Varicose veins are swollen veins that lie under your skin that develop when blood doesn’t flow properly to the heart through the veins in your legs. When blood doesn’t flow properly, pressure builds up. This is due to the problems with one way valves that stop the blood from leaking back into the superficial veins. When the blood pools in the veins, they become varicose veins. These are very common, affecting up to a third of people, typically women more than men.
Symptoms of Varicose Veins
Symptoms of varicose veins can vary, they include:
- Throbbing legs
- Itchy or restless legs.
- Swollen feet and ankles.
- Lumps or bulging veins.
Complications of varicose veins include the following:
- Varicose eczema
- Venous ulcers.
Causes of Varicose Veins
While the exact reasons are still unknown, it is thought that varicose veins are caused by weak vein walls. This causes the valves in the vein to expand and separate, damaging them. It prevents blood from traveling up the veins as easily as it should which increases the likelihood that it pools.
The attending physician (AP) will ask about symptoms and do an examination. He or she will also ask about medical history. If symptoms are severe or there are complications, the AP may refer a vascular surgeon (a doctor who specializes in blood vessels). While varicose veins are easy to see in your legs, it can be difficult to determine the location and extent of the valve damage without the following tests:
- A Doppler test: This is an ultrasound technique that uses sound waves to produce an image of the inside of the leg. It will give the doctor information about the direction of blood flow in the vein and whether the valves are working properly.
- An ultrasound scan (duplex): This will allow the doctor to examine the deep veins in detail.
Treatment of Varicose Veins
Treatment of varicose veins for cosmetic reasons are unlikely to be covered by an insurance or a government program. However, if there are complications of varicose veins, there are some opportunities to have coverage. Doctors will explain everything and help find the appropriate course of action.
Compression stocking will help the blood flow up towards the heart. These stockings may relieve the swelling and aching, but it isn’t known if they prevent varicose veins from developing. Standing for only short periods of time may help with any symptoms.
The surgeon will advise on which procedure is most appropriate. A common procedure is ligation and stripping where the surgeon will tie off the faulty vein (ligation) to stop blood flowing through it and then remove it (stripping). There is also a phlebectomy, a procedure consisting in ligation and stripping to remove the smaller surface veins that lie under the skin.
Although many people won’t need any further treatment after surgery, it’s possible that new varicose veins can form.
Sclerotherapy (Liquid or Foam)
This procedure involves injecting a substance into the varicose veins. It then shrinks the veins and closes them. It’s a good procedure to treat smaller veins. For larger veins, foam sclerotherapy is used. After the treatment, the doctor will put a compression bandage over the area, this can last for up to two weeks.
Studies have shown that this treatment is very effective at treating varicose veins short-term. This procedure also has several serious potential complications, such as stroke or damage to the nerves. Patients who suffer from deep vein thrombosis (DVT) should tell their doctors and discuss the safety of Sclerotherapy.
Endovenous Laser Treatment
In this treatment, the surgeon will pass a fine laser inside the varicose vein. The laser will heat the inside of the vein wall, causing it to close.
In radiofrequency ablation, a high frequency electrical current heats the wall of the varicose vein. This will damage the vein and cause it to close.
Trans-Illuminated Powered Phlebectomy
In trans-illuminated powered phlebectomy (TIPP), a special light under the skin removes the varicose vein by suction. This treatment is relatively new so less is known about its long-term effectiveness.