Varicose veins are abnormal, dilated veins that predominantly occur in the leg. They
can occur also in the pelvis and often around the womb, but most patients get varicose veins
within the leg and that’s the commonest form of presentation. It occurs in about one
in three individuals throughout their life. It actually starts at a young age, in the
teenage years, but it's far more common as you get older. It’s a misconception that
varicose veins are only in the elderly because we commonly see patients with veins in the
twenties, some as young as a teenager and as you get older, they become more frequent.
They’re caused by weak valves within the main vein and they just start to swell and
dilate. That can cause disfiguration and unsightly legs and can cause many problems within the legs.
Varicose veins are caused by a weakness in
the valve that lies within the vein. These valves present every 8cm and are there to
allow blood to return from the foot back to the heart against gravity. These valves can
progressively become weak. As they become weak, they start to leak blood back towards
their feet. That increases the pressure within the vein and causes them to dilate and swell.
As they swell, that puts more pressure on other veins which progressively swell. It’s
a stepwise progression of a weak valve that causes the vein to swell and dilate.
In most cases varicose veins have no underlying cause but there are rare causes of varicose
veins such as deep vein thrombosis, malignancy, pregnancy, obesity, but they are the least
common. They can occur in the most unexpected patient such as a young, slim, fit individual
who has no family history of varicose veins. They can also occur conversely in obese elderly
patients who can get varicose veins just through longevity of life. There is no rhyme or reason
who get or do not get varicose veins. They do run in the family, but it’s not always
the case that if your parents have varicose veins, you will get varicose veins.
When at the British Varicose Vein Centre, we see many patients with no symptoms apart
from the veins pain unsightly. Some patients come with very big, ugly-looking veins, some
come with small thread veins and they get no symptoms apart from the cosmetic issue.
Other patients however can get symptoms from aching legs, night time cramps, swelling of
the legs, restless legs, and heavy legs. Other more advanced symptoms can cause skin damage
such as eczema, skin irritation, bleeding from the veins, thrombophlebitis which is
where veins develop blood clots. In advanced cases, they can cause leg ulcers
which can be quite serious. Often, advanced patients with varicose veins have skin damage
and pigmentation. If that were to occur, the veins have been left too long for treatment.
The best time to treatment is to treat the veins before they’ve started to damage the
skin. Of course, if you’ve got varicose veins that are unsightly, you treat them at an early stage.
There are many treatments for varicose veins
and it can be very difficult for any individual to navigate their way through the treatment
options. The main treatment and the most successful treatment is endothermal ablation of the veins.
That is when a heat probe used in laser fiber or radiofrequency is passed within the vein
to cause the vein to close. That undoubtedly is the most successful with a 99% success rate.
Alternative treatments include chemical ablation
using machines such as ClariVein, glue, or foam sclerotherapy. These techniques aren’t
as effective and occasionally have some advantages in certain situations such as recurrent veins.
At the British Varicose Veins Centre, we have the most outstanding facilities for treating
veins in a one stop shop. I think when patients look for treatment in varicose veins, one
of the things that they should ask their consultant is how many sessions of treatment is going
to be required and whether they need sedation or no sedation. Many patients are quite fearful
and require sedation simply because they’re nervous. Many small units on high streets
are unable to offer the sedation facilities. That can leave the patient uncomfortable.
We offer sedation facilities at our unit and it makes the patient’s journey and experienced
far more pleasant.