Patient Information for Varicose Veins by Amrita Clinic
PATIENT INFORMATION FROM YOUR SURGEON & SAGES
What are varicose veins?
Varicose veins are veins under the skin of the legs, which have become widened, bulging, and twisted.They are very common and do not cause medical
problems in most people.
There are two main systems of veins in the legs:
Deep veins. The leg muscles squeeze the deep veins during walking, carrying most of the blood back up the legs to the heart.
Superficial veins occur under the skin which are less important and can form varicose veins.
All of these veins contain one-way valves to ensure that the blood flows towards the heart.
Failure of these valves allows blood to flow backwards down the veins and results in an overload of pressure when standing. This excess pressure leads to widening of the veins so that they do not close properly. Blood then flows back into the leg along these veins and causes varicose veins.
Raised pressure in these veins also encourages the development of spider veins and discolored areas which look like bruises.
What causes varicose veins?
Varicose veins and spider veins often run in families and there may be a hereditary component.
Women are more likely to suffer from varicose veins and up to 50% of women may be affected.
Hormonal factors- puberty, pregnancy, menopause, the use of birth control pills, and HRT affect the disease.
Pregnancy: It is very common for pregnant women to develop varicose veins during the first trimester.
Pregnancy causes increases in hormone levels and blood volume which in turn cause veins to enlarge.
Other predisposing factors aging, standing for long periods of time, obesity and leg injury.
What are the symptoms?
Many people have no symptoms at all .the commonest symptoms from varicose veins are aching, discomfort, and heaviness of the legs, Sometimes the ankle can swell, too.
These symptoms are not medically serious, but can be treated if they are sufficiently troublesome.
In a few people, the high pressure in the veins causes damage to the skin near the ankle, which can become brown in colour, sometimes with scarred white areas.
Eczema (a red skin rash) can develop.
Other problems which varicose veins can occasionally produce:
Phlebitis means inflammation of the veins, and is often accompanied by clotting of blood inside the affected veins, which become hard and tender.
Bleeding
The risk of bleeding as a result of knocking varicose veins worries many people, but this is very rare. It will always stop with firm pressure and the veins can then be treated to remove the risk of further bleeding.
Varicose veins are associated with DVT in some patients.It is not clear whether varicose veins themselves increase the risk of DVT, but certainly DVT leads to varicose veins and skin damage around the ankle. Other problems which varicose veins can occasionally produce:
Phlebitis means inflammation of the veins, and is often accompanied by some thrombosis (clotting of blood) inside the affected veins, which become hard and tender.
Bleeding The risk of bleeding as a result of knocking varicose veins worries many people, but this is very rare. It will always stop with firm pressure and the veins can then be treated to remove the risk of further bleeding.Varicose veins are associated with DVT in some patients.
What tests are there to investigate varicose veins?
-continuous wave Doppler. It indicates where the veins have come from and helps in the planning of any operation that might be required.
-An ultrasound scan (duplex) may be performed instead. This will allow detailed examination of your deep veins particularly if there is a past history of deep vein
thrombosis.
Varicose veins behind the knee and recurrent varicose veins will also require duplex scanning.
Treatments available:
- Operation
- Endovenous Laser Therapy
- Foam Sclerotherapy
- Radiofrequency ablation
(Read more: Varicose Veins Treatment)
All of the above will require duplex scanning as part of their selection process and the monitoring of the treatment itself.
Is treatment successful?
Stockings are effective in controlling symptoms and preventing skin complications. They are only effective if worn regularly, but can reliably avoid the need for surgery in the majority of patients. Injection of varicose veins can be successful, but the long term outcome of the new treatment of foam sclerotherapy requires further evaluation. Surgery is followed by a recurrence rate (varicose veins returning) of about 1 in 7 over a ten year period. This recurrence may be due to poorly planned or performed surgery, new vein formation, or due to new valve leaks beginning elsewhere. There is a small risk of deep vein thrombosis (DVT) after surgery 
which can be reduced by wearing compression stockings and remaining mobile after the operation.
Can I help myself?
Simple measures wearing support stockings will control the symptoms for many people.
Stockings may help to prevent progression or enlargement of varicose vein.
If you are overweight you should try and lose weight.
Whilst we make every effort to ensure that the information contained in this patient information sheet is accurate, it is not a substitute for medical advice or treatment.
The information provided is intended to support patients, not provide personal medical advice.
