Everything you need to know about swollen and enlarged veins in the legs and feet.
Suffering from swollen and enlarged veins on your legs? You are not alone. Varicose veins are extremely common and for the most part do not cause medical problems.
We speak to Professor Mark Whiteley, Venous Specialist at The Whiteley Clinic about varicose vein diagnosis and treatment:
What are varicose veins?
Varicose veins affect up to 30 per cent of adults in the UK and usually come on with advancing age. They are often no great inconvenience apart from being unsightly, but if left untreated, they do have the potential to develop into further health complications including leg ulcers, DVT and blood clots.
‘Varicose veins occur when the valves in our leg veins stop working properly, meaning the blood falls down the veins when standing up, rather than flowing upwards towards the heart,’ says Professor Whiteley.
‘In their simplest form, varicose veins can be identified as bulging veins which protrude from the legs. However, half of varicose veins sufferers will show no overt signs of the condition, as many problematic veins remain hidden under the skin.’
What’s the difference between veins and arteries?
The heart pumps blood through the arteries to all parts of the body – the vital organs, the head, arms and legs. The blood is then spread through tiny vessels called capillaries which form a network. Later it is returned in increasingly large vessels – veins – which complete the circulation of blood back to the heart.
You can feel arteries as they pulsate as they have high pressure, whereas veins collapse when felt, as they have low pressure.
‘Both arteries and veins transport blood,’ says Professor Whiteley. ‘However, the main difference between them is the specific job they carry out within the body. Arteries carry blood containing oxygen and nutrients at high pressure from the heart around the body.
‘Veins bring the blood back from the body to the heart under low pressure, carrying carbon dioxide and waste products. You can feel arteries as they pulsate as they have high pressure, whereas veins collapse when felt, as they have low pressure.’
Who is at risk of varicose veins?
The risk of developing varicose veins can increase for the following reasons:
- A family history of the condition.
- An occupation that involves prolonged periods of standing.
- Symptoms can worsen before and during menstruation.
Diagnosing varicose veins
‘We all know about the unsightly bumps on the legs on standing that disappear on lying down. These may be blue, green or even colourless depending on how deep the varicose vein is,’ says Professor Whiteley.
‘However, up to half of all varicose veins sufferers will show no overt signs of the condition until a complication arises, as the troublesome veins can remain hidden deeper under the skin and cannot be seen without a duplex scan.’
If you suffer from varicose veins you are likely to experience the following:
✔️ Tired/heavy/aching legs (worse while standing, and in hot weather).
✔️ Enlarged, snake-like, blue veins most easily seen under the skin while standing.
✔️ Painful lumps, which can indicate phlebitis.
✔️ A creeping sensation across the skin and possibly night-time cramps in the legs
✔️ Venous blood clotting in the varicose veins.
✔️ Itching which can be a sign of venous eczema.
✔️ Tender/painful skin on the inner part of the lower leg – which can indicate that a venous leg ulcer is forming.
When should I seek help for varicose veins?
If you have varicose veins and they do not cause you any discomfort, you may not need to see a doctor. However, you should speak to your GP if your varicose veins cause irritation during the day, fluid accumulates in the legs, standing up for long periods causes discomfort, or they interrupt your sleep.
If you think you have varicose veins then you should always have them checked out by a professional.
‘If you think you have varicose veins then you should always have them checked out by a professional who specialises in venous conditions, as they can have more serious medical consequences and should not just be considered as an aesthetic problem,’ says Professor Whiteley.
‘Although many people look for a vascular specialist, vascular mean “arterial”. Therefore it is important to check the specialist is a venous specialist to get the best opinion.’
How can I stop varicose veins from developing?
There’s little evidence to suggest you can prevent varicose veins from developing, but if you do have them, the following could ease symptoms:
- Engage in moderate exercise, avoiding triggers that make your symptoms worse.
- When resting keep your legs elevated.
- Weight losscan help if obesity is a problem.
- In mild cases, lightweight elastic compression stockings should ease the discomfort but they will not remove the varicose veins.
How are varicose veins treated?
‘There are a number of cutting-edge techniques available for treating varicose veins quickly and effectively – we have come a long way since the outdated technique of stripping which was not only very painful, but it also stimulated the varicose veins to grow back!’ says Professor Whiteley.
The most common varicose vein treatments include:
- Endothermal ablation – heat is used to seal the affected veins.
- Ligation and stripping – surgically removing the affected veins.
- Sclerotherapy – using foam to close the veins.
The NHS does not provide treatment for cosmetic purposes, so if you are concerned about the way they look, you will have to pay for cosmetic treatment privately.
When should I be concerned?
Ask your GP to refer you to a specialist if you experience any of the following:
✔️ Bleeding from the veins (requiring immediate referral).
✔️ Veins found in association with troublesome lower limb symptoms (typically pain, aching, discomfort, swelling, heaviness and itching).
✔️ Lower limb skin changes, such as pigmentation or eczema, thought to be as a result of the varicose veins.
✔️ Superficial vein thrombosis (characterised by the appearance of hard, painful veins) and suspected venous incompetence.
✔️ A venous leg ulcer (a break in the skin below the knee that has not healed within two weeks).
✔️ A healed venous leg ulcer.