VARICOSE VEINS
Questions and Answers on Varicose Veins
You can review frequently asked questions and answers about varicose veins in the content below.
What Does Varicose Vein Mean?
Varicose veins occur as a result of the inability of the veins to do their job properly and are a sign of venous insufficiency.
It is generally known as the abnormal enlargement of the superficial veins in the legs, becoming prominent and visible in purple or blue.
In some patients, it causes symptoms such as pain, itching or swelling in the legs. Sometimes, without these symptoms, aesthetic discomfort may upset the patients due to the veins that become visible.
Why Do Varicose Veins Occur?
Varicose veins can occur because of different reasons. We can briefly answer the question “Why do varicose veins occur?” as “Varicose veins are caused by reasons such as weakening of the vessel walls, improper functioning of the valves in the veins or genetic factors.”
However, the main reasons for the occurrence of varicose veins are:
- Weakness of the vessel wall: Vessel walls may weaken due to genetic factors, aging, or other factors. The pressure in the vein can lead to enlargement and elongation of the veins due to this weakness.
- Vascular valve insufficiency: The valves in the veins allow blood to flow in one direction from the foot to the heart (against gravity). These valves allow blood to move upwards while preventing it from escaping backwards. In the case of vascular valve insufficiency, these valves do not work properly, and blood may escape backwards (downwards). This may result with dilation of the venous vessels.
- Blood collection (stasis): Standing or sitting for a long time can cause blood to accumulate in the leg veins due to gravity. This may lead to dilation of the veins and the formation of varicose veins.
- Hormonal changes: Hormonal changes caused by pregnancy or other reasons can cause weakening of the vessel walls and the formation of varicose veins.
What Are the Symptoms of Varicose Veins?
Varicose veins do not occur with the same symptoms in every patient. Each patient’s varicose veins are unique.
The most common symptoms are:
- Feeling of heaviness and fullness in the legs
- On the feet, ankles, or legs
- edema or swelling
- itching, tingling and burning sensation,
- night cramps,
- feeling of restlessness,
- color changes,
- visible vasodilation
- Blunt (not sharply limited) pain in the legs
The symptoms that occur in each patient may be different depending on the degree of venous insufficiency and the individual vascular network.
Symptoms may be felt more, especially in the summer months when the veins can expand and become evident due to higher temperatures.
Elevating the legs in a supine position can alleviate symptoms. However, this precaution does not prevent the formation of new varicose veins.
What Are the Types of Varicose Veins?
The types of varicose veins are usually given different names according to their anatomical location and the degree of enlargement. The various types of varicose veins can be summarized as follows:
- Great Vein Varicose Veins: These are varicose veins that occur due to insufficiency of the great saphenous vein, which we may mention about as the main varicose vein, are located deeper in the muscles and tissues and are usually not visible from the outside, but can cause leg pain, swelling and other symptoms. These are also anatomically superficial veins, but they are located generally more deep to be seen throughout the skin. They can be seen as larger varicose veins in weaker patients or in patients whose veins are anatomically located close to the skin.
- Lateral Branch Varicose Veins: These are enlarged veins in the side branches of the main venous vein. These side branches originating from the main veins in the superficial venous system usually cause superficial varicose veins to become apparent.
- Superficial Venous Varicose Veins: These types of varicose veins are enlarged veins located just below the surface of the skin and usually appear blue or purple. Their locations, distributions and forms may vary from patient to patient.
- Perforating Venous Varicose Veins: These are veins that provide the connection between the superficial and deep veins. Perforating venous varicose veins are formed as a result of the dilation of these connecting veins and can sometimes become apparent on the skin surface.
- Reticular Varicose Veins: These varicose veins are small, thin and irregularly dilated veins. They are usually purple or greenish in color and are located just below the skin surface.
- Telangiectasis (Spider Varicose Veins): They are very small, red or purple dilated capillary veins. They get their name from their spider web-like appearance and are usually found spread out on the skin surface.
These types of varicose veins may vary in terms of signs, symptoms and treatment methods. Each case should be evaluated by a specialist and an appropriate treatment plan should be created.
What Are the Stages of Varicose Veins?
To answer some questions like; “How many types of varicose veins are there?“, “Will my varicose veins progress?“, we can briefly talk about the stages of varicose veins:
- C0: No obvious vein appearance
- C1: Spider (web-shaped) or reticular (bluish) capillaries
- C2: Large varicose vein expansions or varicose veins visible, no edema
- C3: Edema and swelling in the legs and ankles
- C4a: Color changes (pigmentation) and dermatitis-like changes in the feet
- C4b: Skin changes (lipodermosclerosis), skin collapses (atrophy)
- C5: Healed wounds in addition to C4
- C6: Active ulcers with skin changes
Is there such a thing as hidden varicose veins?
The term “hidden varicose veins” is generally used to describe situations where varicose veins are located in deep veins in a way that is not visible or obvious from the skin surface. These types of varicose veins may have no or minimal external symptoms.
The signs and symptoms of hidden varicose veins may be less obvious. However, some people may experience symptoms such as leg pain, a feeling of heaviness, or swelling. Generally, hidden varicose veins may only be detected using medical imaging techniques (such as ultrasound imaging).
Treatment for hidden varicose veins varies depending on the severity of symptoms, the location of the varicose veins, and potential complications. Treatment options may include conservative treatments (such as elevating the legs, using compression stockings), sclerotherapy, endovenous ablation, or surgery. It is important to consult an expert when determining and implementing treatment.
What Are Our Recommendations to Patients Suffering Varicose Veins?
Patients with varicose veins should be careful about some personal habits to make their lives more comfortable and prevent varicose veins from progressing.
Exercising every day, such as walking and swimming, are effective in preventing the progression of the disease and reducing complaints.
Weight control is also very important to prevent varicose veins from occurring or progressing and to alleviate complaints.
Wearing tight clothes can trigger varicose vein occurrence as it can block venous flow. Wearing high-heeled shoes is also not recommended for varicose veins.
In terms of nutrition, fibrous and healthy foods should be consumed.
It is recommended to use varicose vein stockings during the day. Our general recommendation is to wear them when you wake up in the morning and take them off just before going to bed at night. However, since there may be patient-specific changes, it would be appropriate for each patient to use them according to the recommendation of their examining physician. At the end of the day, massages and keeping the feet elevated may contribute to reducing patients’ complaints.
- Regular exercise: Regular exercise can be beneficial to strengthen the leg muscles and increase blood circulation. Activities such as walking every day, as well as cycling and swimming can be recommended for varicose vein patients.
- Healthy diet: Having a balanced and healthy diet is important for weight control and maintaining vascular health. It may be beneficial to choose foods that contain sufficient fiber, vitamins and minerals. Chronic constipation may facilitate the formation of varicose veins, and this can be prevented with a healthy diet.
- Keeping your feet elevated: Keeping your feet elevated can ease the symptoms of varicose veins by facilitating the return of blood.
- Varicose stockings: Using varicose stockings with appropriate tightness (pressure) as recommended by your doctor can support blood circulation, reduce complaints and swelling in the legs, and slow down the progression of varicose veins.
- Avoid sitting or standing for long periods of time: Sitting or standing for long periods of time, that is, remaining motionless and fixed for long periods of time, may facilitate the formation of varicose veins or may increase existing varicose vein symptoms. In all our daily lives there are situations that make us stand or sit. The point we need to be careful here is to take breaks while sitting or standing, take short walks or move our legs in place. Leg movements make the leg muscles work and with the effect of the muscle pump, they significantly contribute to blood flow in the veins.
- Regular doctor check-ups: It is important to be controlled by a Cardiovascular Surgery Doctor in order to monitor the presence and the course of varicose veins or venous insufficiency and determine appropriate treatment methods. It is of great importance to follow your doctor’s recommendations and treatment plan.
While these recommendations are generally useful for varicose vein patients, each patient may have different needs. Therefore, it is important to get personalized advice from a Cardiovascular Surgeon regarding the treatment and management of varicose veins.
What are varicose vein stockings?
Varicose vein stockings, as we call compression stockings, are special produced types of stocking designed mainly for people with varicose veins or circulatory problems in the legs. These are not ordinary stockings, but medical products used to help relieve the symptoms of varicose veins in the legs. Varicose stockings have special fabrics with a certain level of tightness (pressure) and support blood circulation by increasing the pressure applied to the legs.
Some of the basic features of varicose stockings are:
Varicose stockings increase blood circulation by applying pressure to the legs. They act at different pressures at the ankle, knee and thigh level. This pressure can help the blood accumulated in the legs to return to the heart better and reduce the symptoms of varicose veins.
Compression stockings have different levels of tightness. The tightness is usually applied starting from the ankle and decreasing upwards. This tightness creates more pressure on the lower legs, while providing lighter pressure on the upper parts. The tightness of the stockings that each patient should use according to the degree of varicose veins will be recommended by their physician.
Compression stockings can be used in different lengths such as below the knee, above the knee or along the entire leg. The length selection can be made with your doctor depending on the treatment requirements due to the severity of the disease and personal preferences.
Compression stockings usually are helpful to reduce the symptoms of varicose veins or circulation problems. However, it is important to consult a health professional for the correct tightness and length selection before use. It is also important to be informed about regular cleaning and maintenance of compression stockings.
How Are Varicose Veins Treated?
Varicose vein treatment is not the same for every patient. We have various treatment options such as medical therapies, surgical treatments, intravenous treatments with laser and radiofrequency devices, compression therapies and those applied to veins visible through the skin (generally known as “foam treatment” in public). Depending on the degree and prevalence of the patient’s varicose veins, one of these treatments may be applied or several of them may need to be applied together. The choice of treatment is determined by the patient’s general health status and the condition of the varicose veins. At this point, the Cardiovascular Surgery Doctor will decide which treatment method or methods are necessary after examining the patient.
Varicose vein treatment methods can be classified as follows:
