Varicose veins are veins that have become enlarged and twisted. The term commonly refers to the veins on the leg, although varicose veins occur elsewhere. Varicose veins are common in the superficial veins of the legs, which are subject to high pressure when standing especially when the junction between superficial and deep veins is defective, causing the blood to flow back in superficial veins. Besides cosmetic problems, varicose veins are often painful, especially when standing or walking. They often itch, and scratching them can cause ulcers.
Symptoms
Varicose veins are dark purple or blue in color and may appear twisted and bulging – like cords. They commonly appear on the backs of the calves or on the inside of the leg. However, they can form anywhere on your legs, from your groin to your ankle.
Spider veins are similar to varicose veins, but they’re smaller. Spider veins are found closer to the skin’s surface and are often red or blue. They are mainly a cosmetic problem, otherwise they do not cause any significant trouble.
Some people with varicose veins don’t experience any discomfort from the condition. When painful signs and symptoms do occur, they may include:
* Aching, heavy legs (often worse at night and after exercise)
* Ankle swelling
* A brownish-blue shiny skin discoloration around the veins
* Skin over the vein may become dry, itchy and thin
* The skin may darken, because of the waste products building up in the legs
* Minor injuries to the area may bleed more than normal and/or take a long time to heal
* Rarely, there is a large amount of bleeding from a ruptured vein
* In some people the skin above the ankle may shrink because the fat underneath the skin becomes hard
Causative factors
1. More common in women
2. Heredity
3. Pregnancy
4. Obesity
5. Menopause
6. Aging
7. Prolonged standing
8. Leg injury
9. Abdominal straining (constipation, urinary problems, heavy work)
Screening and diagnosis
In making a diagnosis, your doctor will examine your legs while you’re standing and will look for swelling and dilated veins. He or she may also ask you to describe the pain and aching in your legs. Finally, your doctor may perform an ultrasound test also known as colour doppler to see if the valves in your veins are functioning normally or if there’s any evidence of a blood clot.
Complications
1. Skin ulcers
2. Bleeding, especially near ankle area
3. Leg swelling
4. Blood clots in deep veins especially while travelling (air travel)
5. Clots and pain in dilated superficial veins (thrombophlebitis)
Treatment
Fortunately, treatment usually doesn’t mean a prolonged hospital stay or a long, uncomfortable recovery. The following treatments can be used for varicose veins:
1. Medicines like Daflon or mild painkillers
2. Compression stockings
3. Sclerotherapy has been used in the treatment of varicose veins for over 150 years. In this procedure, your doctor injects small and medium-sized varicose veins with a solution that scars and closes those veins. In a few weeks, treated varicose veins should fade. Although the same vein may need to be injected more than once, sclerotherapy is effective if done correctly. It is often used for spider veins and varicose veins that persist or recur after vein stripping.
4. Surgical treatment has been the time-tested method of dealing with varicose veins, especially in the case of those who have a faulty junction between superficial and deep veins. This treatment includes an incision in the groin and ligating the junction of deep and superficial veins. This is followed by stripping out the superficial vein. The small dilated veins on the legs are divided by giving small cuts on the varicose veins. The long-term benefits of surgery are better than those of sclerotherapy.
5. There are newer methods for treating varicose veins, such as laser treatment, radiofrequency ablation and foam sclerotherapy, but these are not as well studied, especially in the longer term. In addition they are costlier and available only in developed countries at present.
Prevention
There’s no way to completely prevent varicose veins. But improving your circulation and muscle tone can reduce your risk of developing varicose veins or getting additional ones. Traditional, common-sense approaches include:
* Exercise. Get your legs moving. Walking is a great way to encourage blood circulation in your legs.
* Watch your weight and your diet. Shedding excess pounds takes unnecessary pressure off your veins. What you eat makes a difference, too. Use a low-salt, high-fibre diet to prevent constipation and thus unnecessary abdominal straining.
* Watch what you wear. Avoid high heels. Low-heeled shoes work calf muscles more, which is better for your veins. Don’t wear tight clothes around your waist, legs or groin.
* Elevate your legs. To improve venous circulation, take several short breaks daily to elevate your legs above the level of your heart. For example, lie down with your legs resting on three or four pillows. Raise the foot end of the bed but be careful if you have acid problem in the stomach.
* Avoid long periods of sitting or standing. Make sure you change position frequently to encourage blood flow. Try to move around at least every 30 minutes.
* Don’t sit with your legs crossed. This position can aggravate circulation problems.
In a nutshell, varicose veins are a common problem, often ignored by people till they develop some complications. Non-surgical treatments include sclerotherapy, elastic stockings, elevating the legs, and exercise. The traditional surgical treatment has been vein-stripping to remove the affected veins. Newer surgical treatments are less invasive but more costly and long-term results are still to be seen.