Varicose veins

What are varicose veins?

Varicose veins are twisted, enlarged blood vessels found under the skin. They are blue, purple, or red and are mostly found in the legs. They can be itchy and painful. Sometimes, small purple or red thin veins appear around the varicose veins known as spider veins.

Almost 23 percent of the adult population suffers from varicose veins. It is very common in obese and pregnant women. Varicose veins are easily visible as raised swollen veins on the skin’s surface. They are usually not harmful and can be treated at home with simple home remedies and lifestyle changes.

On some occasions, varicose veins develop deep inside the legs and cause serious pain, discomfort, and even blood clots. If the symptoms become severe, doctors recommend laser therapy, injections, or surgeries.

Who can get varicose veins?

Varicose veins are more common in women. Here are a few factors that increase the chances of getting varicose veins:

Old age

Older people are more likely to get the disease. With age, the valves and the lining of the blood vessels lose their elasticity and become stiff.

Genetics

People with a family history of varicose veins.

Women

Hormonal changes due to menopause, pregnancy, or birth control pills.

Smokers

Smoking or overconsumption of tobacco.

Obese people

Increased weight puts pressure on the blood vessels.

Posture

Sitting in the same position or standing for long periods can decrease blood circulation.

Clothing

Compression garments like tight clothes, skinny jeans, girdles, or tight waistbands in trousers or skirts.

Causes for varicose veins

Our veins have crescent-shaped flaps that help the blood to move in one direction. These are one-way valves that prevent blood from backflow. In varicose veins, the valves stop working properly. The muscles are weak and no longer able to push the blood. As a result, the blood accumulates in the veins. This increases the venous pressure and causes the vein to bulge and twist. Superficial veins closer to the skin’s surface lack muscle support and have a propensity to become varicose.

Other causes:

• Obesity.
• Old age.
• Pregnancy.
• Menopause.
• Family history.
• Sedentary lifestyle.
• Standing or sitting for too long.
• Chronic constipation.
• Previous leg injuries.
• Tumors.
• Restrictive clothing.
• Hormonal changes.

Treatment options

Doctors recommend treatments if there is discomfort or pain. Some patients are bothered by the appearance of varicose veins and seek treatment for cosmetic purposes. For mild symptoms, there are certain home remedies and lifestyle habits that help.

Home remedies:

Exercise regularly

Regular exercises increase blood circulation and regulate blood pressure. Physical activities and exercises help the accumulated blood to flow properly. Do moderate exercises like calf-muscle exercise, walking, swimming, yoga, cycling, etc. They do not strain the body and help to regulate the blood pressure which can contribute to varicose veins.

Maintain body weight

Obesity is one of the prime causes of varicose veins. Excess body weight puts additional pressure on the blood veins. The veins push harder to allow the blood to flow and this leads to varicose veins. A healthy diet and physical exercises help to regulate the body weight and prevent the condition to aggravate.

Compression stockings

Wearing compression stockings puts pressure on the legs. It helps in venous blood circulation and moves the blood towards the heart. It also relieves pain and swelling in the legs. Compression stockings are available at local drugstores or can be bought online. Prescription compression stockings are given by doctors. They are custom-made that adjust the compression strength according to the need of the patient.

Elevate the legs

Put your legs on a pillow or a high stool for fifteen minutes. Repeat the process once in two hours. Keep the legs on a pillow while you are asleep. This helps the blood to flow in the right direction.

Move your body

Avoid sitting or standing for long time. People with sitting jobs can take frequent breaks. Move around or change the position. It helps in blood circulation.

Apply moisturizer

If you have flaky skin, dryness, or itching, apply a good moisturizer. Emollient cream and petroleum jelly can give relief to varicose eczema.

Take care of your diet

Increase fibers in your food. It prevents constipation. Straining during bowel movements can aggravate blood vessel damages. Flaxseed, oats, nuts, legumes, wheat, whole grains, etc. are fiber-rich foods. Avoid salty foods. Salts retain water in the body. Eat foods that are rich in potassium like almonds, leafy vegetables, lentils, pistachio nuts, fish like salmon and tuna, potatoes, etc. Potassium reduces water retention in the body.

Flavonoids

Flavonoids are plant compounds found in some vegetables, fruits, cocoa, tea, etc. They contain natural ingredients that improve blood flow and reduce blood retention in the veins. They help to maintain the blood pressure and relax the blood vessels. Foods like cocoa, broccoli, onions, spinach, grapes, apples, blueberries, garlic, etc., are rich sources of flavonoids.

Wear loose clothing

Tight-fitting clothes restrict blood flows. Try wearing loose-fitted trousers, jeans, and skirts. Avoid wearing heels as much as possible. Flat shoes and slippers improve blood flow in the veins.

Body massages

Apply some oil or moisturizers and gently massage the affected area. It relaxes the veins and improves blood flow. Don’t put too much pressure on the legs. It can damage the veins.

Herbal remedies

Horse chestnut is a herb that contains a compound called aescin. Oral consumption of horse chestnut extracts reduces the symptoms. Extracts from pine barks and grape seed strengthen the blood vessel tissues and reduce swelling. Butcher’s broom (Ruscus aculeatus) contains components that improve blood circulation. It is taken orally.

Essential oils

Oils extracted from herbs, flowers, plants, or trees are often used to treat varicose veins. Grapevine oil, sea pine, and lavender oils have compounds that reduce swelling, skin ulcers, or edema.

Over-the-counter medications:

Anti-inflammatory medications like ibuprofen and aspirin reduce pain and inflammation. If pain persists and there is discoloration of the skin, there are chances that the deep veins are affected. Patients must seek immediate medical consultation.

Surgery:

If home remedies or lifestyle changes do not relieve the symptoms, doctors may decide to perform surgery. Surgeries are more invasive and remove the affected vein through small incisions.

Procedures:

Besides surgery, there are other procedures like sclerotherapy, endovenous ablation therapy, laser therapy, etc., to block the vein.

Varicose vein diagnosis

Physical examination

Doctors perform a physical examination of the legs. Patients can stand or sit.

Patient history

Patients will give details about their symptoms and medical history.

A duplex ultrasound

A duplex ultrasound helps to examine the blood flow. High-frequency sound waves are used to project images of the veins. It also locates the damaged blood vessels and blood clots.

Venogram

The doctor injects a dye into the legs to take x-rays. It gives a better view of the veins and the blood flow. It also locates blood clots.

Venous Doppler exam

Venous doppler test checks the circulation of the blood vessels and the presence of clots or obstructions. It also examines the direction of the blood flow.

Preparation for procedures

Follow the instructions and guidance of the healthcare team and be ready for the procedure.

Before the procedure you have to:

• Get ready with all the preoperative test results.
• Give details about medications, medical history, and allergies if any.
• If you are obese, lose some extra weight before the procedure. Follow a healthy diet and exercise regularly. This improves your recovery process.
• Quit smoking for a few days before and after the procedure for the healing process.
• Stop blood-thinning medications like aspirin and ibuprofen.
• Ask the doctor about medication restrictions before the procedure.
• Inquire about your eating and drinking restrictions if you are having general anesthesia.
• Make arrangements for transportation after the procedure.

Which procedure is best for you?

The doctor will decide the procedure based on certain considerations:

• Your age.
• Overall health.
• The extent of varicose veins.
• Symptoms.
• If you are fit for the procedure.
• Doctor’s expectation for recovery.

Procedures

Procedures are done mainly to:

• Close the varicose veins.
• Remove the varicose veins.

Close the veins

Sclerotherapy

In this procedure, the doctor injects a solution into the affected vein. It scars the varicose vein. The blood flow shifts to the healthier veins. The scarred tissue is absorbed by the surrounding tissues. There is no need for any numbing agent. There will be slight discomfort as the needle pricks the skin. Patients have to wear compression stockings for a few weeks.

Microsclerotherapy

This procedure is similar to sclerotherapy and treats smaller veins.

Laser therapy

The doctor uses high-intensity light to close the veins. This therapy normally treats veins that are smaller and closer to the skin.

Endovenous ablation therapy

This technique treats large varicose veins. The doctor uses radio or laser waves to close the veins. A numbing agent is used to numb the area and a small incision is made. A tube is inserted that projects radio or laser waves to generate heat. The heat closes the varicose vein. The doctor wraps the leg with a compression bandage. After resting, patients can go home.

Endoscopic vein surgery

A tiny tube with a small camera is inserted through a small cut. The surgical devices close the vein. This procedure helps to treat varicose veins causing ulcers.

Remove the veins

Ambulatory phlebectomy (AP)

This is an outpatient procedure. This is a simple procedure to remove varicose veins that are closer to the skin’s surface. The doctor numbs the incision site. A cut is made to remove the vein. Patients are released the same day.

Vein ligation and stripping

Doctors use this procedure to treat large varicose veins. It is also recommended if there are venous skin ulcers, bleeding, severe pain, or swelling. Typically, the surgery is done under general anesthesia. The doctor makes a cut, ties the varicose veins, and removes them.

Will I feel pain after the surgery?

There will be mild pain, discomfort, or bruising after surgery. Take your prescribed pain medications properly. You can resume normal activities after two days depending on the procedure. Contact the doctor if you are having complications.

When should you go for varicose vein treatment?

In general, varicose veins do not have any symptoms. But in severe cases, patients exhibit signs and symptoms that need immediate medical attention. Mild symptoms are relieved with home remedies, the elevation of legs, wearing compression stockings, etc. If the pain and discomfort are severe, doctors recommend surgical intervention.

Signs and symptoms of varicose veins:

• Twisted and bulging veins.
• Dark purple or blue veins.
• Aching legs.
• Heaviness in the legs especially at night or after exercise.
• Pain and swelling in the legs after standing or sitting for long hours.
• Ankle swelling.
• Spider veins (telangiectasia).
• Leg cramps.
• Restless leg syndrome.

Call your doctor if:

• The pain and discomfort are escalating.
• Patients have developed stasis dermatitis (venous eczema). The skin becomes flaky, dry, and discolored. It can lead to bleeding and skin ulcerations.
• Phlebitis or inflammation of the vein due to blood clots.
• Varicose vein injury leading to excessive bleeding.

Surgery options

Varicose vein surgery is an outpatient procedure. The procedure can be done in a small surgical facility or a hospital.

Small clinics

Pros

• No room charges.
• Individual service.
• Fast service.

Cons

• Fewer amenities to handle critical patients.
• A small team of medical staff.

Big hospitals

Pros

• Multiple specialties under one roof.
• High success rates.
• Large medical team to manage emergencies.

Cons

• High costs.
• Longer waiting periods.

Cost of surgery

The cost of varicose vein surgery depends on multiple factors:

• The type of procedure.
• Tests ordered.
• Surgeon’s fees.
• Hospital charges.
• Anesthesia cost.
• Duration of hospital stay.

Post-operative instructions:

• Follow the doctor’s instructions regarding the removal of the surgical dressing. Generally, the dressing is removed the following morning. Leave the steri-strips intact. The surgical team will provide you with extra steri-strips on discharge. You can use them if the steri-strip starts to come out.
• Wear compression stockings for the first three weeks. Remove them while showering or sleeping.
• Take your medications properly.
• Walk on flat surfaces. Avoid stairs.
• Avoid standing or sitting in the same position for a prolonged time.
• Keep your legs elevated while resting.
• You can shower. Do not wet the wounds.
• Inform the doctor immediately if you see signs of serious complications like increased pain, bleeding, fever, swelling, or wound drainage.

Prevention

You can’t prevent varicose veins. But following a healthy lifestyle reduces the chances of developing varicose veins.

• Avoid standing or sitting for prolonged periods.
• Raise the feet to allow blood flow to the heart.
• Maintain body weight.
• Quit smoking.
• Try to stay active. This improves blood circulation.
• Wear compression stockings.
• Avoid wearing restricted clothes.

Best option

Varicose vein procedures are minimally invasive and do not need hospitalization unless the patient has complications. Goficure is a one-stop solution for elective surgeries. They work with top hospitals and provide complete treatment packages for patients. It is an asset-light enterprise that aims to provide services for all regardless of their economic condition.

Goficure will help you with:

• Appointments
• Treatment facilities.
• Hospital stays.
• Recovery and follow-up visits.
• Transportation.
• Insurance claims.
• Counseling.

References