Varicose Veins

What are VARICOSE VEINS?

Varicose veins are far more than a cosmetic concern alone. In some cases they can lead to significant and long term venous health problems.

Most people can recognise lumpy veins in the legs as “varicose veins”. However varicose veins can take many other forms, including hidden varicose veins in the leg under the skin, blue reticular veins, spider veins and even prominent vulval or vaginal veins. Visible veins are often part of a more extensive issue beneath the skin. These abnormally-functioning visible and/or non-visible veins together form the continuum of Superficial Venous Incompetence.

So what does the term “varicose veins” actually mean?

The task of our veins is to return used blood to the heart. In the case of our legs, the return of this used blood should flow up the leg towards the heart. The body relies on a number of factors to be able to do this, and importantly relies on well-functioning valves, (or gates) which are interspersed inside the vein along its lining which should open to allow the blood to flow one-way up the leg, and should close tightly to prevent reverse (or downwards) flow. For many reasons, for many people, these valves can sometimes fail. This allows used, or deoxygenated, blood to move incorrectly downwards. This is known as “retrograde flow”. This increases pressure inside the vein, and coincides with dilatation of the vein. It also causes the vein to elongate and even become twisted.

From this point, veins can not only become larger and longer, but can be more visible. The abnormal veins can then subsequently lead to abnormalities developing in branched veins. The larger and longer veins pool more venous blood, which perpetuates the problem. Symptoms can then arise from this dysfunctional blood flow. Some people have no symptoms from their varicose veins. Others experience a sense of pressure, pain, cramping, tenderness, tightness, heaviness, aching, burning, itching, swelling, and even restlessness in the legs. Symptoms can occur in very normal-looking legs if the veins which are abnormal lie a little way under the skin.

This is known as “superficial venous incompetence”.

COMPLICATIONS OF VARICOSE VEINS

In some cases, prolonged chronic venous incompetence can lead to what is known as “chronic venous insufficiency” with:

  • venous eczema

  • increased pigmentation of the skin of the lower leg

  • inflammation and thickening of the skin and fatty tissue of the lower leg, known as lipodermatosclerosis

  • extensive small veins around the feet and ankles

  • swelling

  • thrombophlebitis (inflammation and clots in varicose veins)

  • deep vein thrombosis and leg ulcers.

WHAT CAUSES VARICOSE VEINS?

Varicose veins is a common problem that affects about 40% of the population at some stage during their lifetime, to varying degrees. It most commonly becomes apparent between the 3rd to 6th decade, and usually presents earlier in women than men, mostly due to childbearing.

The most common underlying predisposition is having a family history of varicose vein disease. Varicose vein development has been associated with occupations involving prolonged standing. However prolonged sitting and immobility can also contribute. Having a previous blood clot in the leg veins can increase the likelihood of developing varicose veins, as can any significant trauma to the leg which may involve trauma to vein valves. Obesity is also a risk factor for varicose vein development.

Your doctor can help you understand more about what factors may be causing your venous disease. Schedule an appointment now.

CAN VARICOSE VEINS BE PREVENTED?

There is very little anyone can do to prevent varicose veins, particularly if you have a family history of this. However, keeping mobile, walking regularly, and maintaining a healthy weight can all play a part in optimising vein health. Compression hosiery (including support socks) can go some way in improving symptoms of tired and aching legs which can arise from even early superficial venous incompetence. However venous disease cannot be cured per se, and it will slowly progress over time. Definitive treatment, individually tailored to each person’s unique anatomy of their problem veins, is the most effective management strategy. Recurrence can occur. Dr Andronicus can discuss conservative measures with you to optimise your vein health.

HOW CAN VARICOSE VEINS BE TREATED?

There is compelling medical evidence nowadays that the non-surgical approach offers patients convincing success rates and unequivocally low recurrence rates, without the risks of general anaesthetic, hospital admission and surgery.

Most international guidelines now recommend the non-surgical approaches over traditional surgical interventions such as high ligation and stripping.

At Southern Vein and Cosmetic Centre, we offer the internationally-recommended non-surgical treatments of endovenous laser ablation and ultrasound-guided sclerotherapy. Read the latest international recommendation guidelines published to treat superficial venous incompetence published here.

Book an appointment with Dr Andronicus to discuss which treatment options are best suited to your particular concerns and issues.