What you need to know about varicose veins

Manjula Ramakrishnan

Varicose veins affect one in every two people aged 50 and older, and 15 to 25 per cent of all adults in the UAE. But the seemingly harmless varicose veins may turn dangerous, says Dr Ashkan Haghshenas, specialist vascular surgeon, specialised in Varicose Veins at Burjeel Hospital for Advanced Surgery, Dubai.

“Many people wrongly see it solely as an aesthetic issue when, in reality, it is a chronic disease that affects a growing number of people in the UAE each year. Furthermore, if left untreated, varicose veins can lead to potentially dangerous complications.

“While the majority of patients treated for varicose veins are women, men also suffer from venous diseases, even if they're less likely to seek treatment.”

Dr Ashkan Haghshenas, specialist vascular surgeon, Burjeel Hospital, Dubai.

What are varicose veins?

Varicose veins are swollen, twisted, and enlarged veins that you can see under the skin. They are often red or blue in colour. They most often appear in the legs, but can occur in other parts of the body too. Doctors quite often diagnose these veins through a physical examination, but sometimes additional tests might be required in certain conditions.

How are such veins formed?

Normally, one-way valves in your leg veins keep the blood moving up towards the heart. When the valves do not work properly, they allow blood to back up into the vein. The vein swells from the blood that collects there, which causes varicose veins.

What are the main symptoms of varicose veins?

The main symptoms include heavy and uncomfortable legs after standing for a long time, swollen feet and ankles, burning or throbbing in your legs or feet, muscle cramps in your legs – particularly at night – and dry itchy and thin skin over the affected legs. Interestingly, symptoms are usually worse during warm weather and, contrary to popular belief, the problem is not limited to women.

What are the other contributing factors for this condition?

Factors as old age, heredity, pregnancy, hormone replacement therapy, contraceptives, being born with defective valves, history of blood clots in your legs, family history of varicose veins, standing or sitting for long periods of time and obesity can also contribute. In hot countries such as the UAE, the veins swell and open up in order to help cool the body and prevent overheating. This swelling makes veins larger and allows more blood to pool in one place.

Is the condition treatable?

Varicose veins are perfectly treatable but the risk of recurrence depends on the patient’s heredity and way of life. The risk increases if the patient does not take various health precautions, such as exercising regularly, avoiding standing for prolonged period, refraining from smoking and monitoring their weight.

What are spider veins?

Spider veins are smaller and resemble spider webs; these again are the result of weak or damaged valves in the veins. Spider veins are small, thin red capillaries or blue blood vessels that can be seen under the skin, whereas varicose veins are stretched-out veins.

What are the complications arising out of varicose veins?

If left untreated they can cause various complications such as venous ulcers/sores and chronic venous insufficiency, when the veins of the legs are unable to pump the required volume of blood back to the heart. Other complications are increased venous pressure and bad circulation in the lower legs. Edema – swollen ankles and lower legs, thrombosis – blood clotting within the affected veins, bleeding, varicose eczema, lipodermatosclerosis, which causes the skin to become reddened and tight are also a result of varicose veins. Pregnant women may also develop varicose veins because pregnancy increases the volume of blood in a woman’s body.

What are the types of treatment available?

Some of the treatments available include wearing compression stockings, taking medication or having the vein closed (ablation). There are various ablation procedures to choose from including liquid injection sclerotherapy, foam injection sclerotherapy, skin-type (topical) laser treatment and endo-venous laser treatment (EVLT), minphlebectomy, which involves the removal of faulty veins through minute incisions.  Even though not all conditions of varicose veins require treatment, in some instances it is more to ease pain, discomfort, to reduce the risk of developing leg ulcers, swelling or skin discolouration or for aesthetic purposes.

What lifestyle changes will prevent the condition?

Avoid wearing tight clothing and high heels; keeping the legs on a slightly elevated foot stool, not crossing the legs, regular exercising to improve blood circulation in the legs are some of the basics to be followed.