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Varicose Veins – The Essentials


Here are 5 essential facts about Varicose Veins to help inform you when you make your decision about whether to have specialist treatment. I will cover What are they, what do they look like, what causes them, when are they a problem and how they can be treated.

What are they?

Varicose veins are enlarged lumpy and twisted veins beneath the skin which have abnormal reverse flow in them, called venous reflux.

typical-varicose-veinsWhat do they look like?

Varicose veins are instantly recognised by most people as clusters of lumps, sometimes referred to as a bunch of grapes.

What causes them?

No one knows for sure what causes varicose veins, but your age and whether your parents had varicose veins (heredity) are the 2 most important factors in their development. Many people notice varicose veins for the first time in pregnancy, and jobs that involve prolonged standing (hairdressing for example) may aggravate the condition.

Although surface varicose veins are pretty obvious, the cause of varicose veins is deeper under the skin. It is a problem called superficial venous reflux. That is a defect in the one-way valves that keep blood flowing in the correct direction. Venous valves are delicate folds in the lining of the vein that open and close keeping blood flowing in the correct direction. In the legs, healthy vein valves direct blood from the foot upwards back towards the heart. When the one-way valves in the veins do not work properly, gravity can pull the blood downwards in the wrong direction. Whenever fluid flows in the wrong direction in the body, it is called reflux. So, for example, many of you may be familiar with indigestion caused by acid reflux and a hiatus hernia, well, varicose veins and nearly all the common vein conditions such as spider veins, varicose eczema and leg ulcers are caused by reflux in the superficial veins. The only way to accurately diagnose vein conditions and their underlying cause is with a venous duplex ultrasound scan. This examination is performed with the patient standing and the deep veins, superficial veins and their connections are checked as well as the function of the valves. With a duplex ultrasound scan, problems such as obstruction and blockages as well as reflux and thrombosis can be accurately diagnosed and identified. A duplex ultrasound scan is the only reliable way to accurately diagnose the cause of vein conditions and it provides the information essential to formulate the correct treatment. NICE, the National Institute for Health and Care Excellence provides evidence-based national guidance on health matters and it recommends in its clinical guideline CG168 to use duplex ultrasound to confirm the diagnosis and to plan treatment. In its Quality Standard QS67 it also recommends that successful treatment should abolish reflux and the only way to confirm that this has happened is with a venous duplex ultrasound scan. So as you can see, ultrasound is necessary at all stages of vein diagnosis, treatment and aftercare. Surprisingly, superficial venous reflux may exist in the absence of visible surface varicose veins. Reflux can cause ache, throbbing, tiredness or even symptoms such as restless legs. Medical problems such as varicose eczema and varicose ulcers can develop without visible varicose veins. As the superficial venous reflux is the underlying cause, and as venous duplex ultrasound is the only way to identify superficial venous reflux reliably, it is clear that everyone with suspected vein problems, including spider veins, varicose eczema, leg ulcers, phlebitis or even deep vein thrombosis must have a venous duplex ultrasound scan to establish an accurate diagnosis.

When are varicose veins a problem?

Leg Varicose veins and superficial vein reflux can cause complications such as phlebitis, bleeding, varicose eczema, leg ulcers and deep vein thrombosis. In addition, many people suffer from ache, itch and ankle swelling. These symptoms can be distressing and aggravated by warm weather or after standing for long periods. It is generally acknowledged now that even thread veins cause symptoms in cases where they are caused by reflux. It is easy to dismiss how unsightly varicose veins and thread veins can be and many people can be so embarrassed about their veins that it affects what they can wear, what leisure activities they can peruse and even whether they enjoy a beach holiday.

Leg vein problems tend to get worse and a minority will go onto develop problems such as phlebitis, varicose eczema, deep vein thrombosis, bleeding and leg ulcers. Therefore, many vein specialists recommend early treatment. Not only will this reduce the risk of complications, but it will give better results.

How can they be treated?

People with varicose veins, under the advice of a healthcare professional, and in the absence of other health conditions such as diabetes or artery disease, can consider wearing good quality medical-grade compression socks or stockings, at least in the short term. Compression socks will relieve symptoms and reduce the risk of medical complications. For a longer-lasting solution, a vein scan and the advice of a vein specialist should be sought.

All our treatments for varicose veins are based on an individualised plan after a thorough duplex ultrasound scan of the deep and superficial veins of both legs. Depending on the nature of the problem, the most suitable treatment involves a combination following:

At your initial assessment, all these treatment options for varicose vein removal and thread vein removal will be discussed with you including their merits, side-effects and limitations as well as the cost. Your consultation will not be rushed and you will have ample opportunity to ask questions. Our treatment programme is in line with expert opinion from the National Institute for Health and Care Excellence (NICE Clinical Guideline CG168)

Varicose vein treatments can be carried out safely under local anaesthetic as a walk in, walk out non-invasive procedure.

If you would like more information about varicose veins please get in contact and one of our advisors will be happy to help you.