Varicose Veins

The flow of blood upwards against gravity in the legs is maintained by the pumping action of the leg muscles and by the presence of valves in the veins which allow blood to flow upwards but not downwards. In a varicose vein one or more of the vein's valves becomes faulty, so that blood collects in the vessel and causes it to swell.

Standing up a great deal does not in itself cause varicose veins but can encourage the condition to start. Similarly, in pregnancy, the extra demands put upon the circulation by the fetus can also trigger the development of varicose veins.

Symptoms

The first symptom is a prominent, blue, swollen vein in the leg. Because of the stagnation of blood in varicose veins, tissue fluid is not absorbed properly and the leg also becomes swollen and discoloured. A complication is varicose eczema, caused by scratching of the irritated skin over the swollen veins.

The eczema causes further irritation and may spread to other parts of the body. Another complication of varicose veins is leg ulcers, which are a result of slow healing of a wound because of the poor blood circulation.

Because the blood in a varicose vein is moving slowly it may clot and form a thrombus, leading to phlebitis. This is dangerous because it can result in an embolus breaking off and blocking an artery elsewhere in the body.

Treatment

Treatment of varicose veins consists of resting with the legs raised to reduce the effect of gravity, and wearing firm­support elastic stockings or bandages. The only long-term cure for large varicose veins is surgical removal of the swollen veins (stripping) through small incisions in the skin. Smaller veins are treated by injections. The blood then returns through other veins in the leg, which take over the function of the removed vein. Any skin changes can be treated using a solution of the salt potassium permanganate.