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How to treat varicose veins

If you suffer from varicose veins - as millions in the UK do - you may be tempted to hide your legs under thick tights regardless of the temperature. But this condition is more than a minor cosmetic problem for some, and can cause aching, swollen legs and even ulcers.

Feeling the pressure

Varicose veins are thickened, knobbly veins just under the surface of the skin, usually on your lower (or upper) legs. Blood is supposed to go one way around your system - from your heart through your arteries back to your body organs, and back via your veins.

But the pressure in your veins is much lower than in your arteries, so they have one-way valves to stop blood flowing backwards. If one of these gets weakened the blood can start leaking backwards. This puts more pressure on the next valve down the line and so on. The result? Thick, knobbly varicose veins.

Varicose veins are different from thread veins, like little ‘starbursts’ under the skin. They don't stand out from the skin surface and can't be felt if you run your fingers over your legs. Since they don't cause the same complications as varicose veins, they can't be treated on the NHS.

Fact or fiction

There are all sorts of old wives' tales about why people get varicose veins. In fact, there's usually no obvious cause. They do often run in families, and it's possible that some people inherit a tendency to weakness in the vein valves that keep blood flowing in the right direction. They do get more common with age, and often crop up in pregnancy - the more babies you have, the less likely they are to settle once your baby is born.

There's not much evidence that standing for long periods increases your risk, but it's probably best to avoid just in case. You may develop varicose veins after having a clot on a deep vein in your leg, called a DVT. Being overweight increases your chance of varicose veins if you're a woman, but not a man - life's not fair!

At best, varicose veins don't cause any symptoms and you won't know you've got them unless you look. But they can also cause:

  • Aching.
  • Itching.
  • Heaviness or swelling in your legs.
  • Dry or thickened skin, called varicose eczema.
  • And, in severe cases, leg ulcers.

Varicose veins can also sometimes get inflamed, causing them to become red, hot and sore. Occasionally they may also bleed, especially if they're knocked. If this happens, lie down with your leg in the air (or lie flat on the sofa with your leg up on the arm). Apply a clean cloth and press hard for at least 10 minutes. If the bleeding persists or is heavy, call an ambulance.

Remember that taking blood-thinning medicine like aspirin or warfarin means it will take longer for bleeding to stop.

Keeping them away

If your symptoms are mild, simple lifestyle measures can often keep symptoms at bay. Your legs are more likely to ache from having varicose veins if you sit or stand still for long periods, so move around regularly. Sitting or ideally lying with your legs up whenever you can will relieve aching and swelling. Compression or support stockings can relieve pressure and aching - although compression stockings in particular can be tricky to put on, especially if you have arthritis.

If you're significantly troubled by aching, itching or swelling, or if you have varicose eczema, you're likely to be eligible for treatment on the NHS. These days the traditional 'stripping' operation, where the offending veins are physically stripped out under anaesthetic, is rarely done. You're more likely to be offered treatment with lasers or a foam or chemical injected into the veins to shut them off (called sclerotherapy).

These newer techniques provide good results for most people, with a lower risk of bruising and other complications. You do need to keep the veins compressed with bandages or compression stockings for a couple of weeks. You'll also be encouraged to keep walking.

With thanks to 'My Weekly' magazine where this article was originally published.