Summer is here and it is time to show off your legs. But some of us are not so lucky because we have varicose veins. Nobody likes varicose veins. They are unsightly. But, do we have to hide our legs because of these veins. I hope not.
Varicose veins are enlarged veins that look dark purple or blue. They appear twisted and bulging. They are commonly found on the backs of the calves or on the inside of the leg.
Spider veins are similar to varicose veins, but they are smaller. They are closer to the surface of the skin than varicose veins. They can look like tree branches or spider webs. Spider veins can be found on the legs and face.
Deoxygenated blood from our lower limbs is transported to the heart through the veins located in the superficial and deep parts of the leg and thigh. These veins have valves which allow blood to flow one way towards the heart. Contractions of the calf muscles (also known as second pump) facilitate this process. When the valves become weak and defective there is a backflow of blood in the veins. This backflow stretch the veins and they become varicose veins.
Varicose veins and spider veins are common problems. About 40 to 50 per cent of Canadian men and women have this problem. There are many reasons why a person gets varicose veins or spider veins. The common reasons are: increasing age, genetic factors, pregnancy, hormonal changes, obesity, prolong standing and history of deep vein thrombosis (blood clot in the deep veins of the calf). Usually, there is more than one reason why a person develops varicose veins or spider veins.
Conservative measures like regular exercise (walking two miles a day), wearing support stockings and keeping legs elevated when resting and maintaining your weight does help prevent varicose veins and keep symptoms under control for those who have the problem. These veins are not life threatening. They are a nuisance and unsightly. They may give you aching legs, swelling or discoloration of the skin. They may become painful and inflamed (phlebitis).
Not all doctors treat varicose veins. Some doctors have a special interest and expertise in this area of medicine. The treatment requires patience, perseverance and some technical skills. You have a choice of conservative therapy (mentioned earlier), sclerotherapy, laser surgery or surgical ligation and stripping.
Sclerotherapy is a common treatment for both spider veins and varicose veins. The treatment involves injection of a solution into the vein that causes the vein to seal shut. You may need more than one treatment. There is about 50 to 90 per cent success rate and it is done in the doctor’s office.
Laser surgery has become very popular method of treatment. It transmits very strong bursts of light onto the vein. The vein slowly fades and disappears. The procedure involves no needles or surgical incisions. But the laser beam does produce heat sensation on the skin and can be painful. Cooling helps relieve the pain. More than one treatment is required depending on the severity of the problem.
Treatment of larger veins like the saphenous vein requires more invasive therapy. Endovenous techniques (radiofrequency and laser) require insertion of a very small tube called a catheter into the vein. Once inside, the catheter sends out radiofrequency or laser energy that shrinks and seals the vein wall. Surgical ligation and stripping of varicose veins is an old fashioned technique to fix the veins in the operating room mostly under general anaesthetic.
Choice of treatment depends on the severity of the problem. Each procedure has advantages and likely complications. Discuss your problem with your family doctor and get a referral to a physician who is skilled in the management of this problem. Don’t forget to work on your second pump.
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