Varicose veins are twisted, enlarged veins near the surface of the skin. They commonly develop in the legs and ankles. Varicose veins are common and usually will not cause serious medical problem. However, in some cases, varicose veins can signal a blockage in the deeper veins that requires evaluation and possibly treatment. People with leg skin changes associated with varicose veins may develop chronic sores which are difficult to heal (as shown in Fig. B).
Normally, the one-way valves in these veins keep the blood flowing efficiently against gravity up towards the heart. Varicose veins develop when you have faulty valves in your veins and weakened vein walls. When these valves do not function properly, blood pools and pressure build up, hence the veins are weakened, enlarged and twisted.
Patients often feel no discomfort but may be concerned about the appearance of the veins. Varicose veins are visible through the skin and appear dark blue, swollen and twisted. Some may experience distending discomfort, tiredness, swelling and pain in the leg. Symptoms may worsen after standing or sitting for long periods of time. Varicose veins can also cause darkening of skin, dry, thickened skin, open sores (ulcerations), inflammation (thrombophlebitis) or bleeding.
Your doctor will examine your legs and feet. Varicose veins are easy to see, especially when you are standing. If a problem with the deep veins or complications are suspected based on your symptoms and examination, an ultrasound study may be required.
The goals of treatment for varicose veins are to reduce symptoms and prevent long term complications. Some treatment options include -
EVLT and RFA are both done under local anesthesia. It works by using laser or radiofrequency energy to heat the vein from inside which causes it to seal shut and disappear.
Vein litigation and stripping are done as day surgery under regional or general anesthesia. EVLT/RFA can be done under local anesthesia. The leg will be bandaged with crepe and stockings for two weeks after the operation. Most often, you can return to work within a few days. After two weeks, you can resume normal leisure and recreational activities.