Varicose veins are elongated, swollen and tortuous superficial veins, most commonly found in the legs. They are caused by weakness (incompetence) of the valves in the veins, which results in a back flow and stagnation of blood in these vessels which return blood to the heart. This, in turn, causes a rise in pressure in the veins resulting in swelling and distortion of the veins. Obesity, pregnancy, prolonged standing, familial tendency, lack of exercise, disease - such as abdominal fluid or masses, large fibroids, for example - can also be the cause of the problem. The symptoms of varicose veins can vary from the mildest to the severe. There may just be a bluish streak on the skin. In some, the veins may look horrendous but give no trouble at all. However, there may be aching, burning and/or itching. The skin may be pigmented with a dry scaly rash (gravitational or varicose eczema). Sometimes the skin can break down and ulcers, often large, can occur and be most difficult to treat. In the elderly, particularly, a slight knock on a varicose vein can result in a catastrophic bleed which may be life threatening and should be treated as a medical emergency.

Small thread like veins that are of no medical significance will upset some people, usually women. This is a purely cosmetic matter and these vessels can usually be treated with superficial laser. Other people may have enormous varicose veins but do not seek help because they give no problems. Most patients, seen in a doctor’s surgery with varicose veins, do have symptoms, usually aching. In these circumstances medical treatment includes elastic stockings, which can help to prevent the stagnation of blood, injection of sclerosant fluids which can block the most damaged veins, and surgical removal, or stripping, of the affected veins. Healthy life styles– exercise, loss of weight, if obese – of course, help, but other treatment is usually required, particularly in those whose life style is blameless but who have a strong family history of varicose vein problems. Avoiding constipation, and straining, may be of some help and a high fibre diet is recommended. Standing or sitting in the same position for too long should be avoided and some occupations e.g. hairdressing, have a tendency to produce varicose veins for this reason.