consult a Doctor

When patients notice dilated visible veins in their legs or any of the symptoms mentioned above, they should consult a doctor for a medical opinion.

Frequently Asked Questions

Varicose veins are primarily caused by weakened vein walls and faulty valves. The veins become stretched and lose elasticity, allowing blood to pool and the veins to become enlarged and twisted.

Varicose veins are generally not a sign of poor overall health, but they can cause discomfort, achiness, and cosmetic concerns.

Yes, walking and regular exercise can help improve circulation and reduce the symptoms of varicose veins, such as pain and swelling.

Varicose veins often improve or diminish within a few months after childbirth. Wearing compression stockings and elevating the legs can aid in speeding up this process.

To prevent varicose veins during pregnancy, maintain a healthy weight, engage in regular exercise, elevate your legs when possible, and avoid sitting or standing for long periods.

LASER and GLUE treatments for varicose veins are highly successful when performed by experienced vascular interventional radiologists. Success rates typically exceed 95-98%.

Spider veins are small, red or purple veins that appear close to the skin's surface, often resembling spider webs or tree branches.

While treatments for varicose veins are usually effective, there is a small chance of recurrence, especially in non-compliant or obese patients. However, success rates are generally high.

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