Introduction
Varicose veins range from large ropey veins to smaller surface reticular veins and then even smaller spider veins. They are very common and depending on their size and location can cause a range of symptoms.
Causes
Most varicose veins occur due to an abnormality of the normal one-way valves inside veins. The valves become leaky and allow increased pressure to develop in the vein which then gradually increase in size due to the abnormally high pressure. The cause for the abnormal valves is not fully understood. Genetics play a role and varicose veins commonly run in families. Pregnancy, prolonged standing and sedentary lifestyle all aggravate varicose veins.
Symptoms
Larger varicose veins tend to cause aching and tired legs. There is a risk of thrombosis or clots developing in them and they may cause bleeding at times. In the long term there is a risk of ulceration developing. Smaller spider and reticular veins may produce similar symptoms however this is much less common. They are often very dark in colour and mostly treated for cosmesis.
Tests
Ultrasound assessment of the valve function in veins is very important to determine the best management options. If there is incompetence (leaky) valves in the larger veins then it is worth treating that before dealing with the smaller veins.
Diagnosis
Diagnosis is generally made on physical assessment of the leg and then ultrasound scanning to assess the major leg veins.
Treatment
Treatment will vary depending on the veins involved. Larger varicose veins invariably require ablation therapy or surgical treatment. The smaller spider and reticular veins are best managed with a procedure called sclerotherapy.
Sclerotherapy is the process of injecting the abnormal veins with a drug. The drug damages the lining of the vein and forces the body to break the vein down. This is a simple rooms-based procedure. Compression stocking are required for at least 7 days after the procedure and the treatment may be repeated depending on how extensive the veins are.
Related Information
Varicose Veins
Pelvic Congestion Syndrome
Superficial Thrombosis
Venous Ulcers
Endovenous Ablation of Varicose Veins
Sclerotherapy
Vein Stripping