Once this happens at one valve there is extra pressure of blood on the next valve down. A combination of a slightly weak wall and extra pressure of blood may then cause the lower valve to become leaky too, and so on. This process can take a long time, but may gradually progress along the length of a vein. Blood then 'pools' in the enlarged vein and makes it stand out.
Who develops varicose veins?
About 3 in 10 adults develop the thick 'trunk' type of varicose veins at some time in their life. The thinner reticular or telangiectasia type varicose veins are more common, but may not be as obvious as the larger, 'knobbly' varicose veins. Most people with varicose veins do not have an underlying disease and they occur for no apparant reason. However, the chance of them developing is increased with:
- Pregnancy. This is partly due to the baby causing extra pressure on the veins, and partly because hormones you make during pregnancy tend to relax vein walls. The more babies you have, the more the risk of permanent varicose veins developing.
- Age. They are more common with increasing age.
- Being overweight which appears to increase the chance for women but not men.
- Standing lots. Jobs which involve lots of standing are often said to cause varicose veins. However, there is little scientific evidence to support this theory - so it may not be true.
Sometimes an underlying disease may cause varicose veins. For example, they may develop in superficial leg veins if you have had a previous blood clot (thrombosis) in a deep leg vein.
What are the symptoms of varicose veins?
Apart from being unsightly, most people with varicose veins have no symptoms. Larger trunk varicose veins sometimes ache or feel 'heavy' at the end of the day. Sometimes the skin over the veins may itch.
Are there any complications of varicose veins?
Most people with varicose veins do not develop complications. Complications develop in a small number of cases. If complication d o develop it is typically several years after the varicose veins first appear. However, it is impossible to predict who will develop complications. The visible size of the varicose veins is not related to whether complications will develop.
Possible complications include: inflammation of the vein (phlebitis); swelling of the feet; discolouration of the skin over the prominent veins; eczema of the lower leg; skin ulcers.
Do I need treatment for varicose veins?
Most people with varicose veins do not need any treatment. You may want to have treatment for one of the following reasons.
- Cosmetic reasons. You may not have any symptoms but the veins can look unsightly. Treatment for cosmetic reasons is not usually available on the NHS. However, many surgeons offer treatment privately.
- If complications develop which occur in a small number of cases. If leg swelling, skin discolouration, or eczema develops over prominent veins then treatment is usually advised to prevent a skin ulcer from developing. If a skin ulcer does occur then treatment of any varicose veins may help to cure it.
- For symptoms of itch or discomfort.
What are the treatment options for varicose veins?
- Support tights and stockings counter the extra pressure in the veins. They may help to ease ache but there is little proof as to how well they work. If you have symptoms such as ache, then they may be worth a try. Support tights and stockings may also help to prevent early complications such as foot or calf swelling from getting worse.
- Surgery. There are different techniques which can be used to remove the veins depending on their site and severity. A surgeon will advise. Usually. large 'trunk' varicose veins are stripped from the leg. Many people are treated as day cases and surgery is successful in most people. One to three weeks off work may be needed afterwards, depending on your job. Like all operations there is a small risk of complications, for example, damage to a nearby nerve. About 1 in 4 people treated with surgery develop recurrent varicose veins within 10 years.
- Injection into the vein with a chemical can 'sclerose' (close and compress) the vein. This is mainly used for smaller veins. It may cause staining of the skin near to the injection site.
- Laser or high intensity light treatment may be advised for tiny 'telangiectasia' varicose veins.
However, newer techniques have recently been developed to treat varicose veins. The aim of the new treatments is to reduce the need for traditional 'stripping' of the veins, and to reduce bruising or other possible complications of surgery.
One new method is to use a 'probe' which can be passed up a vein which can then 'obliterate' the vein by using heat or lasers. Another method is a new type of 'sclerosant' (similar to that mentioned above) but which can be used to treat larger veins.
These new methods have not yet become 'routine' or standard practice and need to be further evaluated. They are not normally available on the NHS. However, they may become more popular in the future. Your surgeon will advise as to the latest developments in treatment tecniques, and whether they are avaialable in your area.
©EMIS and PIP 2005
