Varicose Veins

This blog discusses varicose veins and how they can potentially develop and some of the treatment options if you are suffering from them including lifestyle changes and support stockings.

Clinical Features / Signs:

Varicose veins and telangiectasia are both signs of venous insufficiency. Varicose veins look like thick, blue, tortuous veins just below the surface of the skin. They are highly visible, twisted and swollen. They are far more common in females than in males, particularly on the leg and foot of elderly patients.

In some patients the skin may change, resulting in discolouration (a blue-ish skin colouration around the vein), rashes and sores that may develop into ulcers.

As a result of venous insufficiency any injury to the area may bleed heavily, take a long time to cease bleeding and take a long time to heal (resulting in an increased risk of ulceration).

Symptoms:

Symptomatic i.e. the feet and ankles may be swollen and the patient may describe the symptoms as burning, throbbing or severely aching. Some patients may describe their legs as feeling heavy, particularly at night or after standing for long periods or exercising. The skin over and around the varicose veins is likely to be thin (this may lead to venous/varicose eczema) and the patient may experience constant itching.

Sometimes the poor venous return (and associated build-up of waste products) may result in a condition called stasis dermatitis (a darkened, itchy skin condition).

These conditions are more common during the day. In really severe cases the patient may develop leg ulcers and thrombophlebitis (an infection of a section of the vein, which may result in the development of a clot). Furthermore, the condition can be very unsightly, which causes particular problems for female patients.

Aetiology / Cause (acquired / congenital):

Venous insufficiency results in varicose veins and various forms of telangiectasia.

Varicose veins develop when the valves of the veins become damaged / incompetent, which results in pooling of the blood in the veins, which in turn results in the veins becoming enlarged and visible beneath the surface of the skin.

Varicose veins can be caused by hormones (as seen in menopause, pregnancy or puberty), which together with increased blood volume weaken vein walls (pregnancy is a key factor contributing to the formation of varicose and spider veins). Varicose veins may be inherited or develop as a result of excessive body weight, or previous leg injury.

Lifestyle and occupation are two other factors, which play a role in the development of varicose veins and telangiectasia e.g. prolonged standing or sitting. In both instances blood continually pressing on closed valves causes them to fail, which in turn leads to vein distension.

Some people are far more prone to this condition than others and may require repeated treatment due to the condition reoccurring.

Pathology:

Normal veins / valves allow blood through the valves (on its way back to the heart) and then close to prevent backflow.

Abnormal veins / valves allow blood through the valves (on its way back to the heart) and then fail to close properly, which allows backflow.

Treatment / Management:

There are several treatments available for this condition:-

  • Small veins (less than 4mm in diameter) can be removed by laser / light therapy.
  • Larger veins can be surgically removed.
  • Surgery (in severe cases) to remove the veins.
  • Alternatively, a combination of the above treatments may be used to provide the best results.
  • Management of the condition could include wearing support-stocking to prevent the condition from worsening, moderate exercise such as walking, not standing for too long, avoiding crossing legs, lying down and raising the legs.

 Patient Advice:

 

  • Wear support-stockings helps to prevent the condition from worsening.
  • Do not cross your legs.
  • Do not stand for long periods of time.
  • Engage in a daily regime of moderate exercise such as walking.
  • Lie down and raise the legs (a pillow under the feet should be sufficient).
  • Anti-inflammatory medication such as aspirin or ibuprofen can be taken to reduce the symptoms.
  • Try to reduce body weight to the normal range for your height.

 

 

At The Footcare Centre the podiatrist will provide suitable treatment plans and advise on management of the condition. For any further information regarding the following treatment options please do not hesitate to contact us on 01932 849373 or book online.

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