Varicose veins are more than a cosmetic concern

Chronic varicose veins can cause problems ranging from solely cosmetic to discomfort and more severe problems such as blood clots. — TNS

Many women notice bulging, twisted veins on their legs and assume they are merely a cosmetic issue – unsightly, but harmless.

However, these varicose veins are much more than that.

They can cause pain, discomfort, and if left untreated, lead to serious health problems.

As vascular surgeons, we often see many cases where women ignore their symptoms for a significant period of time, believing it’s just part of ageing or something they just have to live with.

However, the truth is, varicose veins can significantly impact your health.

The good news?

They can be treated effectively with modern, minimally-invasive techniques.

Weak walls and faulty valves

Simply put, varicose veins are enlarged, dilated and twisted veins in the legs caused by weak vein walls and faulty valves.

These valves are meant to keep blood flowing upward to the heart, but when they fail, blood pools in the veins, causing them to swell and bulge.

In individuals prone to varicose veins, the vein walls weaken, the venous valves loosen and blood starts leaking downward toward the feet.

This process, known as venous reflux, is responsible for the symptoms of varicose veins, and ultimately, its long-term complications.

Women are 2.5 times more likely than men to develop varicose veins, and the condition often worsens during pregnancy.

This is likely due to the effects of female hormones – i.e. oestrogen and progesterone – on vein walls.

Additionally, jobs or activities that require prolonged standing may exacerbate symptoms.

Several factors increase the risk of developing varicose veins, including:

• Family history of varicose veins
• Advancing age
• Lack of exercise
• Obesity.

One common question I get from patients is how varicose veins differ from spider veins.

Spider veins are tiny, dilated venules (small branches of veins) that appear prominent because they lie just beneath the skin.

Unlike varicose veins, they are harmless.

However, if you notice bulky, twisted veins in your legs, it’s important to consult a vascular surgeon.

A useful guideline: If the enlarged veins protrude from the skin’s surface and appear twisted, they are varicose veins.

Spider veins, on the other hand, do not protrude.

They do not require treatment unless you are concerned about their appearance.

If varicose veins cause leg swelling, discomfort or skin changes, you should see a vascular surgeon immediately.

Hidden health risks

Many people assume varicose veins are purely a cosmetic concern, but in reality, they can lead to significant health issues.

When blood doesn’t flow properly, pressure builds up in the veins, leading to a condition called chronic venous hypertension.

This can cause swelling, aching, and eventually, skin damage.

Over time, the skin around the ankles may become discoloured and hardened.

In more severe cases, varicose veins can lead to leg ulcers, i.e. open wounds that heal poorly and are prone to infection.

Another serious concern is blood clots.

Poor circulation in varicose veins increases the risk of clot formation, leading to superficial thrombophlebitis, which causes pain and inflammation.

There is also a small risk that these clots could extend into the deep venous system, resulting in deep vein thrombosis (DVT), or in rare cases, break off and travel to the lungs causing a life- threatening pulmonary embolism (PE).

Certain warning signs should not be ignored; if you should experience any of the below, do see a doctor as soon as possible:

• Persistent leg swelling, itching or skin darkening around the ankles – these indicate that your veins are under stress and may be causing long-term damage.
• A leg ulcer or wound that doesn’t heal within two weeks – instead of relying on repeated dressings and antibiotics, seek help from a vascular surgeon.
• Varicose veins that suddenly become hard, red and painful – this could indicate a blood clot and requires immediate treatment.

Current treatment methods for varicose veins usually have a fast recovery time. — dpa

Less invasive treatments

The good news is that treatment for varicose veins has advanced tremendously.

Gone are the days of painful open vein-stripping surgery with long recovery times.

Today, minimally-invasive treatments offer excellent results with little downtime.

Common treatments include:

> Endothermal ablation techniques

Radiofrequency ablation (RFA) and endovenous laser ablation (EVLA) use heat energy to seal off affected veins, preventing blood from pooling.

Studies show a 93-94% success rate after the first treatment, and virtually all patients can go home the same day.

> Foam sclerotherapy

A special chemical foam is injected into the vein, causing it to collapse.

There is a higher recurrence rate with foam treatment of large varicose veins.

However, it is effective for smaller branches.

> Medical-grade glue closure

This newer technique seals veins shut, but is more expensive and has less long-term research supporting it.

One of the best things about modern treatments is the fast recovery time.

Most patients are encouraged to walk immediately after the procedure, as movement helps prevent blood clots.

There is a small risk of pain and numbness.

Mild bruising or discomfort is common, but usually resolves with simple pain relief and anti-inflammatory ointments.

However, varicose veins can recur over time.

Even after successful treatment, about 30% of patients will develop new varicose veins within ten years, as the body naturally tries to recanalise (reopen) the veins.

Tips for prevention

While some risk factors, like age and family history, cannot be changed, there are steps you can take to support your vein health:

• Maintain a healthy weight

  Excess weight increases pressure on your veins.

• Stay active

  Walking, swimming and cycling help keep blood flowing properly.

• Avoid prolonged standing

  If your job requires standing for long periods, take breaks to sit and elevate your legs.

• Wear compression stockings

  These provide external support to improve circulation.

• Follow a balanced diet

  Eat plenty of fresh fruits, vegetables and lean proteins while avoiding ultra-processed foods high in sugar and salt, which contribute to obesity and poor circulation.

For women, especially those who are pregnant or have a family history of varicose veins, being proactive about vein health is key.

Small lifestyle changes, like taking the stairs instead of the elevator or walking more throughout the day, can make a big difference in preventing vein problems.

At the end of the day, varicose veins are not something you should ignore.

They can have a real impact on your quality of life, from aching legs and discomfort to serious complications like ulcers and blood clots.

But the good news is, you don’t have to just live with them.

Safe, effective treatments are available.

If you’re struggling with symptoms, seek medical help and take control of your vein health.

Whether through prevention or medical intervention, addressing varicose veins early can keep your legs healthy and pain-free for years to come.

Dr Yow Kuan Heng is a consultant vascular and endovascular surgeon. For more information, email [e-mail]. The information provided is for educational and communication purposes only, and should not be considered as medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this article. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.