Assessment of varicose veins

Varicose veins are swollen and enlarged veins that usually occur on the legs.

Varicose veins may be blue or dark purple and are often lumpy, bulging, or twisted in appearance.

Veins in the legs have valves that allow blood to flow back to the heart, against gravity. When varicose veins appear the valves are no longer working effectively. A build-up of pressure causes the veins to distort and become twisted and stretched. This pressure can also cause symptoms and damage to the skin.

Varicose veins can run in families. Up to 50% of people may develop varicose veins during their lifetime.

What symptoms do varicose veins cause?

Other than cosmetic concerns, the commonest symptoms from varicose veins are aching, discomfort, and heaviness of the legs. These symptoms are usually worse at the end of the day.

In a few people, the high pressure in the veins causes damage to the skin near the ankle, which can appear like brown staining of the skin or eczema (flaky, itchy skin).

Ulceration of the leg may occur if these skin changes are allowed to progress, or if the skin is injured.

Other problems that varicose veins can cause are phlebitis and bleeding. Phlebitis, or thrombophlebitis, means inflammation of the veins. The affected veins become hard and tender. This is not the same as deep vein thrombosis (DVT) and is not usually dangerous.

The risk of bleeding as a result of injury to varicose veins worries many people, but this is very rare.

Most varicose veins originate from faulty valves at groin level or, less commonly, behind the knee. A detailed scan, called a Duplex ultrasound scan, is required if treatment is planned.

The scan can detect leaking valves and map out the anatomy of the problem veins.

If you have varicose veins there are a number of reasons why you may decide to have an intervention. Your consultant will discuss all the treatment options with you before you decide which treatment is best for you.

The aim of varicose vein interventions is to reduce the pressure in the superficial veins. This will hopefully help relieve any symptoms caused by the varicose veins.

Support stockings and daily moisturiser can further protect the skin.

St Joseph's Hospital provides a walk-in, walk-out specialist clinic for the treatment of varicose veins. Treatments include endovenous ablation (EVA), ultrasound-guided foam sclerotherapy (UGS), phlebectomy, and traditional varicose vein surgery.

The vast majority of patients are treated with the latest minimally invasive techniques.

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