Varicose veins are bulging enlarged veins near the skin surface that most often affect the veins in the legs because standing and walking increase the pressure in the veins of the lower body. Spider veins are like varicose veins, but they’re smaller. Spider veins are found closer to the skin’s surface and might look like a spider’s web.
They commonly present with the following symptoms:
-An achy or heavy feeling in the legs.
-Burning, throbbing, muscle cramping and swelling in the lower legs.
-Worse pain after sitting or standing for a long time.
-Itching around one or more of the veins.
-Changes in skin color around a varicose vein.
Causes of varicose veins
Weak or damaged valves can lead to varicose veins. Arteries carry blood from the heart to the rest of the body. Veins return blood from the rest of the body to the heart. To return blood to the heart, the veins in the legs must work against gravity.Muscles tighten in the lower legs to act as pumps. Vein walls help blood return to the heart. Tiny valves in the veins open as blood flows toward the heart, then close to stop blood from flowing backward. If these valves are weak or damaged, blood can flow backward and pool in the veins, causing the veins to stretch or twist.
The two main risk factors for varicose veins are:
Family history. If other family members have varicose veins, there’s a greater chance you will too.Obesity. Being overweight puts added pressure on veins.Other things that might increase the risk of varicose veins include:Age. Aging causes wear and tear on the valves in the veins that help control blood flow. Over time, that wear causes the valves to allow some blood to flow back into the veins, where it collects.Sex. Women are more likely to get the condition. Hormones tend to relax vein walls. So changes in hormones before a menstrual period or during pregnancy or menopause might be a factor. Hormone treatments, such as birth control pills, might increase the risk of varicose veins.Pregnancy. During pregnancy, the blood volume in the body increases. This change supports the growing baby but also can make the veins in the legs bigger.Standing or sitting for long periods of time. Movement helps blood flow
Complications of varicose veins include:
Ulcers. Painful ulcers can form on the skin near varicose veins, mostly near the ankles. A discolored spot on the skin often begins before an ulcer forms. See your healthcare professional right away if you think you have a leg ulcer. Blood clots. Sometimes, veins deep within the legs get larger. They might cause leg pain and swelling. Seek medical help for ongoing leg pain or swelling. This can mean a blood clot.Bleeding. Rarely, veins close to the skin burst. This mostly causes only minor bleeding. But it needs medical help.Leg swelling. Longtime varicose veins can cause legs to swell.
Management of varicose veins.
1.Conservative management:
This includes lifestyle changes to avoid exacerbation of varicose veins.
Compressive stockings are the mainstay treatment. Measurement must be done to get the correct size of the stockings. A specialist must advice the level of the stockings depending on the varicose veins present. They could be up to the level of the knee, mid-thigh or upper thigh.
2.Surgical management:
1. Sclerotherapy: Sclerotherapy involves injecting a chemical solution (sclerosant) directly into the varicose or spider vein. The solution causes the vein walls to swell, stick together and seal shut, stopping the flow of blood. As a result, the vein fades within a few weeks.
2. Laser ablation of varicose veins. Instead of tying and removing the abnormal veins, they are heated by a laser. The heat kills the walls of the veins, and the body then naturally absorbs the dead tissue and the abnormal veins are destroyed. Blood is then redirected to normal veins. This method is minimally invasive since there are no incisions made on the skin avoiding any formation of scars
3. Radiofrequency ablation of varicose veins. This procedure is similar to laser ablation but instead of using laser, radiofrequency energy is used to ablate the veins. The outcomes are excellent and recurrence minimal.
4. Varicose veins stripping. Involves making of a small groin incision and accessing the great saphenous vein. Tying and ligation of the vein is done together with all its tributaries then the stripping of the vein is done up to below the knee.
In 2023 KUTRRH organized a medical camp where over 500 people were screened and several with varicose veins were treated. To date the cardiology department attends to varicose veins patients. Book an appointment through our telephone number 1558 to see a specialist.
By Dr. Enoch Makori : HOD- Cardio Thoracic Department-KUTRRH