Why do I have varicose veins?
Those bulging blue or dark purple and cord-like veins on your legs, varicose veins, develop when the valves in the veins don’t work properly.
“Our veins normally take blood from the feet back up to the heart, and they’ve got valves that prevent blood from going back down the leg,” explained Vascular Surgeon Dr Anthony Freeman.
“When the blood refluxes back down the leg, this causes the pressure to rise and the veins become distended. People can experience pain, swelling, skin changes and ulceration.”
Who’s at risk?
“If you have a family history of varicose veins you are more likely to get them,” Dr Freeman said.
“Varicose veins can also worsen during pregnancy because progesterone levels go up.
“If you do have varicose veins, being overweight doesn’t help, but it doesn’t cause varicose veins,” he stressed.
And if you aren’t overweight but spend Monday through Friday at your desk, and all weekend watching Netflix, this isn’t helpful for varicose veins either.
Dr Freeman encourages his patients to get moving. “Walking stimulates the calf muscle pump, which helps with venous return,” the flow of blood back to the heart.
Diagnosis and treatment
“The best way to see what’s going on with the venous valves is with an ultrasound,” Dr Freeman said.
While wearing compression stockings, losing weight and being more active might help with the problems related to varicose veins, “none of these things will fix the incompetent valves.
“The aim [of treatment if necessary] is to address the problematic vein (or veins),” Dr Freeman said, referring to the several treatment options available.
“These include injection sclerotherapy, which treats the veins locally, causing the bulging varicose veins to be shut down.
“To treat significant venous incompetence, surgical stripping has been largely replaced with either endovenous laser ablation or gluing of the vein.
“Using glue is a new treatment that has the advantage of not requiring general anaesthesia.”
When to see your doctor
Uncomplicated varicose veins don’t necessarily require treatment, Dr Freeman said.
“However, if varicose veins are bothering you due to the appearance, discomfort, or swelling, then you should get the opinion of a [vascular] specialist.
“If the skin of the leg becomes pigmented or in extreme cases, breaks down, you can end up with ulcers. There is then a stronger argument for treatment.
“One other complication of varicose veins is superficial blood clots in the leg, which can be quite painful” - but unlike a potentially fatal deep vein thrombosis, superficial clots do not pose any serious health risks, Dr Freeman said.
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