Varicose veins are veins under the skin of the legs, which have become widened, bulging, and twisted. They are very common and do not cause medical problems in most people.  

There are two main systems of veins in the legs:

Deep veins:  The leg muscles squeeze the deep veins during walking, carrying most of the blood back up the legs to the heart.

Superficial veins: These occur under the skin which are less important and can form varicose veins.

All of these veins contain one-way valves to ensure that the blood flows towards the heart.   

Failure of these valves allows blood to flow backwards down the veins and results in an overload of pressure when standing.  This excess pressure leads to widening of the veins so that they do not close properly.  Blood then flows back into the leg along these veins and causes varicose veins to develop.   

Raised pressure in these veins also encourages the development of spider veins and discoloured areas which look like bruises.

Many people have no symptoms at all from their varicose veins, except for the fact that they are noticeable and their appearance can be embarrassing.   

Other than cosmetic embarrassment, the most common symptoms of varicose veins are aching, discomfort and heaviness of the legs, which are usually worse at the end of the day.  Sometimes the ankle can swell, too.  These symptoms are not medically serious, but can be treated if they are sufficiently troublesome.

Although varicose veins can get worse over the years, this often happens very slowly.   

In a few people the high pressure in the veins causes damage to the skin near the ankle, which can become brown in colour, sometimes with scarred white areas.   Eczema (a red skin rash) can develop.   If these skin changes are allowed to progress, or if the skin is injured, an ulcer may develop.

Other problems which varicose veins can occasionally produce:

Phlebitis - Phlebitis (sometimes called thrombophlebitis) means inflammation of the veins, and is often accompanied by some thrombosis (clotting of blood) inside the affected veins, which become hard and tender.  This is not the same as deep vein thrombosis (DVT) and is not usually dangerous.  It does not mean that the varicose veins necessarily have to be treated.

Bleeding - The risk of bleeding as a result of knocking varicose veins worries many people, but this is very rare.  It will always stop with firm pressure and the veins can then be treated to remove the risk of further bleeding.

Deep Vein Thrombosis - Varicose veins are associated with DVT in some patients.  It is not clear whether varicose veins themselves increase the risk of DVT, but certainly DVT leads to varicose veins and skin damage around the ankle. If you feel that your varicose veins are presenting any of these symptoms, please call us or schedule an appointment.

How to evaluate and diagnose varicose veins will be discussed in next article.