There are many things you can do for yourself during the COVID-19 lockdown to self-manage your varicose veins. This is particularly important NOW, when this period of social distancing means that routine treatment for varicose veins is prohibited.
Measures that you can take now include:
- Elevation of the feet (ideally above hip level);
- Regular walking (even if up and down stairs, hallway or around a room) helps to reduce venous pressure which can reduce aching and swelling.;
- Skin care by daily moisturising;
- Wearing compression hosiery.
Compression hosiery can significantly relieve the symptoms of varicose veins and deep vein problems. These stockings can also reduce the risks of phlebitis, deep vein thrombosis and leg ulcers.
Compression hosiery in the UK is divided into three compression types. Class 1 is for light compression, Class 2 moderate and Class 3 is for firm compression. Class 3 which is usually used for patients with lymphoedema. Usually we recommend Class 2 compression for vein disorders.
Hosiery can be
- Below knee (which reduces pressure at the ankle and therefore is usually adequate for most patients with varicose vein symptoms even if the varicose veins are also located in the thigh)
- Full length thigh (which are used mainly after treatments or in patients who have had phlebitis in the thigh)
- and tights. The tights are infrequently prescribed as they can be a struggle to apply and are unnecessary for most patients.
Hosiery can also be
- open-toed (so the stockings end just before the toes)
- or closed like a normal sock. The type chosen is dependent entirely on preference. People with nail conditions like in-growing toe-nails often prefer the open toes and people with painful bunions tend to prefer the sock-like closed-toe versions.
When in bed, the ankles are at heart level and the vein pressure is reduced so it is not usually necessary to wear the stockings at night. Also, after removing them each day the skin can be checked regularly to ensure that there are no signs of damage. Well-fitted hosiery should be comfortable and shouldn’t leave deep indents. After removing them at night, this is a good opportunity to apply some moisturising cream. The legs should be moisturised at night after the stocking are removed. Putting on stockings shortly after creams is almost impossible, so moisturising in the morning should be avoided.
When we are planning to do a treatment for varicose veins the consultant will check to ensure that the arteries and capillaries are working sufficiently because before compression hosiery is applied, it is important to exclude any arterial problem which could worsen with compression. It is therefore important to avoid wearing stockings if you have any arterial disease or diabetes unless you have been checked by a nurse or doctor.
Whilst we are all avoiding unnecessary trips outside it is possible to purchase stockings online. The website I and my colleagues at the VeinCare Centre recommend is daylong.co.uk. The stockings on this site are reasonably-priced, it is clear which ones are also available on prescription, the delivery is usually speedy and the way to measure your legs is clearly demonstrated.
After you have measured your legs (usually just two measurements, the ankle and calf – unless a full length is required- when there will also be a third, the thigh measurement) you can look at the chart on daylong.co.uk to see which size you should be ordering. It is important that all your measurements should fall within the same size and ideally be in the middle of the range as this will mean that the stocking is likely to be more comfortable.
So for example, if your ankle measures 24cm and calf 38cm, then you can see that Although the small Altiform® stocking would fit, the medium Altiform® would be ideal for you as your measurements are nicely within its ranges. You fall outside the small Activa® range for calf measurement but the medium Activa® would be a good fit.
Some stocking manufacturers do long below-knee stockings for taller patients and extra-extra-large sizes but not all companies offer open toe versions or many colour options.
One important point about the fitting of below knee stockings is that they are not designed to come right up to below the knee as this is usually a smaller circumference than a hands-breadth below the knee joint. If the stockings are pulled up too high then they will roll down and this is likely to form a tight band which is counter-productive. Throughout the day it is important to check for wrinkles and any of these smooth out to prevent any skin damage. If the stocking alleviates symptoms and feels comfortable, it is doing its job; if it is painful or leaves dents or areas of skin irritation, something is wrong. The Daylong Site has a Customer Helpline: 0800 195 0160 (09:00-17:00) and you can speak to knowledgable members of staff.
Stockings can be washed in a machine but we would not recommend the use of tumble driers.
*This post was specially written by Miss Catharine McGuinness for our VeinCare Centre Website.