Varicose veins: Skin serpents

The veins in our legs have to carry blood against gravity to bring it to the heart. To assist in this, the veins have valves that prevent the backward flow of blood. Sometimes, with age, as these valves wear out the veins become bigger in size. They then start to appear prominently as dark blue serpentine veins, just below the surface of the skin.

This widening of the veins is called varicose veins and is a common reason for pain in the calves. Though varicose veins can occur anywhere in body they are most commonly seen in the legs. Our veins have valves in them at multiple levels. These are meant to promote unidirectional flow of blood i.e. towards the lungs and heart.

What causes varicose veins

• Some people have a absence of valves in their legs since birth.
• People who are in professions that require them to stand for long hours, such as doctors, paramedics, lecturers, chefs, hairdressers are all prone to developing varicose veins.
• During pregnancy the flow of blood from the legs to the pelvis is decreased. This also causes varicose veins to appear.
• It is more commonly seen in people who are obese.
• In certain cases tumours,  deep vein thrombosis [DVT] and enlarged lymph nodes compressing the veins and thereby lead to back pressure and varicose veins.

Appearance of varicose veins

It’s very easy to diagnose this condition and you may even be able to do it yourself.  But you do need to seek a professional’s help to plan your treatment.

In the initial stages they may appear as very fine veins that start to become obvious below the skin. These are known as spider veins. These fine veins later develop into varicose veins. This condition may also show skin changes and swelling of the ankle, foot or entire lower limb.

Tests

Venous doppler is the basic investigation required before planning treatment. It tells the location of the faulty valves and more importantly whether one has deep venous thrombosis [in which case surgery has to be avoided]

A sonography of the abdomen and the pelvis is done to check for lumps, tumours, lymph nodes .

Treatment

In the initial stages only compression with varicose veins stockings is advised. Since standing causes this condition to worsen, limb elevation and  rest after prolonged standing, running or traveling is advised

If the veins become too prominent or swelling starts to develop in the feet one would require some  some form of intervention for definitive treatment. Surgery could be used to provide relief from your symptoms. This is after your symptoms have been reviewed by a physician.

Decision regarding the optimum interventional modality to be used for advanced varicose veins depends on the age of the person as well as how severe the condition has become.

Recurrence after surgery

Generally speaking, the traditional surgery i.e. stripping of the veins seems to be the most complete and reliable option. However, no matter which treatment is used, there is always a chance of recurrence. But recurrences tend to be small and focal i.e. localised to one small part of the limb. These recurrences do not cause significant symptoms and can be treated locally if required.

This was first published in February 2013 issue of Complete Wellbeing.