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Varicose veins

Everybody has two sets of veins in the legs. These are the superficial veins close to the surface of the skin and the deep veins that we hear about with Deep Vein Thrombosis (DVT). The job of veins is to return blood back towards the heart. There are a number of valves in the veins to allow blood back towards the heart and to prevent blood from flowing back. If the valves stop working efficiently then blood will flow back into the veins causing the veins to become large and irregular (varicose veins).

Varicose veins are common and affect about 30% of women and 15% of men.

They tend to run in families and most people with varicose veins recall a family member being affected.

The exact reason some people suffer with veins more than others is not clearly known. Reasons that are thought to contribute to varicose veins include:
  • Pregnancies
  • Prolonged standing over long periods of time
  • Obesity
Veins become varicosed when there is a failure of the valves in the veins that usually only allows one-way blood flow (a leaky valve).
Poorly functioning valves result in pooling of blood in the legs and results in lengthening and swelling of the veins with the end result being characteristic varicose veins

Schematic video clip of incompetent varicose veins


Symptoms

Cosmetic appearance is the most common complaint with varicose veins.

Many people have no symptoms at all. Only a small number of people ever develop ulcers



varicose veins swollen legs
Varicose veins

Swollen legs


There are usually warning signs of skin changes and eczema of the skin at ankle level.


Varicose vein skin changes venous Ulcer

Skin changes
Venous ulcers



Many people will have aching and throbbing and also a feeling of heaviness in the legs. This is more noticeable towards the end of the day especially following prolonged periods of standing. Some people will also complain of itching and swelling at the ankles.

Varicose veins that are not causing problems do not need to be treated. A vascular surgeon can advise you as to which treatments are possible and can help make a decision about the treatment you may wish to have.
Treatments can be conservative, with
Radiofrequency (VENEFIT©) ablation, or with FOAM sclerotherapy

There has been recent guidance published by the National Institute for Health and Care Excellence (NICE) regarding varicose veins which can be viewed here.

NICE Guidance