THE NUISANCE & PAIN OF VARICOSE VEINS
What do varicose veins have to do with LDC's heart health week, we hear you ask! Well, although varicose veins aren't necessarily a sign of a heart condition, they do fall under the umbrella of cardiovascular conditions are are very common - so, we thought they deserve a mention as part of our heart health week!
What Are Varicose Veins?
A good place to start, is to think of varicose veins as once normal veins that have become swollen or enlarged, and turned blue or purple in colour. If you have varicose veins, you might also find that they appear twisted or lumpy in appearance.
The purpose of veins is to carry blood back to the heart, and in order to do this, they must work against gravity. They have pairs of one-way leaflet valves which close to prevent blood from flowing backwards.
When veins become varicose (swollen and enlarged), the leaflets of the valves no longer meet together properly, and the valves no longer work. This is referred to as 'valvular incompetence'.
The result of this is blood flowing backwards - as such, the veins enlarge and become visible to the naked eye.
Where Are Varicose Veins?
Any vein in the body can become varicose, but varicose veins are most common in the superficial veins of the leg (the ones just beneath the skin), as these are subject to high pressure when standing and walking.
Types of Varicose Vein
Depending on your symptoms, you may have one of a number of different types of varicose veins. Some of the more common types are listed below:
1. Trunk Varicose Veins
These are situated near the surface of the skin and are thick and lumpy. They are usually visible, quite long and can look unsightly.
2. Reticular Varicose Veins
These veins are red in colour and are sometimes grouped close together in a network.
3. Telangiectasia Varicose Veins
These are also known as thread veins, are small clusters of blue or red veins that sometimes appear on your face or legs. They are harmless to your health and don’t bulge, but are source of embarrassment for some people.
Causes of Varicose Veins
Varicose veins occur when the walls of your veins stretch or lose elasticity, and the essential one-way valves weaken. The reasons why this happens are not fully understood, and some people develop varicose veins for no obvious reason. Some risk factors (things that make you more likely to develop the condition) are listed here:
- Gender - being female
- Age - getting older!
- Genetics - having a family member with the condition
- Being overweight
- Being pregnant
- Occupation - standing or walking for long periods of time
Having a job where you are on your feet for long periods of time (like a waiter or waitress) is a risk factor for varicose veins
Symptoms of Varicose Veins
As we have mentioned earlier in this article, the appearance of your varicose veins will depend somewhat on which type you are suffering from. Other symptoms to look out for include:
- A range of colour from dark purple to blue
- Twisted or bulging in appearance
- Aching and uncomfortable legs which may feel heavy
- A burning or throbbing sensation in the legs
- Dry, flaky or itchy skin over the area of the varicose vein
- Swollen feet or ankles
These symptoms will usually worsen with standing, and in warm weather. Walking or raising the legs can often relieve the symptoms.
Some people who have visible varicose veins do not experience any symptoms at all.
Diagnosis of Varicose Veins
If you have varicose veins that don’t cause you any discomfort, you may not need to see your GP. But you should see your GP if:
- Your veins cause you discomfort or make you feel conscious of your appearance
- The aching in your legs or muscle cramps result in difficulty sleeping
Your GP will evaluate your symptoms, and ask about any risk factors that apply to you, for example, if you have a family member with the condition or if you have ever sustained an injury to the affected area.
Your GP will also examine your legs, and will check for signs of varicose veins (such as swelling) when you are standing up. If your GP feels that your condition is severe enough to warrant further investigation, they may decide to refer you to a vascular specialist (a doctor who specialises in treating disorders of the veins).
Varicose Vein Investigations
There are two main tests that can be used to investigate varicose veins. These are:
- Doppler test
- This uses an ultrasound scan to evaluate the direction of blood flow in your veins
- Colour duplex ultrasound scan
- This produces colour images of the structure of your veins, allowing any abnormalities to be identified
Treatment of Varicose Veins
You may need treatment for your varicose veins to ease your symptoms, to treat complications, or to improve your self-esteem regarding your image. The type of treatment you receive will depend on your state of health, and the size, location and severity of your veins. We will briefly outline the treatment options below, but your GP will explain more if needed.
These are snug stockings that are designed to apply extra pressure to the legs to improve circulation, encouraging blood to flow up towards the heart. You would usually wear these stockings throughout the day, and remove them at night.
Large or symptomatic veins may need to be surgically removed, and this surgery is usually carried out under general anaesthesia.
For surgery, most surgeons use a technique called “ligation and stripping”. This involves tying off the vein, and then removing it. Two small incisions will be made – one in the groin near the top of the vein, and the other in the area of the knee or ankle.
You can usually leave hospital on the same day, but it will take up to three weeks to recover completely.
This is suitable for small to medium varicose veins. The procedure involves injecting a chemical solution in to the vein which scars it, sealing it closed. The injection is guided into the vein using ultrasound.
Larger veins may require foam sclerotherapy. Instead of the liquid chemical, a type of medical foam is injected into the affected vein, which closes it.
There are several new treatments that have been developed to treat varicose veins. They are:
- Radiofrequency ablation
- Endovenous laser treatment
- Transilluminated powered phlebectomy
These new treatments are less invasive than traditional surgery because they require fewer or smaller incisions. However, more time and research is required to assess their effectiveness.
If you've noticed any unsightly varicose veins, or are struggling with pain and aching symptoms of such veins, why not book a GP consultation at any of our convenient central London clinics. Our experienced private doctors can examine your veins, provide a diagnosis, and discuss your options for treatment. Simply choose which of our GP surgeries is easiest for you and call or book online - we even have same day doctor appointments available. As always, if you're searching for a "GP near me", we're here for you!
By Melissa Dillon