- Aching, heavy legs (often worse at night and after exercise).
- Appearance of spider veins in the affected leg. Ankle swelling, especially in the evening.
- Redness, dryness, and itchiness of areas of skin, termed statis dermatitis or venous eczema, because of waste products building up in the leg.
- Cramps may develop especially when making a sudden move as standing up.
- Whitened, irregular scar-like patches can appear at the ankles. This is known as atrophie blanche.
Most varicose veins are reasonably benign, but severe varicosities can lead to major complications, due to the poor circulation through the affected limb. These include-
- Pain, tenderness, heaviness, inability to walk or stand for long hours, thus hindering work.
- Skin ulcers especially near the ankle, usually referred to as venous ulcers.
- Development of carcinoma or sarcoma in longstanding venous ulcers. Over 100 reported cases of malignant transformation have been reported at a rate reported as 0.4% to 1%.
- Acute fat necrosis can occur, especially at the ankle of overweight patients with varicose veins. Females are more frequently affected than males.
Varicose veins are veins that have become enlarged and twisted. The term commonly refers to the veins on the leg, although varicose veins can occur elsewhere. Veins have pairs of leaflet valves to prevent blood from flowing backwards (retrograde flow or venous reflux).
Arteries carry blood from your heart to the rest of your tissues. Veins return blood from the rest of your body to your heart, so the blood can be recirculated. To return blood to your heart, the veins in your legs must work against gravity. Muscle contractions in your lower legs act as pumps, and elastic vein walls help blood return to your heart. Tiny valves in your veins open as blood flows toward your heart then close to stop blood from flowing backward.
types of varicose veins-
- Trunk varicose veins – these are near to the surface of the skin and are thick and knobbly; they are usually visible, often quite long, and can look unpleasant
- Reticular varicose veins – these are red and are sometimes grouped close together in a network
- Telangiectasia varicose veins – also known as thread veins or spider veins, these are small clusters of blue or red veins that sometimes appear on your face or legs; they are harmless and, unlike trunk varicose veins, do not bulge underneath the surface of the skin
Traditionally, varicose veins were investigated using imaging techniques only if there was a clinical suspicion of deep venous insufficiency, if they were recurrent, or if they involved the saphenopopliteal junction. This practice is not now widely accepted. Patients with varicose veins should now be investigated using lower limbs venous ultrasonography. The results from a randomized control trial on patients with and without routine ultrasound has shown a significant difference in recurrence rate and re operation rate at 2 and 7 years of follow-up.
However, there are ways to ease symptoms of existing varicose veins, such as: avoiding standing or sitting still for long periods and trying to move around every 30 minutes, taking regular breaks throughout the day, raising the legs on pillows while resting to ease discomfort.
treatment
Treatment can be either conservative or active. Active treatments can be divided into surgical and non-surgical treatments. Newer methods including endovenous laser treatment radio frequency ablation and foam sclerotherapy appear to work as well as surgery for varices of the greater saphenous veins.
Most varicose veins don’t require any treatment. If treatment is necessary, your doctor may first recommend up to six months of using compression stockings, taking regular exercise and elevating the affected area when resting.