Varicose Veins
Varicose veins are enlarged, twisted, superficial veins — most commonly appearing in the legs as bulging, rope-like cords beneath the skin, often bluish or greenish in colour. They are an extremely common condition, affecting roughly one in three adults to varying degrees, and are caused by malfunction of the one-way valves within the veins that normally prevent blood from flowing backwards towards the feet.
How they develop
The veins in the legs face the considerable challenge of returning blood against gravity to the heart. This is normally achieved through the action of leg muscles (which squeeze the deep veins during walking) combined with one-way valves that prevent retrograde flow. When these valves become incompetent — due to a combination of genetic predisposition, prolonged standing, pregnancy, obesity, and ageing — blood pools in the superficial veins, which gradually dilate and elongate under the increased pressure to form varicosities. The great and small saphenous veins are most commonly involved.
Symptoms and complications
Many people with varicose veins experience no symptoms. Others complain of aching, heaviness, or throbbing in the legs — particularly after prolonged standing — as well as itching over the affected vein, and swelling of the ankles. Complications of longstanding, neglected varicose veins include venous eczema (skin inflammation around the ankle), lipodermatosclerosis (hardening and darkening of the skin), venous ulceration (open sores above the ankle that are notoriously difficult to heal), superficial thrombophlebitis (inflammation and clotting within a varicose vein, causing a tender, red, hard cord), and — rarely — significant haemorrhage from a ruptured varicosity close to the skin surface.
When varicose veins need treatment
Varicose veins causing significant symptoms, venous eczema, ulceration, or repeated episodes of superficial thrombophlebitis warrant treatment. Purely cosmetic treatment is also available but may not be funded through health services.
Choosing where to be treated
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