Ref: CHB/News Bulletin/004/2014

Varicose veins

v1Have you looked down at your legs and seen blue elevated lines that closely resemble a road map? Then most likely you could be having a condition called varicose vein.

A varicose vein can appear anywhere on the body, but is most commonly found on the feet and lower legs, particularly on the backs of the calves


Normally, the veins return oxygen-depleted blood from throughout the body to the heart, where the blood is then pumped through the lungs to once again become oxygen-rich. Gravity makes this return trip to the heart and lungs difficult, particularly when blood needs to flow upward from the feet and legs and the veins have to work extra hard to get that blood back up to the heart. Fortunately, veins have one-way valves to keep blood flowing upstream; the valves open as the blood flows upward and then snap shut to keep blood from flowing backward.

v3When these valves stop working efficiently, and when some of those veins wear out over time, blood pools in the veins and causes them to become enlarged and tortuous. The veins not only appear swollen, but also take on a deep cerulean hue. Why so blue? Because they are full of deoxygenated blood that should have been re-circulated through the lungs, but instead was left behind in a malfunctioning varicose vein

Spider veins, which are like smaller versions of varicose veins, look like tiny squiggles on the skin’s surface

What are the symptoms?

Varicose veins look dark blue, swollen, and twisted under the skin. Some people do not have any symptoms. Mild symptoms may include:

  • Heaviness, burning, aching, tiredness, or pain in the legs. Symptoms may be worse after you stand or sit for long periods of time.
  • Swelling in the feet and ankles.
  • Itching over the vein.

More serious symptoms include: 

  • Leg swelling.
  • Muscle cramps, soreness or aching in the legs
  • Skin changes, such as: 
    • Color changes.
    • Dry, thinned skin.
    • Inflammation.
    • Scaling.
  • Open sores/ulcers


Who is more likely to develop varicose veins? 

  • Age. As one ages, veins lose elasticity causing them to stretch.
  • Pregnancy. Pregnancy increases the volume of blood in the body, but decreases the flow of blood from the legs to the pelvis. This circulatory change is designed to support the growing fetus, but it can produce an unfortunate side effect — enlarged veins in the legs. Changes in hormones during pregnancy also may play a role. Varicose veins that develop during pregnancy generally improve without medical treatment within three months after delivery.
  • Being a female:Hormonal changes during pregnancy, or menopause may be a factor. Female hormones tend to relax vein walls.
  • Family history of varicose vein
  • Obesity. Being overweight puts added pressure on the veins.
  • Standing or sitting for long periods of time causing impairment of blood circulation

Varicose may be prevented to some extent by:

  • v5Wearing compression stockings. Compression stockings work simply by squeezing the leg, thereby reducing the amount of blood and pressure in the veins thus improving circulation.
  • Regularly elevating the legs. Elevating the legs helps keep the blood from pooling in the lower legs and improves blood flow to the rest of the body. At the end of the day, sitting with your legs propped higher than your heart for 10 to 15 minutes helps drain any pooled blood
  • v6Avoiding long periods of standing or sitting. Sitting or standing still for long periods of time puts added stress on the veins in the legs. Avoid sitting crossed legged.
  • Exercising and controlling weight. Walking, bicycling, and swimming are recommended for varicose veins.
  • Opt for flats over heels as wearing heels prevent full contraction of muscles

These suggestions can relieve your symptoms, slow the progression of varicose veins, and prevent complications such as sores or bleeding. They are especially important if there is a family history of varicose veins. These measures may help avoid surgery or other medical treatment for varicose veins.

 When is treatment necessary?

Varicose and spider veins may require medical treatment if complications arise such as.

  • v7Venous stasis ulcersthat result when the enlarged vein does not provide enough drainage of fluid from the skin. As a result, an ulcer (open sore) may form.
  • Fungal and bacterial infections may occur as the result of skin problems caused by fluid buildup (edema) in the leg. These infections also increase the risk of tissue infection (cellulitis).
  • Thrombophlebitis: Inflammation of the vein due to blood clot formation.
  • Venous hemorrhage: Bleeding in the vein.

Medical treatment for varicose veins:

  • Sclerotherapy. involves the injection of a solution directly into the small- and medium-sized varicose veins that cause them to collapse and disappear
  • Laser surgeries.Laser energy is used to scar and destroy varicose veins. This is called ablation.
  • v8Ligation and stripping. Incisions are made over the varicose veins, and the vein is tied off (ligated) and removed (stripped). Removing the vein does not adversely affect circulation in the leg because veins deeper in the leg take care of the larger volumes of blood.

Varicose veins tend to get worse over time. Taking self-care steps can help relieve achiness and pain, keep varicose veins from getting worse, and prevent more serious problems.

Compiled by Dr Neelam A Ismail


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