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Varicose Veins: Causes, symptoms & Prevention

Team AckoJan 17, 2024

Have you noticed that some people have clearly visible, large bluish veins creeping up their legs? These enlarged veins are called varicoses or varicosities. The human body has two major kinds of blood vessels, namely arteries and veins. Arteries carry blood with oxygen from the heart to all organs and tissues, whereas veins carry carbon dioxide and waste products from the body to excretory organs and eventually back to the heart.

Long hours of standing and walking can increase the pressure in the veins of the legs. This can be absolutely asymptomatic in some patients and intensely painful in others. Read ahead to get an overview of Varicose Spider Veins.

Contents

What are Varicose Veins?
What causes Varicose Veins?
What are the symptoms of Varicose Veins disease?
How are Varicose Veins diagnosed?
What are the complications of Varicose Veins?
What is the treatment for Varicose Veins?
- 1. Medical management
- 2. Surgical management
Frequently Asked Questions (FAQs)

What are Varicose Veins?

The term Varicose Veins refers to veins that become swollen, enlarged, and twisted. It is a condition affecting superficial veins, which refers to those that are present just beneath the surface of the skin. While any veins can be affected, the veins present in the legs are most commonly affected. Varicose Veins are quite a common occurrence, affecting around 30% of the population. Women are twice as likely to be affected than men, and the rate of incidence increases with age.

What causes Varicose Veins?

The exact cause of Varicose Veins is still not known. However, there are several well-known contributing factors. There is also a hereditary association. Some of the most common risk factors contributing to Varicose Veins are as follows.

Prolonged standing: People in professions like teaching, traffic policing, etc., where they stand for long periods of time are at higher risk.
Pregnancy
Menopause
Obesity
Lack of exercise
Conditions that cause continuous strain on the abdomen (such as chronically lifting heavy weights, prolonged coughing, etc.)
Leg injury
Chronic alcohol consumption
Pooling of venous blood (a phenomenon called venous reflux)

A major mechanism that causes Varicose Veins is the malfunctioning of the valves present in veins. Valves are mechanical structures that prevent the backflow of blood in veins. To simplify, they make sure that the blood from the legs continues to move upwards toward the heart instead of simply pooling in the feet. If there is valve damage or failure, it results in venous blood backflow and pooling at the peripheries.

What are the symptoms of Varicose Veins disease?

The most common symptoms of Varicose Veins are as follows.

The appearance of swollen, twisted/tortuous veins over the lower limbs
Aching pain in the legs
Muscle cramps on movement
Swelling of the ankles
Hardening of skin over the ankles with thinning of the skin
Burning or throbbing sensation in legs
Colour change of the skin over affected veins: Black-brown discolouration is usually seen
Dryness of skin with pronounced itching of the area: This is also known as venous eczema or dermatitis. It is due to the pooling of venous blood.
Formation of ulcers in affected areas: Varicose Veins result in wounds over the legs which have poor healing known as venous ulcers

How are Varicose Veins diagnosed?

If you notice any bulging veins in your legs along with colour changes in the skin and pain, you could probably be suffering from Varicose Veins. Your doctor will be able to make a diagnosis based on history and clinical examination. They will perform certain clinical tests to determine which venous systems may be involved. Your doctor may also order some scans like an ultrasound of your lower limbs, which is useful in assessing blood flow and functioning of the veins. An ultrasound scan is a non-invasive procedure that uses sound waves in high frequency. This is called a Doppler scan.

Another test that can be done is a venogram. This is an invasive test where a dye is injected into the veins and x-rays of your leg are taken. The dye is visualised on the x-ray film, and its flow through the veins can be correlated with disease progression.

These investigations are also important in ruling out other causes of lower limb pain, particularly a condition called Deep Vein Thrombosis, where there is a block in the deep veins of the leg, and can cause serious issues if left untreated.

What are the complications of Varicose Veins?

Leaving Varicose Veins untreated can result in a number of problems, resulting in worsening of the condition, such as the following.

Severe pain & tenderness
Inability to walk or stand for even short periods of time
Chronic ulcers over the legs that heal poorly and can extend to the underlying bone
Infections
Bleeding: This can be particularly severe in the elderly even after minor injuries
Thrombophlebitis: This is a condition wherein blood clots form in the affected areas. This can become a serious issue when it progresses to involve the deep veins, a condition called Deep Vein Thrombosis.

What is the treatment for Varicose Veins?

Depending on the severity of the Varicose Veins as assessed by your doctor, they may recommend conservative management or surgical intervention.

1. Medical management

Conservative management of Varicose Veins primarily involves the usage of Compression Stockings. These are used in conditions where surgical intervention is not possible in the immediate future. Compression stockings help relieve swelling and pain and improve microcirculation in the region. Pneumatic compression devices are also available which work similarly to provide symptomatic relief.

Leg elevation and regular exercise are recommended to both prevent as well as manage the disease. Calf muscles act as a peripheral pump and exercise promotes blood flow from the peripheries back to the heart.
Painkillers, both for local application and as tablets, can be used to provide temporary pain relief.
Venous ulcers require regular dressing and targeted treatment to prevent complications.

2. Surgical management

Surgical management remains the cornerstone of the treatment of Varicose Veins. Invasive treatment is recommended if:

Varicose Veins are symptomatic or recurring
Associated skin changes of the lower limb (colour changes, eczema, etc.) are seen
Thrombophlebitis
Ulcers occurring due to Varicose Veins

The surgical treatment options for Varicose Veins are as follows.

Surgical removal of the affected veins: This is a procedure where the affected vein is isolated, tied off, and stripped.
Sclerotherapy: A sclerosing agent is a substance that acts as an irritant. It is injected into the affected veins, where it triggers inflammation, closing, and shrinkage of the veins. It is usually done under local anaesthesia and under ultrasound guidance.
Ablation of the veins: This is a procedure that involves the application of either heat or lasers inside the vein canal. This damages the canal and closes it. It can be done under local or general anaesthesia, usually under ultrasound guidance.

Professionals like teachers, bus conductors, nurses, surgeons, traffic police, security guards, vendors, stage actors, etc., who stand for long periods of time are at higher risk. Preventive measures like losing weight, regular exercise, avoiding standing for long periods of time, etc., are helpful in preventing the occurrence of this disease.

Frequently Asked Questions (FAQs)

Here’s a list of common questions and answers related to Varicose Veins.

Can Varicose Veins be treated permanently?

Although surgical treatment methods are very effective, they may not guarantee a permanent solution. New veins can enlarge if appropriate preventive measures are not taken.

Why do Varicose Veins cause itching and rashes on the feet?

Varicose Veins hamper the circulation of blood. As a result, blood often pools near the feet. Because of this, red blood cells in the blood degenerate and release a pigment called hemosiderin. This pigment can get deposited in the skin and cause allergic changes called stasis eczema or stasis dermatitis. This causes itching and rashes in patients with Varicose Veins.

What are some home remedies to treat Varicose Veins?

While home remedies don’t provide a cure they do help prevent the worsening of Varicose Veins. Low-impact exercises like walking or swimming, a healthy diet with potassium-rich and high-fibre foods, and elevating the legs frequently are recommended.

Disclaimer: The content on this page is generic and shared only for informational and explanatory purposes. Please consult a doctor before making any health-related decisions.