Varicose Veins
Anyone can get varicose veins. They can affect both men and women of all ages. Varicose veins occur more frequently in people who have a strong family history and may worsen with occupations that require prolonged standing. Commonly, varicose veins can affect people between 34 and 64 years of age, and can even be brought on by pregnancy.
Symptoms
Varicose veins can range from small thread-like veins called spider veins (or telangiectasia), to slightly larger blue veins or reticular veins, to large and bulging varicose veins. Varicose veins can affect any part of the leg or pelvic area.
Common varicose vein symptoms are:
- localised pain and aching in legs
- leg fatigue and heaviness
- burning, itching and throbbing
- cramping and restless legs
People with venous disease or problem veins may present with:
- Prominent veins alone – visibly large and bulging varicose veins, smaller thread-like spider veins or reticular veins
- Prominent veins plus symptoms – swelling in the leg or venous ulcers (breakdown in skin around the lower leg or ankle region)
- Symptoms alone – no visible abnormal veins
Skin rashes, small blue veins on the feet, skin discoloration and ulcers can also occur. These symptoms can indicate advancing vein problems. Severe venous disease can lead to complications such as eczema, inflammation or even ulceration of the lower legs.
Moderate Varicose Veins
These large, dilated, ropey veins that bulge above the skin surface, and are usually blue or green in colour. They no longer serve the primary function of veins, which is to return blood to the heart. Varicose veins can occur alone or with many of the physical manifestations of chronic venous disease. Many patients do not realise they have a complication of venous disease until they see a phlebologist (vein doctor).
What are the symptoms of moderate varicose veins?
The signs and symptoms of moderate varicose veins may include aching and heavy legs, tiredness, burning, itching, and throbbing.
Some patients may present with none of these symptoms, and may feel that there is nothing wrong with the affected leg. However, there can be real medical consequences to leaving varicose veins untreated. This can be a progressive condition and new faulty veins can develop with time, along with worsening symptoms and complications.
How do we treat Moderate Varicose Veins?
Moderately severe varicose veins can be treated non-surgically with a combination of Endovenous Laser Ablation and Sclerotherapy using Ultrasound. Some doctors may also perform Modified Ambulatory Phlebectomy for any larger problem veins.
Vein Health Medical Clinic’s treatments are safe and effective procedures with a high success rate. These treatments do not require general anaesthetic or hospital admission, and avoid the potential scarring effects of surgery. In the past, an in-hospital stay for surgery was necessary, but now patients can walk-in, have varicose veins treated in less than an hour, and walk out. No downtime from work is required; patients can return to normal duties immediately.
Dr Paraskevas specialises in non-surgical treatment of varicose veins of all levels of severity, and has developed a reputation as a leader in the application of simple and successful techniques to treat varicose veins.
Endovenous Laser Ablation (EVLA)
Under ultrasound guidance, a laser fibre is placed into the abnormal vein through a tiny incision. When the laser is activated and the fibre is slowly removed, this produces a reaction in the vein wall along the treated section, resulting in collapse and sclerosis of the vein wall with minimal discomfort.
Ultrasound Guided Sclerotherapy
Ultrasound Guided Sclerotherapy is a highly specialised procedure involving injecting a sclerosant solution into the abnormal veins using ultrasound guidance, causing the vein wall to collapse. The veins dissolve and disappear as the body gradually absorbs them.
Radiofrequency Ablation
Radiofrequency ablation (RFA) relies on thermal (heat based) damage to the vein, that leads to immediate closure of the vein. Once the vein is treated by radiofrequency ablation, it will gradually undergo complete absorption by the body and disappear over time.
Severe Varicose Veins / Chronic Venous Disease
Patients with severe venous disease may have signs such as venous eczema (venous dermatitis), swelling in the leg (oedema), discolouration of the skin (hyperpigmentation), thickening of the skin of the lower leg or ankle (lipodermatosclerosis), and localised or extensive break downs of the skin barrier, particularly around the ankle region (venous ulceration). As well as this, patients can experience heaviness, aching and tiredness in the legs. If left untreated, these symptoms are likely to become worse with advancing age.
What are the symptoms of severe varicose veins / chronic venous disease?
Patients with severe venous disease may have signs such as venous eczema (venous dermatitis), swelling in the leg (oedema), discolouration of the skin (hyperpigmentation), thickening of the skin of the lower leg or ankle (lipodermatosclerosis), and localised or extensive break downs of the skin barrier, particularly around the ankle region (venous ulceration.) As well as this, patients can experience heaviness, aching and tiredness in the legs. If left untreated, these symptoms are likely to become worse with advancing age.
Lipodermatosclerosis can greatly affect the health of the lower leg and lead to complications such as severe inflammation (phlebitis) and infection (cellulitis); varicose veins can form clots (thrombophlebitis) and venous ulcers can become quite troublesome and difficult to treat, particularly when they bleed, weep or become infected.
Complications of Venous Disease
A brief description of each of the complications of severe varicose veins/chronic venous disease. Learn more about how phlebologists classify venous disease here.
Hyperpigmentation
Venous Dermatitis
Lipodermatosclerosis
Venous Ulceration
Venous Eczema/Venous Dermatitis
The skin surrounding the severe varicose vein becomes scaly, red and wet. This can be mild and limited to the localised areas, or it can cover the whole lower leg, where the skin is very inflamed.
Oedema – Swelling of the leg
Oedema is a complication of chronic venous disease where the ankle, foot, and/or lower leg swells. Swelling can sometimes occur in patients with less advanced varicose veins, but is often present in advanced cases of severe venous disease.
Hyperpigmentation – Discolouration of the skin
A typical sign of venous disease is the development of a brown discolouration in the area above the ankle. If blood leaks out of the damaged blood vessels, the haemoglobin breaks down and disperses in the tissue. This broken-down haemoglobin causes the discolouration.
Phlebitis and Cellulitis
Severe bacterial infection of the vein and the surrounding tissues below the skin.
Lipodermatosclerosis – Thickening of the skin of the lower leg or ankle
One of the stages of skin change prior to ulceration is referred to as lipodermatosclerosis or chronic panniculitis. The is a thickening of the skin and soft tissue in the lower leg and ankle primarily in association with chronic venous disease and varicose veins.
Venous Ulceration – Breakdown of skin barrier
Localised or extensive breakdown of the skin barrier, particularly around the ankle region. If left untreated, severe venous disease leads to worsening symptoms in the lower legs, which will ultimately culminate in the development of a venous ulcer. The ulcer may be small or large. Ulcer treatment can be complex and must be managed correctly, with a combination of conservative and medical interventions by a phlebologist.
Thrombophlebitis
Inflammation and blood clotting of a vein
How We Treat Severe Varicose Veins / Chronic Venous Disease
Ultrasound Guided Sclerotherapy
Ultrasound Guided Sclerotherapy is a highly specialised procedure involving injecting a sclerosant solution into the abnormal veins using ultrasound guidance, causing the vein wall to collapse. The veins dissolve and disappear as the body gradually absorbs them.
Radiofrequency Ablation
Radiofrequency ablation (RFA) relies on thermal (heat based) damage to the vein, that leads to immediate closure of the vein. Once the vein is treated by radiofrequency ablation, it will gradually undergo complete absorption by the body and disappear over time.
Ambulatory Phlebectomy
Ambulatory Phlebectomy is the surgical removal of visible varicose veins, through keyhole incision. The procedure eliminates varicose veins through a series of small punctures (as tiny as 1mm) made in the skin adjacent to the vein.
Pelvic, Vaginal, and Vulvar Varicose Veins
Pelvic, vaginal, and vulvar varicose veins occur in and around the groin area and can be worsened (exacerbated) following previous treatments including laser or radio frequency ablation, sclerotherapy or surgical ligation (with or without stripping) of the sapheno-femoral junction or can also occur after multiple pregnancies, and in some cases after one pregnancy. They can be present with or without accompanying symptoms.
Can Pelvic, Vaginal, and Vulvar Varicose Veins be Treated?
Pelvic, vaginal and vulval varicose veins can be treated quite effectively with ultrasound guided sclerotherapy. This procedure is performed by experienced senior phlebologists. It requires the use of advanced ultrasound equipment and careful isolation of the pelvic veins. As with lower leg varicose veins, the treated veins will undergo a hardening process referred to as sclerosis and will eventually get absorbed by the body. Once these veins have been treated, any congestion or symptoms associated with the build-up of blood within them, should resolve.
Can Varicose Veins in the Groin Region Occur in Men?
Yes. It is not just women who suffer from varicose veins of the groin area. Doctors report men can also suffer from pelvic varicose veins.
When Should You Seek Treatment?
Regardless of the location of the varicose veins, whether in the pelvic region or in the thighs, legs or ankles, getting the appropriate treatment from an experienced phlebologist is important. Treatment will help relieve symptoms and prevent further deterioration of vein disease.
For patients who are currently pregnant, it is appropriate to recommend treatment between pregnancies. Treatment during pregnancy is not recommended. In our experience, varicose veins in the pelvis and legs should be treated before the next pregnancy to avoid deterioration with subsequent pregnancies.
Varicose Vein FAQ’s
Who is affected by varicose veins?
Varicose veins usually run in the family. If one parent has had venous disease you have about a 33% chance of developing vein problems; with both parents this increases to about 90%. Contrary to popular belief, both men and women are affected. It may be noticed earlier in women as symptoms can be exacerbated by pregnancy.
Do I need to treat varicose veins? Isn’t this just cosmetic?
Many patients complain about their varicose veins being ugly – however, we need to be clear, we are dealing with a medical issue that can become worse over time, and lead to severe complications.
How can I prevent varicose veins?
Patients who have varicose veins are predisposed to developing them at birth. The best thing to do to manage them conservatively (in other words, without having any treatment) is to ensure that you get enough rest, eat a healthy diet, and keep your weight down. This will help your overall health, including your veins.
Do you still need those veins?
Varicose veins are no longer serving a useful function to circulation. In fact, when the vein becomes defective, the body develops alternative pathways and bypasses the varicose vein altogether. You will never run out of alternate pathways. When a phlebologist closes down a varicose vein, the circulatory system improves, as do many of the symptoms. The problem veins will not resolve themselves without medical intervention.
How do phlebologists classify the severity of venous disease?
In the past it has been tricky for phlebologists and health professionals to define vein disorders because of the range and severity of symptoms. By creating the CEAP venous disease classification system, discussion of conditions and treatments is standardised across the world. Read more about the CEAP classification system.
Other Vein Conditions
Spider Veins and Reticular Veins
Spider veins are the tiny red or blue veins that can appear anywhere on the body, but more often on the legs, ankles, face, chest, or abdomen. Spider veins are extremely common. They may appear to be short, seemingly unconnected lines, each about the width of a large hair, or they may resemble a spider web or a tree with branches. In medical terms spider veins are called telangiectasias, and usually occur in association with larger dilated blood vessels (often blue / green in colour) called reticular veins. Often dilated blood vessels cause aching especially with prolonged standing.
Periorbital Veins
Periorbital veins (POV) are often a cause of cosmetic concern for patients. POVs are superficial veins which start at the bridge of the nose and stretch below or above the eye to join venous branches on the lateral forehead and scalp. Under normal circumstances, periorbital veins are barely visible to the human eye.
Lipoedema & Varicose Veins
Lipoedema is a chronic progressive condition characterised by the abnormal and excessive accumulation of the fatty tissue, generally in the lower legs and thighs. Other areas frequently affected by lipoedema include the buttocks, thighs, lower legs and ankles. Varicose vein disease is often present in conjunction with lipoedema and associated mild lymphedema.
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read moreMedicare Rebate & Costs
The cost of treating varicose veins depends on severity of the veins as well as which treatment is used. We discuss these costs in detail at your initial consultation.
A Medicare rebate is claimable on all varicose vein procedures, except the most superficial spider veins.
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