Varicose veins

Varicose veins are stretched, wide, visible veins that appear when the valves inside the veins stop working properly and blood pools in the superficial veins. They are most often located on the thighs, the calf muscles and behind the knees. Besides the unsightly appearance of the leg — including skin colour changes — varicose veins cause feelings of tiredness, heaviness and pain in the affected limb. The good news: today varicose veins can be treated with modern, minimally invasive methods, without classic surgery.

Why do varicose veins appear?

Veins are the blood vessels that carry blood from different parts of the body towards the heart. The structure of healthy veins contains only small amounts of muscle — which is why the flow of blood in any direction other than towards the heart is blocked by one-way valves. Varicose veins appear when, for various reasons, these valves no longer work optimally: blood is allowed to flow in both directions, the veins dilate, and their walls weaken and lose their elasticity.

What are the contributing factors?

• standing for too long periods of time
• prolonged and intense muscular effort
• excessive humidity and heat
• obesity
• hormonal imbalances (including those of pregnancy)
• injuries located at the level of the lower limbs
• genetic inheritance

What symptoms do varicose veins cause?

Besides the cosmetic problems, varicose veins produce a series of clinical manifestations:

• itching (pruritus) or heaviness in the lower limbs
• swelling of the legs (oedema)
• night cramps
• tingling and numbness (paraesthesia)
• burning sensations
• intolerance to physical exercise
• restless legs syndrome

How does varicose disease progress?

The symptoms of varicose disease are usually less severe in the early stages of the condition, become moderate in the intermediate ones and worsen after several years of progression. Untreated varicose veins tend to become larger and larger — and with them, the risk of complications grows too.

What complications can untreated varicose veins cause?

• Deep vein thrombosis — a medical condition involving the formation of blood clots in the deep veins. It can lead to pulmonary embolism, an extremely serious, life-threatening complication. Varicose veins are among the risk factors for deep vein thrombosis.
• Chronic venous insufficiency — the normal flow of blood through the vessels is impaired long-term; the main causes of the disease are varicose veins and chronic venous thrombosis.
• Venous (varicose) ulcers — varicose veins and venous insufficiency can cause breaks in the skin’s cell layer. Ulcers appear when the damaged skin allows bacteria and air to penetrate the tissue: open wounds or crusts form, with the surrounding area red and swollen, healing very slowly.
• Rupture of a varicose cluster — can cause massive bleeding and requires emergency medical care.

How can varicose veins be prevented or slowed down?

Genetic factors cannot be changed, but the progression of the disease can be slowed through simple gestures: avoiding prolonged standing or sitting, walking breaks during the working day, maintaining a healthy weight, hydration and regular movement — walking activates the calf muscle pump, which helps the venous return. At the doctor’s recommendation, compression stockings can relieve the symptoms. These measures do not, however, cure the varicose veins already formed — for those there are the minimally invasive treatments.

When should I see a doctor about varicose veins?

A vascular surgery consultation is recommended when veins become visible or unsightly, the legs feel heavy or swollen, or cramps, pain, burning, itching or skin changes appear. Treatment is best started in the early phase of the disease, at the first symptoms: early treatment gives the best aesthetic results and eliminates the risk of developing severe complications.

Frequently asked questions

Do varicose veins go away on their own?

No, as a rule varicose veins do not disappear spontaneously. The exception is some veins that appear in pregnancy, which can fade in the weeks after giving birth. Otherwise the disease progresses slowly, and untreated veins tend to grow.

Can young people get varicose veins?

Yes. Genetic predisposition, prolonged standing, pregnancy, hormonal changes, excess weight or intense effort can lead to varicose veins at young ages too.

Are varicose veins only a cosmetic problem?

No. Varicose veins are both a cosmetic problem and a real venous disease, which progresses and can develop complications — from chronic venous insufficiency to thrombosis and venous ulcers. The aesthetic reason is, however, a perfectly valid reason to seek medical help.

How are the diagnosis and the stage of the disease established?

Through a clinical examination and Doppler ultrasound, which shows how the valves work and the course of the venous reflux. Based on these, the doctor establishes the stage of the disease and the suitable treatment method.