FAQs

Q. What causes varicose Veins?

A. No one knows for sure, but varicose veins are probably due to a failure of the valves that prevent the down flow of blood in the wrong direction. Normally, the flow of blood in the veins is towards the heart and in the legs, the flow is from the feet upwards. Abnormal down flow is called reflux and this leads to varicose veins. Important factors are

• Heredity
• Pregnancy
• Overweight
• Lack of exercise
• Smoking
• Unhealthy life style
• Standing for long periods

Q. What do veins do?

A. There are two sets of veins in the leg. A deep set, within the muscles and a superficial set just underneath the skin. Veins carry blood back from the leg towards the heart and most of the blood (more than 95%) is carried back in the deep system. Very little blood is actually carried back in the superficial veins. The small amount of blood that is carried up by these veins finally enters the deep system at certain points called perforators. The most important drainage points are in the groin and behind the knee.

As the muscles of the legs contract, the deep veins are squeezed and blood is pushed up against gravity towards the heart. When the muscles relax, the blood is prevented from coming back down the leg towards the feet by the closure of valves, which are delicate folds of the lining of the veins. The combined action of the muscles contracting and the valves shutting, keeps blood moving in the correct direction.

If the valves are not working properly, blood may spill down in the wrong direction (called reflux), filling the superficial veins and causing varicose veins. An ultrasound scan is very important in identifying the exact position of the faulty valves.
 

Q. Are Varicose Veins Simply Cosmetic?

A. The majority of people with varicose veins come to no harm at all. Even those people who have ache, discomfort and swelling are unlikely to develop serious complications. For this reason, many doctors believe that varicose veins are not important. Indeed, the treatment of varicose veins is not a priority in the NHS and some people are denied NHS referral and treatment. To some extent this is understandable as the NHS has many pressures that require its valuable resources such as the treatment of cancer, heart disease, diabetes, care of the elderly - to name just a few. Even if your varicose veins are severe, your GP may not be able to help and may not be able to refer you for treatment. Nevertheless, varicose veins cause severe embarrassment for many, who are unable to wear shorts, go swimming or enjoy holidays on the beach.
 

Q. What complications can arise?

A. Varicose veins are associated with abnormal down flow of blood called reflux. When this is present for a long time, the skin may be damaged and a condition called varicose eczema develops. This is a warning sign that the skin is unhealthy and vulnerable. A trivial injury can cause a leg ulcer. A typical injury is a knock from a shopping trolley.

Although many people with varicose veins are concerned about a leg ulcer, in fact, the majority will not develop this condition. If however, the skin around the ankle develops any eczema-like changes, advice should be sought urgently.

 

DVT is a feared complication of varicose veins. Although varicose veins are a risk factor, fortunately DVT is very rare complication. More important risk factors are admission to hospital, major surgery, previous history of DVT, family history of blood clots, long haul flights and long journeys, pregnancy and inherited blood clotting disorders. The diagnosis can be very difficult, but swelling of one calf is suggestive.

We believe that early treatment improves the results  
In some cases, NHS treatment for varicose veins is only available when complications have arisen. Many vein specialists believe that treatment at an earlier stage improves the cosmetic result and prevents these complications.