Varicose veins

Varicose veins are blue or dark purple, curved varicose superficial veins, most commonly manifested on the legs. Although there are no accurate data, it is estimated that almost half of the world’s adult population has a problem with venous circulation, and about 20-25% of women and 10-15% of men worldwide have visible varicose veins.

Veins are blood vessels whose main function is to direct blood from the tissues and organs back to the heart. For this purpose, many of the veins have valves, which allow normal blood circulation. Thanks to the valves, the correct direction of venous blood flow is maintained. This is especially important for the venous vessels of the legs, where if there were no venous valves, due to gravity the blood would move down, in the opposite direction from the heart, ie. would lag in the superficial veins.

Impaired venous valve function is one of the main causes of varicose veins. Weakening of the venous wall, as well as an increase in venous pressure, can also contribute to varicose veins.

Factors that increase the risk of varicose veins are:

-Genetic predisposition. If your immediate family member has varicose veins, your risk of developing the same condition is increased.
-Gender. Women have a higher risk of developing varicose veins. The main reason is thought to be in the variation of female hormones throughout life.
-Age. The risk of developing varicose veins increases with age. Over time, in some populations, the valves of the veins that help regulate normal blood flow become damaged and do not function at full capacity. Therefore, part of the blood, instead of being directed to the heart, lags behind the superficial veins.
-Obesity. Being overweight puts extra strain on the venous system, leading to valve damage and compromising venous blood flow to the heart.
-Pregnancy. During pregnancy, a number of changes occur that can contribute to the appearance of varicose veins. Increased blood volume in the body, reduced speed of blood flow from the legs to the pelvis, hormonal changes that emphasize the dilation of blood vessels, weight gain, as well as pressure of the uterus on the venous system, are reasons that increase the likelihood of occurrence of varicose veins in pregnancy.
Fortunately, if a woman has no other risk factors, in most cases, 3 to 12 months after pregnancy, varicose veins recede.
-Prolonged standing / sitting. The less you move, the harder it is for your veins to pump blood to your heart. Prolonged standing and sitting in one place significantly increases the risk of varicose veins. Therefore, if your job requires prolonged sitting or standing, try to move for a few minutes every hour.

The clinical picture of varicose veins varies depending on the severity of the disease.

It may consist of the following symptoms and signs:
-Blue or dark purple veins visible on the skin surface of the feet;
-Feeling of heaviness in the leg;
-Swelling in the joints and feet;
-Muscle cramps;
-Change in skin pigmentation around the varicose vein;
-Feeling of warmth.

Varicose veins are a relatively benign health condition. Unfortunately, in some cases complications can occur. Most often it is about:

1.Bleeding. Because varicose veins are close to the surface of the skin, the slightest trauma or injury (during showering, dressing or undressing …) can cause bleeding.
CAUTION: If you are bleeding from a varicose vein injury, lie down and lift your legs up while keeping direct pressure on the wound. If the bleeding does not stop, consult your doctor immediately.
2.Venous ulceration. It is a skin change, which most often occurs in the ankle area as a result of impaired venous circulation. This is why venous ulcers are difficult to heal. In many cases, just before the onset of venous ulcers, there is a change in skin pigmentation. Therefore, consult your doctor in time if you notice discoloration of the skin, especially in the ankle area.
3.Superficial (superficial) thrombophlebitis. Thrombophlebitis is a condition characterized by an inflammatory process in which a thrombus forms, leading to blockage of one or more venous blood vessels, most commonly in the lower extremities. If the affected vein is superficial, then it is superficial thrombophlebitis. In most superficial veins where thrombosis develops, phlebitis (inflammation of the venous vessel) is present in parallel, unlike deep vein thrombosis, a condition that can be asymptomatic without phlebitis present.
4.Deep vein thrombosis. Symptoms of deep vein thrombosis may include edema, pain in the affected leg, tenderness, heat, or redness of the skin in the affected area.

A good medical history and physical examination are needed to make a diagnosis. Additionally, a vascular Doppler can be made to visualize dilated venous blood vessels. It is a non-invasive, safe and painless method, which shows the structure and function of blood vessels with ultrasound waves.

Treatment options can be non-surgical and surgical.

-Compression stockings, help the veins function normally by placing the valves in the correct position. This reduces varicose veins, swelling and pain, and can help soothe muscle cramps.
There are several types of socks with different degrees of compression. If the damage to the venous system is greater, socks with a higher degree of compression are needed. Therefore, before purchasing them, it is best to consult your doctor to make the right choice.
-Sclerotherapy. This procedure consists of injecting a solution (sclerosant) using a thin needle, which allows the affected venous vessels to collapse. This prevents blood from flowing to the treated vein and directs it to circulate to other venous blood vessels. This method usually treats small or medium-sized veins.
However, sclerotherapy can give side effects such as brown discoloration of the skin in the area where the treatment is performed, irritation and damage to the tissue surrounding the affected vein.
CAUTION: Sclerotherapy is not recommended if the patient has a positive history of previous venous thrombosis, in pregnant women, in people who are allergic to sclerosant.
-Laser treatment. During this laser treatment, a beam of light is sent into the affected vein, leading to its ablation.
CAUTION: Inadequate use of the laser can cause skin burns and changes in the pigmentation of the treated area.
-Surgical treatment for varicose veins usually includes saphenectomy, phlebectomy, radiofrequency ablation, and endovenous laser therapy.
Large dilated venous vessels are treated with surgery.

In order to prevent varicose veins, practice the following tips:

-Raised leg position. To improve circulation, take a few short breaks during the day and raise your legs above heart level. It is recommended to lie down in a horizontal position, with your legs raised on 3 to 4 pillows.
-Nutrition. Although it is known that the genetic factor is crucial for the appearance of varicose veins, a healthy diet can protect the venous system from further damage. A balanced diet that includes fiber, complex carbohydrates, protein and healthy fats is advised. Adequate fluid intake, at least 2 liters per day, is also recommended, which would contribute to a healthy circulation. In addition, proper nutrition helps prevent weight gain, which is an additional risk factor for varicose veins.
-Compression socks can also be used preventively. In this case, it is advisable to use socks with the lowest degree of compression.
Clothes. Avoid tight, tight-fitting pants, such as skinny jeans. For the prevention of varicose veins, comfortable clothes are recommended, which will not compress the veins of the legs. This ensures normal blood flow, which is vital for healthy venous vessels.
-Footwear. Avoid high heels because due to the non-physiological position of the foot, the normal venous blood flow is disturbed and thus the risk of varicose veins increases.
Physical activity. Exercise is a healthy lifestyle habit, which helps maintain weight and prevent many diseases, including varicose veins. It is recommended to walk at least 20 minutes 3 times a week, but if you are in a sedentary position for a longer period of the day, it is advisable to walk at least 60 minutes.

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