Varicose veins are abnormally dilated and tortuous veins of the legs that result from poorly functioning or damaged valves within the veins. Varicose veins and venous disease is extremely common in the general population, with half of the adult population demonstrating some stigmata of venous disease. This may present as symptoms of vein disease including leg aching, pain, tiredness, fatigue, throbbing, cramping, itching, burning, swelling or restlessness. Visible varicose veins are only noted in 20–25% of women and 10–15% of men.
One very common question I hear from patients is when should I have my varicose veins treated?
The answer to this question is easy for patients who have significant symptoms from their varicose veins and vein disease. If symptoms are significant enough to have an effect on your daily activities of living then it’s time to seek treatment for your varicose veins. If you’re someone that needs to regularly take breaks and elevate your legs for pain relief then it’s time to have your varicose veins treated. Many patients notice swelling of their ankles at the end of the day that has been progressing over the years. They’re finding it harder and harder to put on their shoes and even with the use of their graduated compression stockings, they’re realizing nothing is help. If this is your story, then its time to get your varicose veins treated.
Complications of varicose veins need to be evaluated by a vein expert.
Anyone who has had complications from their varicose veins should have their legs evaluated by a vein expert. If you have ever had severe bleeding from a varicose vein or had inflammation of a varicose vein leading to clotting, then you should be seen by a vein specialist. Because varicose veins can become very large and the skin overlying them can become thinned, they can easily be cut by shaving or some trivial trauma. This can lead to significant bleeding. Bleeding can become very severe and on rare occasions require hospitalization and blood transfusions. Varicose veins can also become inflamed. This inflammation can be painful, causing an area of redness and warmth. If there is associated clotting of the varicose vein the area may become firm and painful to touch. This complication is called thrombophlebitis. Thrombophlebitis is a potentially dangerous complication of varicose veins. Deep vein thrombosis (DVT) is an uncommon complication of varicose veins from the clotting of the varicose vein extending into one of the deep veins of the leg. This complication can be life threatening and lead to clot traveling to the lungs which is called pulmonary embolism (PE).
Deep venous thrombosis (DVT) is an uncommon complication of varicose veins.
Another group that should have their legs evaluated by a specialist are ones that are noticing changes in the skin overlying their varicose veins or ankles. Varicose vein disease leads to inflammation in the vein walls. This inflammation may extend and involve the overlying skin. This can sometimes lead to unusual appearing changes in the skin. A patient may develop areas of skin darkening called hyperpigmentation. These areas of darkening usually start as blotchy areas and can become confluent and cover larger areas of the ankle and foot. Other more complex skin changes that need to be evaluated by a vein specialist include dermatitis, lipodermatosclerosis and atrophie blanche. These complex skin changes are signs that your vein disease has progressed into later stages and should be evaluated by a vein specialist.
Anyone who develops a skin ulcer and has varicose veins, should be seen by a vein specialist.
Venous ulcers represent the latest stages of varicose vein disease and venous insufficiency. Venous ulcers may be large and multiple and risk becoming infected. The longer a venous ulcer is left untreated, the more likely it will become a chronic problem in the future. Any patient with a skin ulcer with or without underlying varicose veins should be seen by a vascular expert. If a skin ulcer is found to be caused by vein disease, the sooner the patient has treatment of the underlying vein disease, the sooner the venous ulcer will heal. Every skin ulcer should be evaluated for an underlying cause and treatment started immediately. Venous ulcers are the reason varicose veins should be treated before developing late complications of vein disease.
I don’t like the appearance of my varicose veins. Can I have them treated even if I don’t have symptoms or complications of vein disease?
Some patients have large varicose veins but are fortunate not to have any complaints of pain or swelling. Their only complaint is not being satisfied with the appearance of their legs. Because treatment of varicose veins has significantly improved over the past couple of decades and can be preformed as an outpatient with minimal risks, treatment of varicose veins is commonly performed for cosmetic reasons. Varicose veins can start in some men and women as early as in their 20’s. The veins can be treated cosmetically to improve the appearance of legs and to keep legs looking and feeling healthy. Varicose vein treatments are now performed in the specialist’s office and patients can return to normal activity in the same or next day. Each treatment takes 30 minutes or less. Patients may need multiple short treatments depending on the severity of the underlying disease. If you have varicose veins and are looking to rid yourself of unsightly veins or significant symptoms, call vein specialist Dr. Vinay Madan, MD, DABVLM at the Center for Varicose Veins at (203) 529–5521 or book a consult online.