Varicose Veins
What are varicose veins?
Varicose veins are enlarged swollen veins present under the skin commonly seen in the legs and feet. They have a blue or purple colour and bulge through the skin. Veins allow blood to flow back towards the heart through internal valves that ensure that blood flows in the correct direction. Varicose veins are caused by faulty valves inside the vein leading to blood flowing in the wrong direction, towards the skin, resulting in the veins bulging under the skin.
What are the symptoms of varicose veins?
The main symptoms for varicose veins include:
• An unsightly appearance due to bulging veins in the legs
• Thread veins which are small clusters of veins present under the skin and are associated with sun exposure and hormone changes
• Heavy aching legs particularly at the end of the day and it tends to particularly trouble those who spend a long time standing e.g. chefs, waiters, teachers.
• Dry itchy skin around the area of the veins
• Skin discolouration
• Cramps in the legs especially at night
• Swollen ankles and feet
• Ulcers which are uncommon but are the most serious consequence of varicose veins
Thread Veins
What are thread veins?
Thread veins are small clusters of veins present under the skin and are associated with sun exposure and hormone changes. They may be associated with larger varicose veins which can be identified with an ultrasound scan. Most patients do not like the appearance of these veins and seek treatment for cosmetic purposes.
An effective treatment available for these veins is microsclerotherapy which involves the injection of a sclerosant through a very fine needle to close the vein. The aim of treatment is to allow these thread veins to fade over time.
Investigations Performed
Ultrasound
The vast majority of varicose veins require an ultrasound scan (duplex) to diagnose where the faulty vein is located that has led to the development of varicose veins. This is a simple painless procedure and takes 15-30 minutes to establish the diagnosis and plan treatment.
Treatment Options
Varicose veins can be effectively managed by seeing Mr Chaudery who will take a detailed history of your symptoms and perform a thorough examination. Most varicose veins require an ultrasound scan (duplex) to allow us to diagnose where the faulty valve in your vein is located. A tailor made treatment plan can then be formulated to ensure you get the best results.
Unfortunately, you cannot prevent varicose veins but there are measures to help relieve the discomfort which include:
• Exercise
• Do not stand for long periods of time
• Keep your skin well moisturised to prevent dry skin and itching
• Elevate your leg when in discomfort
• Wear compression stockings
However, these measures may not help some patients and do not improve the cosmetic appearance of varicose veins and therefore more definitive treatment options that may be recommended include:
• Sclerotherapy - this is commonly used to treat thread veins and small varicose veins using a fine needle to inject a sclerosant which irritates the lining of the vein leading to closure of the vein.
• Endothermal ablation - a walk-in walk-out, local anaesthetic procedure to seal the vein off using heat. This is very safe procedure with a rapid recovery and is the gold standard for treating varicose veins as recommended by NICE (the National Institute for Health and Care Excellence).
Radio Frequency Ablation
This is a minimally invasive safe procedure and is recommended by NICE (the National Institute for Health and Care Excellence) as the gold standard to treat varicose veins. It is performed under local anaesthetic and involves the use of radiofrequency energy so seal the vein. This procedure promotes a rapid recovery.