Varicose veins are extremely common. They occur when tiny valves found inside every vein begin to fail - impairing the flow of blood back to the heart. There are two main types:
1) Larger varicose veins - typically found in the legs and feet. The valves and muscles here have to work hardest to help get blood back to the heart. Varicose veins often develop at points where veins nearer the surface of the skin connect to deeper veins that are found behind the knee and in the groin
Bigger varicose veins are sometimes divided into ‘trunk’ varicose veins (longer, knobbly or bulging veins) and ‘reticular’ varicose veins (red and sometimes grouped closely together)
2) The second type of varicose vein (technically called ‘teleangiectasia’ varicose veins) are the smaller and thinner ‘thread’ or ‘spider’ veins. These can appear anywhere in the body, including in the face (commonly the cheeks, nose, or chin), thighs, knees, and ankles
The first signs of a vein health problem can include cold or numb feet and toes, or tingling in the feet and legs
Soreness and aching are a common feature of varicose veins. The trapped blood in the varicose vein leads to swelling (a build-up of fluid sometimes called ‘venous oedema’) often in the feet or ankles - and cramp. This can occur wherever the varicose veins are - in both legs, for example, or just in one. Swelling like this can be an indicator of varicose veins that aren’t immediately visible
Feelings of cramp in the thigh or calf can also indicate a problem with vein health. Typically brought on after time standing, or after a long walk, cramps might also occur at night: inflammation that has been steadily increasing throughout the day can suddenly make itself felt once mind and body relax. Warm weather can exacerbate the problem, because the hotter your body and the air get, the more your veins open up
Elevating the legs - by propping them on pillows at night, for example - is one way some patients try to get temporary relief from varicose vein pain in their legs, ankles and feet
Some people with varicose veins wear surgical compression stockings to improve their circulation: these stockings effectively mimic the work your muscles do in pumping blood back to the heart, squeezing tightest at the ankle then applying steady pressure up the rest of the calf and thigh
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The effect of unhealthy veins on the skin and tissue around them can lead to constant itching, and a painful burning or throbbing sensation. It’s a form of dermatitis, caused when the blood leaks into the vessels around the vein, while your impaired circulation deprives this tissue of the oxygen it needs. The result? Skin that’s dry, red, inflamed, and feels hot. The condition can get worse in summertime, as veins and tissues expand to help cool the body
Vein disorders can manifest themselves in the skin in other ways. As circulation deteriorates, the skin can start to look shiny (as it thins). It can also become harder and drier, eventually cracking or becoming discoloured
One result of the build-up of fluid in the feet, ankles and legs is a feeling of fatigue and heaviness. With extra fluid trapped inside, and a lack of healthy blood flow through them, it can feel like you’re having to work extra hard just to move and lift affected joints or limbs
Another phenomenon closely linked to vein disease is a condition known as Restless Legs Syndrome (RLS) or Willis-Ekbom disease. This is an uncontrollable urge to move your legs, often felt most keenly in the evening or at night. Almost all sufferers from RLS find their condition improves after their varicose veins have been treated
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When the skin above these veins breaks, various complications can occur. It can take a long time for any bleeding to stop and for any wound to heal
These ‘venous ulcers’ often develop on the inside of the leg, above the ankle, and at first become red and inflamed. They may start to leak fluid, before the skin at the surface starts to die. It then becomes very difficult to stop the wound reopening or to avoid the risk of infection. The vast majority of ulcers in the legs and feet are caused by vein disease
Beyond the physical and visible effects of varicose veins, there’s a psychological impact too. Feeling that these veins are unsightly can limit our enjoyment of exercise and the outdoors - which can, in turn, leave us in poorer mental and physical health
Developing varicose veins can make us feel older and frailer, while chronic pain and irritation can not only limit your capacity for exercise, but also take a toll on mood and wellbeing. Varicose veins can become problematic when it comes to personal and professional relationships too
When clots start to form in your veins, this can lead to a range of more serious complications, including painful swelling and Deep Vein Thrombosis (DVT). This is when blood thickens and clumps together, forming a clot in the deep vein system
The affected area swells up painfully, may feel warm to the touch, and may turn the skin red. Seek immediate help if you experience shortness of breath or chest pain and if you cough up blood: these may indicate a pulmonary embolism - which means a blood clot is blocking part of your lungs
Also known as ‘Iliac Vein Compression Syndrome’, this leads to swelling of the left leg and is caused by a large artery in the abdomen (the main route for blood from the heart to reach the legs) putting pressure on a large vein in the abdomen (the main route for blood to get back to the heart again).
Restricting the flow of blood like this leads to swelling and can cause Deep Vein Thrombosis (see below) if a clot develops. May-Thurner Syndrome can develop without warning, but it is more common in women and more likely during pregnancy.
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