Varicose Veins

• Symptoms: Swollen blood vessels that are visible on the skin, discolouration of the skin, frequent bruising, heaviness in the legs, unexplained swelling in the legs, itching sensation in the calves muscles
• Causes: Damaged heart valves leading to accumulation of blood in the vessels
• Risk factors: Ageing, hormonal changes in women, pregnancy, obesity, family history, prolonged inactivity
• Severity: Mild to moderate, depending on the stage of varicose development
• Which doctor to consult: Vascular surgeon

Overview

Varicose veins are the superficial appearance of veins due to their enlargement and twisting. These veins are prominent in the legs and show minimal symptoms during the early days. However, affected individuals will likely experience fatigue and pain in the area.

The common phenomenon that leads to varicose veins is increasing venous pressure in the lower limbs as the blood moving upward in the body is slow. Since, most of the blood remains confined to the legs, it leads to varicose veins.

Most people suffer from variations of varicose veins the symptoms of which may range from mild to moderate. While some might need cosmetic procedures based on dermatologists’ consultation, others may require a vascular surgeon.

The treatment may involve home-based care for some patients, while others may have to undergo surgical procedures. Additionally, the condition does not have a definite cause. The risk factors include obesity, lack of exercise, traumatic injury in the legs, and a family history of the condition.

Like varying risk factors, there are multiple options for treatment as well. Some patients may need to change their lifestyle patterns, and others may live with them. There is no doubt that varicose veins affect the quality of life, and patients need significant help with it. Nearly 30% of people are likely to experience varicose veins at some point. In addition, the statistics also reveal that women have more chances of developing this condition as compared to men.

When to consult a doctor?

Even though varicose veins show varying symptoms, they might affect the quality of life and make the condition painful. It is imperative to seek a medical expert’s opinion and consult with them about the treatment under the following conditions:

• Frequent pain: In the initial phase, varicose veins are manageable and do not show prominent symptoms. However, the condition progresses and leads to persistent pain that is dull yet uncomfortable. This could mean that the problem has become chronic and requires immediate attention.
• Heaviness in legs: The heaviness could be due to accumulated blood over a long period. The patient might start feeling heaviness or discomfort in the lower limbs only after a chronic condition. Many people might experience numbness in their legs while folding them to sit on a flat surface for a few minutes.
• Inflammation: It might seem like a minor problem, but inflammation due to visible varicoses can be life-threatening. In many cases, people experience blood clot formation that could lead to deep vein thrombosis or pulmonary embolism.
• Superficial thrombophlebitis: This type of blood clot occurs just under the skin and is prominent because it causes sharp pain in the body. A patient might feel the veins hardening and becoming red in colour. Even though this clot does not travel to the lungs, it is essential to take it as a warning sign for consulting a doctor.

Diagnosis

Getting to know a health problem early can aide on-time treatment and better recovery. Below are the points on how one can diagnose varicose veins:

• Physical examination

This is one of the primary methods to diagnose varicose veins, and it involves the medical practitioner examining the patient’s legs and the visible veins. Since the problem is present in various stages, it is essential to observe the swelling, discolouration, and bulging.

In addition to noticing the physical appearance, the doctors also press the area and enquire about pain and other symptoms.

• Doppler ultrasound

This is a crucial diagnostic test that helps in diagnosing varicose veins. With this test, doctors can find the presence of blood clots. This non-invasive test uses high-frequency sound waves to analyse the blood flow pattern in the veins.

• Trendelenburg test

This type of physical examination follows a standard procedure to assess the veins. The test looks for irregularities in the valves, for understanding the reason behind the difficulty for the blood to flow correctly. The result of this test comes out as positive or negative.

• Venogram

This particular diagnostic procedure uses a dye as an imaging technique to assess the condition of the veins. The doctor injects a dye in the affected area and takes an x-ray of the region. The injected dye is visible and shows blood flowing through the veins.

A doctor may suggest some more imaging tests to assess the condition and examine the case. These tests aim to find out the presence of blood clots, blockages, and the reason behind swelling.

Treatment

A majority of cases in varicose veins can be detected at an early stage. Hence, the treatment plan mainly involves self-care and convenient home-based procedures. However, leaving the veins untreated for a long time might require extensive surgical procedures to heal.

Additionally, it is essential to find the underlying cause of the condition to treat it effectively. Thus, below are some treatments for varicose veins:

• Self-care

Home-based treatment and self-care exercises are advisable for people who can detect their varicosities early. This includes leg exercises to improve leg movement and ensure better blood flow. These exercises are specially curated to ease pain.

• Compression stockings

A compression stocking is wearable like a tight sock that keeps the leg muscles compressed to allow the blood to move efficiently through the vessels. Additionally, the amount of compression varies from brand to brand. However, it is always better to buy the stockings after consultation with a doctor. These stockings are available as over-the-counter products and also on the basis of prescription.

• Surgeries and other procedures

Another way to deal with varicose veins is to go for surgical procedures that heal the condition. However, this is effective for people who are already at the advanced stage of this disease, and other therapies are ineffective for them.

Below are some procedures that you must be aware of to treat varicose veins:

1. Sclerotherapy

This is a simple in-office procedure in which the doctor injects a solution into the affected veins. This solution helps in treating varicose veins and within a few weeks or months, varicose veins get cured. For better results, a patient might have to get it injected more than once.

2. Laser treatment

As usual, a laser uses intense bursts of light that fade the varicose veins and allow them to disappear slowly. This is also a non-invasive procedure that does not involve any cuts or needles.

3. Catheter-based procedure

This is one of the most preferred treatments for people suffering from more prominent varicose veins. A catheter releasing heat or radio waves is inserted into the veins during this procedure. By the end of the process, the veins seal shut and remain closed, eventually removing the varicose.

4. Vein stripping

In simple terms, this procedure removes veins from the leg to get rid of unwanted varicose. However, removing one vein does not impair the blood flow in the legs because the more prominent veins look after it. Additionally, it is essential to go for this procedure when the veins are yet to connect with the more prominent veins.

5. Ambulatory phlebectomy

This is an outpatient procedure requiring leg tissue scarring to get rid of varicose veins. A series of tiny punctures are made to remove the smaller varicose veins visible on the skin.

Risk and Complications if left Untreated

Since varicose veins directly affect the blood flow in the body, these will likely cause significant complications if left untreated. While most people get it treated on time, many fail to observe the developments and advancement of varicose veins.

Below are some risks and complications associated with the condition:

• Heavy bleeding

Varicose veins are prominent on the skin, and a slight bump or cut can lead to severe bleeding. Generally, the bleeding is difficult to control and requires immediate help from a medical expert. However, a first aid activity involves lying down, raising the leg, and applying pressure to the wound.

• Blood clots

As mentioned earlier, varicose veins can progress to form clots under the skin. Some of these clots can travel to the lungs and cause pulmonary embolism.

• Walking difficulty

Due to pain and tenderness in the legs, many people find it hard to walk or balance themselves. Additionally, many patients cannot stand for long due to poor blood circulation in their lower limbs or legs.

• Skin conditions

No matter how unusual it sounds, varicose veins can lead to dermatitis and peeling of skin. The progressive disease also leads to skin ulcers near the ankle, referred to as venous ulcers.

• Carcinoma

Long standing venous ulcers may turn into carcinoma or sarcoma in many cases. However, this progression is very rare with only 1% of varicose patients suffering from venous ulcers.

• Other risks

Some other risks associated with this condition involves necrosis.

Additional Information

Different stages of varicose veins

Although each case of varicose veins might be similar to another, it is essential to be aware of the stages and opt for a doctor’s consultation accordingly.

• Stage 1: Spider veins

This is the first stage of varicose veins that showcases small, spider web-like veins in ankles, neck, face, and other areas.

• Stage 2: Ropy varicose veins

Here, the patient’s legs show a typical rope-like vein structure with knots and wavy patterns. Additionally, this is the stage where people can identify the presence of varicose veins.

• Stage 3: Swelling

At the third stage, the legs and ankles show swelling and indicate an issue in the valves of the circulatory system.

• Stage 4: Discolouration

The fourth stage begins with discolouration in the skin and visible veins in the ankles and calves. In addition, the skin might also become reddish or brown in colour with a leathery texture.

• Stage 5: Ulcers

The final stage begins with ulceration of the skin that is also vulnerable to turning into sarcoma or carcinoma. It looks like active bleeding ulcers that appear like an open wound.