It’s a myth that varicose veins are only a cosmetic concern. Varicose veins left untreated can lead to complications which are very real health concerns: oedema, hyperpigmentation, lipodermatosclerosis, venous ulceration, phlebitis and cellulitis, and thrombophlebitis, to name just a few.
The tell-tale sign of varicose veins is when veins usually in the legs or pelvic region begin to protrude above the skin. These blueish bulges betray a fault within in the vein. Healthy veins and arteries are like a one-way street. Blood pumps in one direction only; first from the heart through the arteries to the extremities, then returned to the heart through the veins. When the one-way valves fail, blood can leak backwards and build up in the damaged section of the vein. The vein enlarges and that’s when you’re likely to be able to identify a varicose vein bulging out on your skin.
Without treatment, venous dermatitis or varicose eczema can occur.
What is Venous Dermatitis?
Venous dermatitis, sometimes called varicose eczema or stasis dermatitis, happens because of poor circulation in the faulty vein. Increased pressure in the varicose veins and superficial capillaries will cause leakage of red blood cells and vascular fluid into surrounding tissue. This leads to inflammation of the tissue which may begin to itch. A chronic cycle of itching occurs and break down of the red blood cells, leading to hyperpigmentation (staining). If the condition is not addressed in a timely fashion, the affected skin will deteriorate, and eventually break down into an ulcer. Venous Dermatitis typically occurs in the medial paramalleolar region of the ankle (inside of the ankle) but can also occur on the outside of the ankle and in the thin part of the lower leg. As illustrated in the CEAP Classification table, oedema (swelling of the ankle and lower leg) is the precursor of this type of dermatitis.
Venous Dermatitis on the ankle
Is there a treatment for venous dermatitis?
The best way to treat venous dermatitis is to treat the underlying cause: varicose veins. Once the problem veins are closed off, the other symptoms will right themselves. Ulcers and dermatitis will heal up nicely. The latest treatments available for varicose veins are non-invasive, fast and no hospital stay is required.
Here’s a quick overview of some of the most common treatments.
Medical Adhesive Closure
Medical adhesives are medical grade ‘glues’ which are used to seal off varicose veins. Once the interior of a varicose vein is glued closed, the vein will harden, heal and be absorbed into the body. Blood flow is automatically rerouted to healthy veins in the legs.
Ultrasound Guided Sclerotherapy (UGS)
This procedure involves injecting a sclerosant solution into the abnormal veins under the guidance of ultrasound. The vein wall then collapses and veins dissolve and disappear as the body gradually absorbs them.
Endovenous Laser Ablation (EVLA)
With ultrasound guidance, a laser fibre is placed into the abnormal vein through a tiny incision. The laser is activated as 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 to the patient.
As you can see, the latest treatments use different ways to basically achieve the same thing – close the problem vein.
- Venous dermatitis (also known as varicose eczema) is caused by varicose veins.
- Treating the underlying cause will usually resolve the dermatitis.
- Common treatments for varicose veins include: medical adhesive closure, ultrasound guided therapy and endovenous laser ablation.
- To find out more book an appointment with Dr Paraskevas.