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Varicose Veins

Prominently visible, large, purplish veins appearing through the skin are usually known as varicose veins. A milder version of this is known as spider veins. This condition more commonly affects women and is usually benign. The condition may, however, become painful at times. Veins that are affected with varicose are usually a cosmetic concern only, however, and appear to affect the legs due to the weight borne by them, more often. This condition is most often self-diagnosed and does not require laboratory imaging. In some cases, it may signify an underlying circulatory problem.


The primary symptoms of varicose veins are highly visible, misshapen veins, usually on your legs. You may also have pain, swelling, heaviness, and achiness over or around the enlarged veins. In some cases, you can develop swelling and discoloration. In severe cases, the veins can bleed significantly, and ulcers can form.

  • ● Aching sensation
  • ● Fatigue, the heaviness of legs
  • ● Pain, throbbing, burning, stabbing
  • ● Cramps in calves and thighs
  • ● Swelling of ankles
  • ● Itching of the skin
  • ● Restless legs, especially at night
  • ● Numbness around the ankles and legs
  • ○ Spider Veins
  • ○ Reticular Varicose Veins
  • ○ Varicose Veins Trunk
  • ○ Chronic Venous Insufficiency
  • ○ Trophic Ulcers

There are different types of varicose affecting superficial veins, and more rarely, more internal veins which can become swollen. Some of these types include:

  • Trunk varicose veins: These are usually long, bulging veins, deemed unsightly due to their prominence. They are thicker than the other types of varicose veins and often result from dilation of the venal walls.
  • Reticular varicose veins: These are usually red and form a network under the skin. They are less bulging than trunk varicose veins and may indicate circulatory concerns.
  • Telangiectasia varicose veins: Commonly known as spider veins, these small clusters of thin, visible venal networks appear on the face or the legs. They are not as prominent as other types in terms of stretching the skin and are harmless.

There are some risk factors that may cause a higher probability of incorrect circulation. Causes of varicose veins include:

  • Gender: Women are at much greater risk of developing varicose veins as compared to men. Weight gain during pregnancy, or otherwise, hormonal changes, and menopause may be some factors which influence the appearance of varicose veins. Birth control pills and pre menstruation are also known to influence this and maybe one of the causes of varicose veins.
  • Aging: Older people are more likely to have varicose veins, and the probability of this development increases as one continues to age, possibly due to the weakening strength of the muscles holding up the veins and the epidermis. The valves that help push the blood to the heart also face increased wear and tear with aging and their slow degeneration may cause varicose veins by letting the blood pool in the veins, instead of being able to correctly circulate it.
  • Pregnancy: Pregnancy requires that a larger than usual volume of blood being circulated through the mother's body, thus creating more pressure on the valves to circulate more efficiently. It also causes weight gain and hormonal changes which are responsible for increased chances of varicose veins.
  • Family history: The chances of varicose veins, as with many other medical conditions, is increased if family members are afflicted with the same condition. While varicose veins are generally not considered very serious, some patients find it unsightly as well as painful, and in case a close family member is known to suffer from the condition, it is helpful to take preventative measures where possible. Most often, family history is one of the determining causes of varicose veins in later life.
  • Standing / Sitting for long: Since varicose veins are caused by circulatory issues, sitting or standing for lengthy periods of time puts undue pressure on more susceptible people, being one of the more common causes of varicose veins and increasing the probability of their development.
  • There are several possible complications that arise out of varicose veins, and although rare, they may sometimes trigger severe health consequences such as:

  • Blood clots: Blood clots can arise out of the faulty circulation in the legs, especially with the blood continually pooling in veins, and may cause swelling and much pain to the patient. In some rare cases, a blood clot may also travel along and cause more severe blockages. Home treatment of varicose veins can prevent such complications, or, in more advanced cases, surgery may be advised.
  • Ulcers: Ulcers may occur on the discoloured skin near the varicose veins and can be very painful. In case a varicose vein has swollen to stretch a patch of skin for a lengthy period of time.
  • Bleeding: Varicose veins may burst at times, if close to the surface of the skin, and while these are rarely serious, it is a resulting complication of the condition.

If family history ensures that varicose veins are to be inherited, there is little that may be done, but preventative measures may lessen their prominence, and keep the risks of developing varicose veins lower. Ensuring better circulation and building better muscle tone in the legs may help with the varicose veins, and also aids in mitigating the discomfort caused by existing ones. Some of the varicose veins prevention techniques include:

  • Avoiding weight gain: Weight gain is often linked to poor circulation, and one of the most common suggestions for varicose vein prevention is to avoid weight gain.
  • Exercising: Exercising helps with improving circulation as well as keeping weight under control and is a regularly suggested means to relieve discomfort arising from varicose veins, as well as preventing them.
  • Preventing water retention: A diet rich in fiber and low in salt can help with water retention issues and better circulation to help with the prevention of varicose veins.
  • Avoiding tight hosiery and uncomfortable pants: Tight clothing can wreak havoc on the body’s circulation, and in case of valves already susceptible to damage, such clothing may increase the chances of developing weaker walls of veins and ineffective valves.
  • Compression pants: Wearing compression pants has been shown to aid circulation, and it has been suggested to be worn even during long flights. These may help with the prevention of varicose veins.
  • Keeping legs elevated: While this is not the most comfortable means of varicose veins prevention, keeping the lower portion of the body elevated prevents the pooling of blood in the veins, preventing discolouration and ensuring that pressure on possibly weakened venous walls is prevented from building in the legs.

Varicose veins are usually self-diagnosed, and there is little in the way of diagnosis that may be attempted by experts since the condition is immediately apparent. Spider veins on feet may appear initially, with clusters of veins showing through and causing discolouration of the patches of skin they show through. A doctor will typically check for further inflammation and possible complications in the case of varicose veins to avoid ruptures and bleeding. They may also suggest an ultrasound test which is non-invasive or a venogram which requires the injection of a dye after which an X-ray is performed to understand if circulation is affected in the body, and in case the legs have blood clots.


Varicose vein treatment is usually suggested through lifestyle changes rather than through surgery. Lifestyle changes such as diet modification or exercise, as mentioned above, may help with curtailing the pain or prevention of further complications arising from varicose veins. Compression may be suggested in combination with other lifestyle changes, and specialized compression socks or tights will help the blood be pushed to the heart correctly despite damaged valves and help relieve some of the pressure on the veins in patients with varicose veins, thus reducing swelling. If the varicose veins are extremely painful and causing recurring discomfort to the patient, and none of the other methods provide relief, the doctor might suggest an invasive operation through which the varicose veins are removed. Vein ligation and stripping is a surgical treatment during which the surgeon surgically removes the varicose vein through incisions on the skin while the patient is anaesthetized. In some cases, slightly less invasive techniques may be utilized as well, which have become more commonly recommended in recent years.

Varicose veins are often considered ugly but rarely develop extreme complications. They tend to worsen with age, once developed, however, even if precautions are maintained. In case of surgery is not recommended by doctors, check-ups at frequencies suggested by doctors can help keep the possibilities of developing sores, ulcers or blood clots at bay. Being on the lookout for complications such as the development of a sore on or near a varicose vein, swelling of feet or ankles would help prevent worse developments. If such complications do not develop, varicose veins do not cause any medical problems.


Recovery after varicose vein surgery usually takes 1-5 weeks depending on the procedure, overall health of the patient, the size of the vein operated upon and care procedures followed. Some pain may be expected after the anaesthesia wears off, even in outpatient procedures. It is important to exercise and stretch after the procedure to ensure correct circulation. Also, watching out for any deteriorating symptoms after surgery is necessary, especially for the first few days, since areas operated upon are most prone to infection immediately after the procedure. Blood clots may also be seen in case of varicose vein surgery, and need to be considered seriously to avoid any circulatory issues.

In case lifestyle changes such as quitting tobacco or restriction of alcohol are suggested by the doctor, it is necessary to ensure that these aftercare measures are adhered to since some substances such as tobacco can delay healing. These may also affect the performance of pain medication, which, following varicose vein surgery, must be used in accordance with prescribed methods. Other lifestyle measures such as wearing compression socks or tights will help keep varicose veins under control and help quicker recovery from the surgery. Any measures to improve circulation to the legs, such as exercise regimens involving specialised yoga or stretching can help with aftercare following varicose vein surgery.

Why is it Important to Treat?

The goals of treatment are to relieve symptoms, improve appearance, and prevent complications such as serious skin ulcers or sores, deep vein thrombosis, skin color changes, and bleeding. Bleeding from varicose veins is a medical emergency.

  • ● Cosmetic Issues
  • ● Leg Pain
  • ● Swelling around ankles
  • ● Pigmentation of skin (darkening of the skin around ankles)
  • ● Eczema (Dermatitis)
  • ● Formation of wounds and ulcers
  • ● Bleeding from rupture of Varicose Veins
  • ● Inflammation of the veins (Thrombophlebitis)
  • ● Formation of a blood clot (Thrombosis)
  • ● Deep Vein Thrombosis (Clots in deep veins)
  • ● Pulmonary Embolism (Clot traveling to the lungs via the heart)
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Dr. Ambrish Raja
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