Varicose veins are dilated, tortuous veins in the legs caused by a failure of valves in the veins. They tend to run in families and are often made worse by prolonged periods of standing or multiple pregnancies. These cause stress to the veins wall, which ultimately begins to stretch and cause more valves to fail
Varicose veins fall into there groups
- Uncomplicated – some patients has no symptoms at all apart from the veins being unsightly. They are usually very active physically and their active leg muscles compensate for the weakness of the vein function.
- Mild symptoms – aching and cramps in the leg, itchiness near the area of the veins and swollen ankle. All these are worse with prolonged standing.
- Severe symptoms and complications – leg ulcers, bleeding and thrombophlebitis.
Varicose veins are not only an appearance issue, untreated it can progress and give rise to other medical problems. There are many reasons why you should seek treatment if you have varicose veins
- Symptoms: Initially, varicose veins do not cause much in the way of symptoms. As they progresses, patients begin to experience discomfort in the form of itch, aches, cramps and ankle swelling.
- Progressive Disease: Once established varicose veins progress over time. Stockings and leg elevation can relieve the symptoms and slow the progression but they don’t deal with the underlying problem. A small number of patients progress to develop skin complications including phlebitis, excema and more permanent discolouration.
- Leg Ulceration: If you see pigmentation and irritation of the skin around the ankle, it may mean that your varicose veins are fairly advanced with a risk developing leg ulceration.
A wide range of treatment options are available
- Thermal ablaton. This can be performed with laser (EVLT) or radiofrequency ablation (VNUS). These are short procedures, carried out under local anaesthesia on a walk in, walk out, walk home basis. A single treatment only is required which takes less than three quarters of an hour. Around 70% of patients can be treated this way and recurrence rates are low.
Ultrasound guided foam sclerotherapy. Here, instead of removing the varicose veins, a foam is injected into the varicose veins to try and close it. This method is quick to perform, cheap and non-invasive. However it may require repeat treatment sessions and recurrence rates are higher.
Varicose vein surgery. Here the veins are completely removed. If there are small numbers of veins only, and no reflux in the main veins, then this can be done simply under local anaesthetic. Where larger numbers of veins are present, or the main veins need stripped, then surgery under genial anaesthesia is required. Operations are usually performed as day cases take between 45 and 90 minutes.
The key to successful treatment is a careful assessment of your veins. Non-invasive treatments such as Thermal Ablation or Foam Sclerotherapy are often the best way to control symptoms or reducing skin complications of varicose veins. Surgical removal often offers the best cosmetic outcome. A detailed ultrasound assessment is carried out, looking looking for the underlying cause of your varicose veins. This will then allow planning of an individualised treatment regimen that best suits your needs.