Varicose veins

Women are twice as likely as men are to develop the condition especially during pregnancy, writes Dr Marga Boyani

Varicose veins are elongated, tortuous veins with incompetent valves. They are unsightly, uncomfortable, bulge, throb and feel heavy. The affected legs and feet can swell and the skin may itch. Most are close to the surface of the skin so can be easily seen, but they may also be hidden in the deeper tissues like in the calves of the legs.

Varicose veins are most often seen in the back of the calves or the inside of the legs between the groin and the ankle. For many people, varicose veins are simply a cosmetic concern while for others; they are a source of aching pain and discomfort.

Varicose veins may, however, be a sign of other disorders of the circulatory system.

Who is the likely victim?

• Women are twice as likely as men are to develop the condition especially during pregnancy. The pregnant uterus obstructs the blood flow back through the leg veins and also just before menstruation because the female hormones tends to relax the walls of the veins.

• Varicose veins usually appear after the age of 30 and get progressively worse.

• When you are in the same position for long periods like standing.

• If other family members had varicose veins, there is a greater chance you, too, will.

• Being overweight puts added pressure on your veins.

Causes:

• Malfunctioning of the valves of the veins is the main cause. While arteries carry blood from your heart to all the other parts of your body, your veins return this blood to your heart for re-oxygenation. To return blood from your legs back to your heart, the veins in your legs must work against gravity. This is accomplished by the muscle contractions in your lower legs. The muscles act as pumps or an ‘artificial heart’ to push the blood up through your legs to the heart. They are assisted by the toned, elastic walls of the veins and their small one-way valves, which open as blood flows toward your heart and close to stop blood from flowing backward. Problems arise when these valves malfunction.

Symptoms:

• Enlarged veins readily seen under the skin of your legs.

• Brownish-grey discolouration on your ankle.

• An achy or heavy feeling in your legs with burning, throbbing, muscle cramping and swelling made worse by prolonged sitting or standing.

• Itching around one of your veins or skin ulcers near your ankle due to long-term ‘water logging’ of these tissues as blood pools in the affected veins.

• Your legs may swell considerably if the veins deep within your legs are involved. Any sudden leg swelling with or without pain and redness may indicate a blood clot and needs urgent medical attention because if part of this clot breaks off, it can travel to the chest and cause death. A varicosed vein can also bleed heavily if injured.

Doctors use an X-ray of the vein called a Venogram or a special ultrasound called a Doppler to confirm that you do have varicose veins and the extent of the problem.

Your doctor may then prescribe drugs that improve the integrity of the wall of the veins. Varicose veins may also be treated surgically.

Before the widespread use of laser in medicine, the doctor could inject the varicose veins with a corrosive solution that forced them to close up and your blood rerouted naturally to healthier veins.

The veins were also stripped or removed through small cuts made by the doctor in the skin. Nowadays, varicose veins are best and more easily treated with even better results using laser treatments.

Self-help measures:

• Improving your circulation and muscle tone can reduce the risk of getting varicose veins or getting additional ones.

• Exercise like walking is a great way to encourage blood circulation in your legs and tone those muscles.

• Shed that excess weight, which put unnecessary pressure on your veins.

• Wear low-heeled shoes because they work calf muscles more than high heels.

• Avoid wearing tight underwear or panty hose, which can restrict circulation.

• Elevate your legs above the level of your heart to improve circulation.

• Avoid long periods of sitting or standing and make a point of changing your position frequently to encourage blood flow.