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Varicose leg veins are a common problem that affects up to 30% of the population at some stage during their lifetime. They can cause many symptoms including heaviness, aching, burning, stinging, throbbing, leg cramps, restless legs and swollen ankles. In severe and longstanding cases they can cause eczema, pigmentation of the skin, ulcers, scarring and they may bleed.
In the normal, healthy circulation arteries and veins act as ‘one-way streets’, allowing blood to flow in one direction only. The heart pumps blood through arteries to the entire body. Blood is then returned to the heart through the veins. The contraction of the leg muscles acts as a pump to move blood up the leg veins against the force of gravity. The one-way valves in the leg veins prevent the backflow of blood down to the feet.
Abnormal or varicose veins have weak walls. Pressure from standing upright along with other factors, causes the veins to distend. The valves no longer function properly. Because of this distension “reflux” or “backflow” occurs in the affected vein. A vein showing reflux is called “incompetent”.
Unfortunately there is very little you can do to prevent varicose veins or surface veins from forming. Support pantyhose can help tired, aching legs but will not prevent veins from occurring. Varicose and surface veins will progress with time particularly if left untreated. Waiting until you have finished having children to treat your varicose veins is not sensible as varicose veins get worse with pregnancy. It is best to treat this condition early to minimize the number of treatments needed and avoid the complications of untreated varicose veins.
There are 3 types of abnormal veins and they are frequently seen in combination. SPIDER VEINS (telangectasias) are the fine red capillary veins. Larger blue veins are called RETICULAR VEINS and are slightly deeper in the skin. VARICOSE VEINS are the largest of the abnormal veins and can often bulge above the skin’s surface. However, they may not be visible yet still be causing reflux, so it is important to have an ultrasound examination at the initial consultation so you are aware of the full extent of your venous problem.
If the ultrasound examination at your initial consultation shows there is reflux in the underlying veins then it is not recommended to just treat the spider veins. While there may be some initial improvement in the appearance of the spider veins they soon reappear as their distension is being cause by the “backflow” from the underlying larger veins. It doesn’t make sense not to treat the underlying problem first. Eventually, congestion from the backflow can cause pain, fatigue, heaviness, aching, burning, throbbing, cramping or restless legs.
If you have a skin rash, dermatitis, lots of blue veins on your feet, discolouration of the skin or ulcers then you have advanced vein problems. Severe varicose veins interfere with the nutrition of the skin and lead to eczema, inflammation and ulceration. Treating the underlying abnormal veins will lead to improvement in most patients even once ulcers have developed.
Early treatment of varicose veins can reverse the symptoms of venous congestion and minimise the risk of varicose vein related complications and further progression of venous disease. Treatment becomes more urgent if there are already complications such as bleeding, inflammation (phlebitis), clots (thrombosis), dermatitis or ulcers. Please remember it is much easier to treat varicose veins when they are smaller, as early treatment tends to be less complicated and less involved.
At Sydney Inner West Vein Centre we recommend treatment before pregnancy as complications such as clotting and bleeding can develop during pregnancy. Varicose veins that worsen during pregnancy may not fully recover after pregnancy and may require more involved and complicated treatment than would be necessary before pregnancy.
At Sydney Inner West Vein Centre Dr David Jenkins is a phlebologist with advanced expertise in ultrasound diagnosis and management of venous disease. Sydney Inner West Vein Centre has the latest ultrasound and endovenous laser technology and we provide advanced techniques in UGS and microsclerotherapy. Phlebologists certified by the Australasian College of Phlebology (ACP) are highly skilled at assessing venous disease and can offer a wide range of treatment options. At Sydney Inner West Vein Centre we can provide you with a range of treatment options carried out by highly skilled professionals.
Spontaneous blood clots may occur with large varicose veins, and more rarely in the deep veins. DVT (deep vein thrombosis) can cause clots which may dislodge and travel to the lungs. This can cause damage to the lungs and in some cases death. Skin changes, including pigmentation, eczema hardening of the skin and underlying fat (called lipodermatosclerosis) and ulcers, may develop. Ulcers can become weepy, infected and painful. They can take months to heal.
© 2011 Sydney Inner West Vein Centre