Many people believe, including some doctors, that varicose veins and other leg vein conditions are simply cosmetic and of no particular importance.
This is quite simply not true.
And it’s not just me saying that: the National Institute for Health and Care Excellence in the UK (NICE – nice.org.uk) recognises varicose veins as a health issue. NICE, supported by the Royal College of Surgeons, states that “all patients with varicose veins who have symptoms …or complications… should be referred to a vascular service.” (Guideline CG168)
So what are the symptoms? Varicose veins are caused by faulty one-way valves giving rise to a condition called “superficial vein reflux” in which blood in the leg veins flows backwards in the wrong direction. In the same way that acid reflux in the stomach can cause indigestion symptoms, superficial vein reflux may cause leg ache, swelling and throbbing after standing for a long period and symptoms are often worse in the evening or at night. Varicose veins frequently deteriorate; the veins enlarge and spread and if you have varicose veins for long enough, you may suffer one or more significant complications. It may be many years before a complication arises. Here are five important ones to be aware of.
First is phlebitis. This is a condition characterised by inflammation and clotting within the varicose veins. The area becomes hot, red and painful. The clot within the vein can spread very quickly into the deep veins causing a deep vein thrombosis. Everyone with suspected phlebitis should have duplex ultrasound scan of the veins, firstly, to confirm the diagnosis and then to guide the treatment. Some people with phlebitis require blood-thinning medication to prevent DVT or to prevent fatal pulmonary embolism. So it is an important complication.
- The second important complication of varicose veins is varicose eczema. This is a condition of the skin that it indicates that the skin is damaged and deprived of nutrients and oxygen. It typically occurs on the lower leg and the area is vulnerable to break down. Sometimes, varicose eczema can in fact occur with so called “hidden or deep varicose veins”. So if varicose eczema is suspected, even if there are no varicose veins, a scan should be performed to check the vein circulation and to look for hidden varicose veins.
- Thirdly, varicose veins can bleed. Fortunately this is not very common. However, big bulging varicose veins on the lower leg are vulnerable and they are under very high pressure, so if they are injured, bleeding can be very serious. In such cases, leg elevation and the application of direct pressure will usually stop the bleeding.
- Fourthly, varicose veins are a risk factor for DVT. The presence of severe varicose veins and reflux increases the risk of developing a deep vein thrombosis in certain situations such as a long haul flight or admission to hospital.
Lastly, varicose veins and venous reflux are a major causes of leg ulcers. 4 out of every 5 leg ulcers are caused by vein problems and early treatment of varicose veins can prevent ulceration. So, there are the 5 important complications of varicose veins – phlebitis, varicose eczema, bleeding, increased risk of DVT and leg ulcers.
If varicose veins are so important and if NICE and the Royal College of Surgeons advise that they should be treated, why is it so difficult to get NHS treatment? Well, we all know that the NHS is under pressure and it has to cope with conditions like cancer, heart attack and trauma to name but a few. Sadly, varicose veins are not a priority and many people are forced to seek private treatment.
My team and I in Dorset provide safe, effective, non-surgical treatments under local anaesthetic on a walk-in, walk-out basis. Our treatments are carried out by medical specialists in line with National Guidance including that of the Royal Colleges and the National Institute for Health and Care Excellence. If you would like to know more, call 01935 873 951 for a free, no obligation chat with our adviser or request an information pack; alternatively, you can use our contact form
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