Varicose veins are abnormally swollen and wriggly veins. Most commonly they are visible just below the skin in the superficial veins. Varicose veins are a result of higher pressure in the veins (venous system). Varicose veins are a quite common condition affecting about 20% of older adults. They range from small reticular (spider) veins which are 1-3mm to large 'rope like' veins which are 1-2cm wide.
The small reticular veins or telangiectasia usually are unsightly but do not usually cause swelling and pain. While the bigger veins tend to cause majority of the symptoms like swelling, pain, and skin damage.
What causes varicose veins?
The higher pressure in the veins can be caused by many reasons and medical conditions. Blood is pumped down to the feet in arteries by the heart. The blood then returns via veins to the heart. However, there is no pump. There are one-way valves inside the vein that help return the blood back to the heart. The most common cause of varicose veins is the one-way valve in the vein not working properly. This can be due to number of factors including age, obesity, and family history of varicose veins. The return of blood back to the heart can also be impeded for multiple other reasons, including blood clots, organ (heart, kidney & liver) problems, and patients can be born with different drainage routes.
In the leg, there are two sets of veins. The deep system is the most important drainage system and is not visible. It carries most of the blood back to your heart. The superficial veins are nearer the skin and carries some of the blood back to the heart. When the valves in these superficial veins malfunction varicose veins commonly develop. The blood pools around the foot and ankle and cause pain, swelling and skin discolouring. The superficial veins can also become prominent if the deep veins are not working, which is why the deep veins are checked with ultrasound scan prior to any intervention.
How do I prevent varicose veins?
Keeping a health weight is the most modifiable risk factor. Obesity put extra pressure on the veins. Preventing clots, which damages veins, is another modifiable factor. This involves keeping active, well hydrated and wearing compression stockings while immobile like long travel. Standing jobs per ser do not directly case varicose veins but can exacerbate your symptoms.
What are the dangers of varicose veins?
Varicose veins are not life endangering condition. Many patients do not get any symptoms and do not need treatment. Some do develop symptoms which range from mild swelling and ache to more troublesome complications. These include venous eczema with recurrent infection, bleeding veins, blood clots, and ulcers. If patients develop these complications, then it is generally advised to get treatment as these conditions are not trivial and can impact significantly on quality of life.