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Varicose Veins

Varicose veins are gnarled, enlarged veins. Any vein may become varicose, but the veins most commonly affected are those in your legs and feet. That’s because standing and walking upright increases the pressure in the veins of your lower body.

For many people, varicose veins and spider veins — a common, mild variation of varicose veins — are simply a cosmetic concern. For other people, varicose veins can cause aching pain and discomfort. Sometimes varicose veins lead to more-serious problems.

Symptoms

Varicose veins may not cause any pain. Signs you may have with varicose veins include:

  • Veins that are dark purple or blue in colour
  • Veins that appear twisted and bulging; often like cords on your legs

When painful signs and symptoms occur, they may include:

  • An achy or heavy feeling in your legs
  • Burning, throbbing, muscle cramping and swelling in your lower legs
  • Worsened pain after sitting or standing for a long time
  • Itching around one or more of your veins
  • A painful cord in the vein with red discoloration of the skin
  • Colour changes, inflammation of the skin or skin ulcers near your ankle, which can mean you have a serious form of vascular disease that requires medical attention

Spider veins are similar to varicose veins, but they’re smaller. Spider veins are found closer to the skin’s surface and are often red or blue.

They occur on the legs but can also be found on the face. Spider veins vary in size and often look like a spider’s web.

 

Causes

Arteries carry blood from your heart to the rest of your tissues. Veins return blood from the rest of your body to your heart, so the blood can be recirculated. To return blood to your heart, the veins in your legs must work against gravity.

Muscle contractions in your lower legs act as pumps, and elastic vein walls help blood return to your heart. Tiny valves in your veins open as blood flows toward your heart then close to stop blood from flowing backward.

Causes of varicose veins can include:

  • As you get older, your veins can lose elasticity, causing them to stretch. The valves in your veins may become weak, allowing blood that should be moving toward your heart to flow backward.

Blood pools in your veins, and your veins enlarge and become varicose. The veins appear blue because they contain deoxygenated blood, which is in the process of being recirculated through the lungs.

  • Some pregnant women develop varicose veins. Pregnancy increases the volume of blood in your body but decreases the flow of blood from your legs to your pelvis. This circulatory change is designed to support the growing foetus, but it can produce an unfortunate side effect — enlarged veins in your legs.

Varicose veins may surface for the first time or may worsen during late pregnancy, when your uterus exerts greater pressure on the veins in your legs. Changes in your hormones during pregnancy also may play a role. Varicose veins that develop during pregnancy generally improve without medical treatment three to 12 months after delivery.

 

Risk factors

These factors increase your risk of developing varicose veins:

  • The risk of varicose veins increases with age. Aging causes wear and tear on the valves in your veins that help regulate blood flow. Eventually, that wear causes the valves to allow some blood to flow back into your veins where it collects instead of flowing up to your heart.
  • Women are more likely to develop the condition. Hormonal changes during pregnancy, premenstruation or menopause may be a factor because female hormones tend to relax vein walls. Taking hormone replacement therapy or birth control pills may increase your risk of varicose veins.
  • Family history.If other family members had varicose veins, there’s a greater chance you will too.
  • Being overweight puts added pressure on your veins.
  • Standing or sitting for long periods of time.Your blood doesn’t flow as well if you’re in the same position for long periods.

 

Treatment

Sclerotherapy

?This procedure involves injecting sclerosant through a tiny needle, very superficially into the veins, causing the lining of the vein to swell and clot. This clot formation stops the onward flow of blood through the vessel. There is usually minimal discomfort with the treatment due to the needle being so small. 

Microslerotherapy is a relatively quick procedure and most people can resume normal activities, including driving, on the same day.

Over the course of several weeks following your treatment, you may feel the veins are more pronounced and injection sites may feel slightly itchy. This is quite common and will fade over time. It is also possible you may need to schedule further treatments as some patients will require 2 to 6 treatments over 4-8 week intervals.

Endovenous Ablation

Varicose vein treatment, also known as endovenous ablation, uses radiofrequency or laser energy to cauterize and close varicose veins in the legs. It may be used for cosmetic purposes, but it is most commonly used to help ease varicose vein related symptoms such as aching, swelling, skin irritation, discoloration or inflammation. Endovenous ablation is safe, less invasive than conventional surgery, and leaves virtually no scars.

Ultrasound is used to visualize the varicose vein. A laser fiber or radiofrequency electrode is advanced to the desired location within the vein through an IV. Local anaesthesia is injected to collapse the vein around the laser and act as insulation for the heat of the radiofrequency or laser energy. Laser or radiofrequency energy is then applied, heating the vessel and causing it to close. Following the procedure, the faulty vein will shrink and scar down.