What are Varicose Veins?

Varicose veins refer to the dilated superficial veins of the lower limb that occur due to venous blood reflux resulting from weakened valves of the veins or genetic factors 1]. Standing and walking for longer durations increases the likelihood of high pressure in the veins of the lower limb resulting in twisted torturous veins. These veins appear blue or purple and itchy or painful bulges on the lower limbs.

 

What are the Symptoms of Varicose Veins?

Apart from being clinically evident, varicose veins may also present with other symptoms as well. Following are the symptoms of varicose veins [2]:

• Bulging veins: Blue/purple twisted dilated web-like veins are visible on the skin. Mostly appear near the ankles and feet where there is most pressure load.
• Itching: Itching is common near these varicose veins.
• Pain and swelling: Dilation results in swelling and pain in the legs, predominantly behind the knee. One might experience throbbing pulsatile pain.
• Ulcers or discoloration: Without medical attention, these blue discolorations might turn brown and result in ulcer formation.

 

Causes of Varicose Veins:

When the valves of veins fail to function properly, varicose veins develop. There are one-way valves present in the veins that prevent the backward flow of the blood.  Weakening or damage to these valves leads to the accumulation of blood in the veins, leading to their enlargement.

Other potential causes for the development of varicose veins are [3]:

• Obesity
• Pregnancy
• Prolonged standing
• History of vein surgery
• Trauma to skin
• Overexposure to Ultra Violet (UV) light
• History of varicose veins in the family
• Menopause

 

 

Complications of Varicose Veins:

While varicose veins mostly do not pose a threat to one’s life, there are a few complications that might result if left untreated [4].

• Blood clots formation
• Bleeding
• Ulceration
• Deep Venous thrombosis (DVT)
• Pulmonary embolism

 

What are the Risk Factors of Varicose Veins?

Multiple risk factors are responsible for the development of varicose veins, these include:

• Age
• Smoking
• Gender
• Hereditary
• Lifestyle

 

Treatment of Varicose Veins:

Asymptomatic cases do not require any treatment. However, if symptomatic cases are not treated, varicose veins may become severe. The treatment options for varicose veins are [5]:

• Leg elevation:

Elevating your feet above the level of the heart three to four times daily for at least 15 minutes can be an effective measure to reduce swelling associated with varicose veins, particularly in mild to moderate cases.

 

• Compression stockings:

Compression stockings are elastic stockings that cause squeezing of the veins to avoid pooling of the blood. Wearing them every day can be helpful in the case of varicose veins.

• Sclerotherapy:

Varicose veins are most commonly treated through sclerotherapy. In this treatment option, the veins are injected with a saline or chemical solution so blood can no longer flow in them. It starts circulating through other normal veins.

Other treatment options include:

• Vein stripping
• Microphlebectomy
• Thermal ablation

 

References:

1. https://www.ncbi.nlm.nih.gov/books/NBK470194/
2. https://www.ncbi.nlm.nih.gov/books/NBK279247/
3. https://www.ncbi.nlm.nih.gov/books/NBK470194/#:~:text=Venous%20reflux%20disease%20or%20venous,and%20telangiectasias%20(spider%20veins).
4. https://pubmed.ncbi.nlm.nih.gov/31150188/
5. https://www.ncbi.nlm.nih.gov/books/NBK470194/#:~:text=Phlebectomy%20involves%20the%20removal%20of,not%20useful%20for%20varicose%20veins.&text=Patients%20with%20milder%20symptoms%20of,symptomatic%20relief%20with%20compression%20stockings.

 

 

 

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