Varicose veins are enlarged blood vessels, which develop due to vein valves weakness and the pooling of blood in the legs veins. They may cause itchiness, discomfort, and swelling around the ankles, and if neglected, may lead to even more severe conditions. Varicose veins are mostly seen after 40 years, although severe varicose veins are not uncommon in young persons.
They are also commonly seen in obese people, those with standing or sitting jobs, and those with a sedentary lifestyle. The problem of Varicose veins left untreated is not how it looks in those areas.
What happens if the Varicose veins are left alone. In some patients, they can lead to significant medical complications. Dr. Shoaib Padaria, the Pioneer of Laser treatment in India, offers some insights on this.
1- Swelling of the legs, especially the ankles:
Swelling of the leg is one of the most common complaints of patients suffering from Varicose veins. Due to increased pressure of leaking blood in the veins, the ankles swelling is usually noticed, usually towards the evening, when the patient has been standing or sitting for a long period.
This swelling usually decreases or completely subsides on elevating the legs or when the patient sleeps at night. However, later on, this swelling becomes more permanent and will not reduce even with leg elevation or by wearing compression stockings. Patients should not wait until this occurs, and consult your Vein Specialist as soon as ankle swelling is noticed, says Dr. Padaria.
2- Skin Infections:
Skin infections of the legs is a risk that accompanies Varicose veins. Due to increased pressure of the blood in the enlarged veins, some amount of fluid and proteins leak out into the lower limbs tissues. This is accompanied by swelling. The leg is now very much prone to bacterial infections, which do not heal quickly. The commonest infection which occurs is known as cellulitis, causing redness and warmth in the infected area. The patient may even develop a high fever and have raised blood cell counts. The cellulitis can sometimes be very severe, involving the entire limb, and may even spread to the other leg. It may occasionally require hospitalization and treatment with intravenous antibiotics. Even after the cellulitis is treated and recovers, many patients are left with some swelling and darkening of the affected skin, which may persist lifelong.
3- Skin Ulcers:
The skin of the patients with varicose veins around the ankles is usually prone to swelling and infection. Furthermore, there is a reduced capacity for healing. Therefore, even small legs small wounds do not heal easily or take a long time to heal. These wounds around the ankles are called Venous Ulcers.
These venous ulcers are usually seen around the inner or outer side of the lower ankle area. They are usually reddish and may be mildly painful. If there is severe pain in the ulcer wound, it is usually due to accompanying infection, associated involvement of the area’s arteries, or damage to the surrounding nerves. Some venous ulcers may take years to heal.
Venous ulcers appropriate treatment is to treat the Varicose veins, followed by proper bandaging and compression therapy for the wounds. Venous ulcers occurrence indicates the presence of very severe varicose veins disease and should not be neglected. Dr. Padaria has treated many patients with venous ulcers and is one of the authors of the Guidelines for Venous Ulcer Treatment in India, published on behalf of the Venous Association of India.
4- Lipodermatosclerosis:
Patients with severe varicose veins will develop significant skin changes around the ankles and lower legs, called Lipodermatosclerosis. There is darkening (pigmentation) of the skin, and it also becomes hard. The fat tissue below the skin also decreases so that the ankles become very thin and narrow, and the skin is seen to be directly over the bone. This damaged skin is very prone to tear and rupture because the underlying fat is absent. Patients who notice darkening of the skin around the ankles, especially those who also have itching in that area, should immediately consult a Vascular Specialist. In most cases, the cause is underlying varicose veins, which can easily be identified by a Venous Doppler sonography test. Venous Doppler study is routinely performed at Doctor House Cardiovascular Centre by Dr. Padaria and our expert radiology team, who have been doing these tests for the last 30 years.
5- Superficial Thrombophlebitis and Superficial Venous Thrombosis:
Occasionally the dilated Varicose veins in the legs may become very painful, swollen, and hard, with the warmth of the overlying skin. This condition is called Superficial Thrombophlebitis and is due to irritation and inflammation of the Varicose Veins. It can be quite painful and disturbing. The treatment is with medicines like anti-inflammatory drugs and compression stockings.
On the other hand, there may be the clotting of blood in the dilated Varicose Veins. This condition is diagnosed by sonography and will require special clot-dissolving medicines for 6 to 12 weeks. Sometimes, the clot may extend into the legs deep veins, causing severe Deep Vein Thrombosis.
6- Deep Vein Thrombosis:
One of the most severe complications in a patient with Varicose Veins is Deep Vein Thrombosis. A blood clot that forms in the Varicose Veins may travel into the legs deep veins and block the flow of blood.
Since the legs deep veins are responsible for returning more than 90% of the blood from the legs back to the heart, this blockage causes the entire leg to swell. Along with the swelling, there is pain.
Occasionally the blood clot from the deep veins can travel to the heart and get lodged in the lungs, causing a severe pulmonary embolism condition. Many patients die from Pulmonary Embolisms. So it is important to treat Varicose Veins in time before they cause any major complications.
7- Severe Bleeding:
Sometimes, the enlarged Varicose Veins can burst and cause severe bleeding. As we know, varicose veins occur because of leakage in the vein valves, with the blood in the veins flowing in a reverse direction towards the ankles. Over some time, the veins dilate, especially the smaller branches, which are very thin. These thin branches can sometimes break ( rupture ).
They may occur spontaneously ( by themselves) or maybe due to scratching the area or during a bath. Most of the time, this bleeding is painless and occurs as a spurt of blood. If it occurs at night during sleep, the patient may lose a lot of blood before becoming aware of the problem.
Bleeding varicose veins indicate that the veins pressure is very high, and the Varicose veins should be treated immediately. At Doctor House Cardiovascular Center, we evaluate all these patients in great detail and formulate a treatment plan.
Every patient is different and may need a different type of treatment. The various treatment procedures include Laser Therapy, Radiofrequency Ablation, Foam Sclerotherapy, Glue (Venaseal), etc. However, it should be understood that every procedure has its advantage and its disadvantages, and Dr. Padaria will explain to each patient what procedure would be most beneficial to that particular patient, depending on the clinical findings and the results of the investigations.
We suggest you contact your doctor when you feel your varicose veins are bulging out or have started to pain. You can call 022 23525001/ 022 23526001 and schedule an appointment with Vascular Specialist Dr. Shoaib Padaria. At Doctor House Cardiovascular Center, we have all investigative facilities for Vascular Diseases in-house.