Varicose veins are simply swollen veins. They appear as raised blue and lumpy blood vessels and usually occur on the legs, on the back of the calf or thigh muscle. Although they may look unsightly, they do not normally pose any risk to health. Varicose veins are common affecting 10 to 15 out of every 100 men and 20 to 25 out of every 100 women.
What causes varicose veins?
Varicose veins occur if the walls and valves in the vein become weak. The valves in the veins are supposed to be one-way - allowing blood to flow only forwards. But if the vein gets stretched or loses its elasticity the valves can get weak enabling blood to flow backwards where it collects in the vein causing it to become swollen and enlarged. It’s not clearly understood what causes this weakening.
How is the condition treated?
Compression stockings (support hosiery) are useful both to prevent varicose veins developing and to prevent them from getting worse. Support hosiery squeezes or compresses the legs from the ankles upwards to support the veins and improve their blood-flow.
The stockings are available in three compression strengths. Class 1 hosiery provides light support and is used in the early stages of varicose veins. Class 2 hosiery provides medium support for varicose veins of moderate severity. Class 3 hosiery provides strong support for large varicose veins. Support hosiery, which come in all sizes and are suitable for men and women, can be purchased from pharmacies or obtained via an NHS prescription.
If leg pain is particularly severe, painkillers such as paracetamol or ibuprofen can be helpful.
For varicose veins that are very troublesome or unsightly, there are a number of medical or surgical procedures to remove or block the veins, provided other veins in the legs are working properly to compensate. A GP can refer you to a vascular surgeon for treatment.
The medical or surgical procedures used will depend upon the size and location of the veins affected. Small, spider veins (telangiectasias) and small veins that are not part of the main veins can be treated by sclerotherapy. Sclerotherapy involves injecting a drug called sodium tetradecyl sulphate that causes the vein to harden and close off. The procedure is carried out under a local anaesthetic.
Larger veins are removed surgically through small puncture-like incisions made in the leg. The procedure is carried out under general anaesthetic.
Other treatments include radiofrequency ablation - which involves using ultrasound and heat to break-down the vein; endovenous laser treatment - using ultrasound and a laser to heat and seal the vein; and transilluminated powered phlebectomy which involves cutting the veins and removing them with a suction device.
Alternative Remedies & Self-help
- Life-style changes can reduce the chances of getting varicose veins, delay varicose veins from forming and, if you have varicose veins, help reduce pain.
- Regular exercise will strengthen your leg muscles, increasing circulation in the legs.
- Keep your legs, ankles and feet moving during the day. If sitting or standing for long periods - tense and relax your leg muscles, rotate your feet and wiggle your toes. Try not to cross your legs as this restricts blood flow in the veins.
- If you have to stand for long periods, wear comfortable shoes and support hosiery. Try to switch your body weight from one leg to another at regular intervals, rather than letting one leg take most of the strain.
- Try to lose weight by eating a balanced diet, increasing fruit and vegetable intake and cutting down on junk foods and saturated fats.
- Drink plenty of water to maintain hydration which will help you keep your blood volume within normal range and to maintain a healthy circulation.
- Avoid wearing tight clothes, especially those that are tight around your waist, upper thighs and legs. Tight clothes obstruct the flow of blood back to the heart and can make varicose veins worse.
- If you smoke, try to give up.