What are varicose veins?

Simply put, varicose veins are veins that have become enlarged. They commonly appear on the lower legs, but may also be found on the thighs or other areas. These enlarged veins may visibly bulge under the skin, and can appear purple or dark blue through lighter skin. Under darker skin, the colour may not show through but the veins will still be lumpy and prominent. Varicose veins may cause pain or discomfort or be completely painless.

They can affect surface veins, or those located in deeper tissue. Do not confuse varicose veins with blue veins or spider veins, these are separate conditions. Varicose veins affect women more than men, and generally affect one in three people. In the UK alone, over 20 million people are blighted by varicose veins.

What causes varicose veins, and can they be prevented?

Veins contain valves that help prevent blood from flowing backwards. Think of them as the flippers on a pin-ball machine. When those valves become damaged or weakened, blood does not travel easily up the legs and may instead pool in areas. These areas of pooled blood are what people see as lumpy bulges. Several factors can cause varicose veins. These include:

Heredity – other members of your family suffer from them
Pregnancy
Obesity
Age
Standing for long periods of time

Prevention

To prevent varicose veins, it’s important to maintain a healthy weight and exercise regularly to improve circulation. Avoid long periods of standing still, as this can increase pressure in your veins. If standing for long periods is unavoidable, wearing compression stockings can help by applying gentle pressure to the legs, promoting blood flow and reducing the likelihood of vein swelling.

How do you know if you have varicose veins?

Healthcare professionals will mainly diagnose varicose veins based on their appearance during a physical examination. They will also take a medical history. If these initial exams reveal issues with deeper veins, if there are complications or if patients are considering surgery for their varicose veins they may be subject to further tests.

Most people become aware of varicose veins by seeing them. There may not be other symptoms, or there may be symptoms that range from mild to severe. These other symptoms may include the following:

Aching or heavy legs
Mild swelling
Itching over the veins
Significant swelling
Fluid build-up
Skin colour changes around the ankle and lower leg
The development of blood clots and inflammation in small surface veins
Open sores

Varicose Vein Complications

Most varicose veins are benign and do not cause complications. However, severe varicose veins can lead to complications due to poor circulation. These complications can include bleeding, eczema, ulcers, and red, painful inflammation of the veins.

Additionally, varicose veins can sometimes be a sign of deep vein thrombosis (DVT), a condition where a blood clot forms in a deep vein, usually in the legs. This condition requires immediate medical attention due to the risk of the clot traveling to the lungs, causing a pulmonary embolism. Therefore, monitoring varicose veins and seeking medical advice if complications arise is crucial for overall vascular health.

What are the Treatments for Varicose Veins?

Varicose veins can be treated at home or by healthcare professionals. Home treatment is usually the recommended route. These remedies include elevating the legs, wearing compression stockings and exercise. If these treatments do not work, or if patients want to further improve the appearance of their veins, more serious treatments can be performed. These include:

Laser Treatment

Laser treatment for varicose veins involves using focused light energy to heat and damage the vein walls, causing them to collapse and eventually fade. This minimally invasive procedure is usually performed on an outpatient basis and can effectively treat smaller varicose veins and spider veins. Patients typically experience minimal discomfort and can return to normal activities shortly after the procedure. The laser’s precision allows for targeted treatment, minimizing damage to surrounding tissues.

Radiofrequency Treatment

Radiofrequency treatment, also known as endovenous radiofrequency ablation (RFA), uses radiofrequency energy to heat and close off varicose veins. A catheter is inserted into the affected vein, and radiofrequency energy is applied to the vein walls, causing them to contract and seal shut. This procedure is minimally invasive and usually requires only local anesthesia. RFA is effective for larger varicose veins, providing significant symptom relief and cosmetic improvement. Recovery is typically quick, with patients able to resume normal activities within a few days.

Sclerotherapy

Sclerotherapy involves injecting a chemical solution into the affected veins, causing them to close and eventually be reabsorbed by the body. This treatment is particularly effective for smaller varicose veins and spider veins. The procedure is minimally invasive and can be performed in a doctor’s office. Multiple sessions may be required to achieve optimal results, and the treated veins may take several weeks to disappear completely. Sclerotherapy also helps improve symptoms such as pain and swelling associated with varicose veins.

Microsclerotherapy

Microsclerotherapy is a refined version of sclerotherapy that uses a finer needle and less solution to target very small thread veins. This procedure is ideal for treating smaller veins that are not suitable for standard sclerotherapy. The technique involves injecting a sclerosing agent into the tiny veins, causing them to collapse and gradually fade away. Microsclerotherapy is minimally invasive, with patients experiencing minimal discomfort and quick recovery times. Multiple treatments may be necessary to achieve the best results.

Ligation and Stripping

Ligation and stripping is a surgical procedure used to remove large varicose veins. The procedure involves tying off the affected veins (ligation) and then removing them through small incisions (stripping). This treatment is typically performed under general or local anesthesia and may require a short hospital stay. Ligation and stripping are effective for severe cases of varicose veins, providing long-term relief from symptoms and preventing recurrence. Recovery can take a few weeks, and patients may experience bruising and discomfort during the healing process.

Thermocoagulation

Thermocoagulation, also known as ThermaVein, uses microwave energy to treat thread veins by heating and sealing them closed. A fine needle is used to deliver microwave energy to the vein, causing it to collapse and disappear. This procedure is particularly effective for facial veins and smaller veins on the body. Thermocoagulation is minimally invasive, with immediate visible results and minimal aftercare required. It is a safe and effective treatment with a low risk of side effects and a quick recovery time.

Many professional clinics would offer a thorough consultation and examination, including ultrasound assessment. This allows them to accurately visualize and diagnose each patient. From there they will develop highly effective, individual courses of treatment using the most modern techniques.

These treatments do not cause scarring, hyper-pigmentation or damage to surrounding tissues. In most cases, patients need only one round of treatments to address all problem veins, and need only wear compression garment for one day following treatment. Significantly, these treatments require little to no downtime, allowing patients to return to work the next day.