Varicose veins are a common phenomenon that many people experience, especially as they age. They often start as a cosmetic concern, but they can develop into a more significant health problem. This guide provides a clear overview of what varicose veins are, what symptoms you can recognize, what the main causes are, and how varicose vein treatment is determined and carried out.
What are varicose veins?
Varicose veins are clearly visible, dilated veins that usually occur in the legs. They occur because the valves in the veins no longer close properly. Normally, these valves ensure that blood flows in one direction back to the heart. When the valves do not function properly, blood partially flows back and remains in the legs. This causes dilation and twisting in the veins that we see as varicose veins.
The valves in the veins play a crucial role in preventing this backflow of blood. If these valves become damaged, for example due to aging or increased pressure on the veins, they can no longer close properly. As a result, blood accumulates in the veins of the legs, leading to varicose veins.
This process can simply be considered a type of valve that fails, allowing blood to flow back down instead of up to the heart, thus increasing pressure in the vein.
Symptoms of varicose veins
The most noticeable symptom of varicose veins is the visible appearance of enlarged, blue or purple veins on the legs. In addition to the visible veins, many people experience a heavy and tired feeling in the legs, especially after standing or walking for long periods.
As varicose veins worsen, complaints may increase. This can manifest as pain, a nagging feeling, itching of the skin around the vein, and sometimes even nighttime cramps, which can disrupt sleep. These symptoms arise because blood circulation is disturbed and there is increased pressure on the veins.
In severe cases, skin changes can occur, such as rashes, thickening of the skin, and eventually an open sore, also known as an ulcer. This is a wound that heals poorly due to poor circulation. Once such symptoms occur, it is advisable to seek medical help.
Causes of varicose veins
Varicose veins are primarily caused by defective valves in the veins, allowing blood to flow back and accumulate in the blood vessels of the legs. This causes the veins to dilate, sometimes permanently.
In addition to this mechanical cause, various factors play a role. Heredity is often decisive: if family members have varicose veins, the likelihood of someone developing them is greater. Pregnancy can temporarily put extra pressure on the veins, which promotes varicose veins. Overweight also puts extra pressure on the legs and veins, and prolonged standing increases the risk due to its effect on blood circulation.
Sometimes varicose veins arise secondarily due to conditions such as thrombosis, where a blood clot obstructs normal flow. This can cause permanent damage to the valves and thus indirectly lead to varicose veins.
How is varicose vein treatment determined?
A good treatment always begins with an accurate diagnosis. This starts with a physical examination where the visible veins and complaints are mapped out. Often, a duplex examination is used, a type of ultrasound that assesses blood flow and the condition of the valves and veins.
Depending on the type of varicose veins, their size, severity, complaints, and location, it is decided which treatment methods are suitable. For example, small superficial varicose veins require a different approach than large deeper veins with severe complaints.
Complaints such as pain, swelling, or skin problems also play a role in the choice, so that the treatment precisely matches the patient's situation.
Common varicose vein treatments
There are various treatment methods available, ranging from simple to more invasive techniques. Elastic stockings are often the first step: they support blood circulation and reduce complaints without being invasive.
Sclerosing, also known as sclerotherapy, is a treatment in which a liquid is injected into the vein to close it and make it disappear. Laser therapy and endovenous methods offer a modern, minimally invasive option where varicose veins are treated from the inside with heat or radiofrequency.
Surgeries such as crossectomy and perforatectomy are used in severe cases where large parts of the varicose vein are seriously affected and other methods are insufficient.
For small varicose veins, there are often less invasive options available that can achieve good cosmetic and functional results.
| Treatment methods | Functioning | Application | Advantages | Disadvantages |
|---|---|---|---|---|
| Elastic stockings | Support blood circulation through compression | For mild complaints and prevention | Non-invasive, simple | Not healing, sometimes uncomfortable |
| Sclerotherapy | Sclerotherapy of varicose veins with liquid | For small to medium varicose veins | Minimally invasive, effective | Multiple sessions needed, aftercare necessary |
| Laser & RF therapy | Heating and closing the vein from the inside | Deeper and larger varicose veins | Short recovery, less pain than surgery | Specialist equipment needed |
| Surgeries | Removal or ligation of the vein | Severe varicose veins | Thorough result | Longer recovery time, pain complaints |
Elastic stockings and support stockings
Elastic stockings are specially designed stockings that apply pressure to the legs to improve blood flow in the veins. This compression reduces the backflow of blood and lowers the pressure on the blood vessels. It also helps to prevent swelling and edema.
Support stockings are often recommended during pregnancy, for people with jobs that require long standing, or in situations where blood circulation needs extra support. They provide a simple, non-invasive way to reduce complaints and prevent further worsening of varicose veins.
Sclerotherapy (injections) and foam sclerotherapy
Sclerotherapy is a treatment in which a sclerosing liquid is injected into the varicose veins. This liquid causes damage to the vein wall, leading to the vein eventually collapsing and disappearing. This stimulates blood drainage through other healthy veins.
Foam sclerotherapy is an advanced variant in which the sclerosing agent is injected in foam form. This provides a larger contact surface with the vein wall and a more effective closure, often under ultrasound guidance so that deeper veins can also be accurately treated.
This method is particularly suitable for small to medium-sized varicose veins and is increasingly used due to its minimal burden and high effectiveness. After the treatment, wearing bandages and elastic stockings is recommended to support recovery.
Endovenous treatments: laser and radiofrequency (RF)
Endovenous laser treatment and radiofrequency (RF) VenClose are minimally invasive techniques that treat varicose veins from the inside. A small puncture is made to insert a catheter into the varicose vein, after which the vein is heated from the inside with laser light or radiofrequency. This closes the vein and stops blood flow in that part of the vein.
The treatment is performed under local anesthesia and is relatively quick. Due to the minimal invasion, the recovery time is shorter and the pain is often less pronounced than with traditional surgeries.
These techniques are mainly applied to larger superficial veins that cause visible complaints or are sometimes combined with surgical treatments.
Operative treatments: crossectomy, perforating vein excision, and Muller method
In more serious varicose vein problems, surgeries may be necessary. Crossectomy involves tying off a large vein near the groin, stopping blood flow through that vein. Perforating vein surgery focuses on removing or tying off perforating veins that connect the deep and superficial veins, causing backflow.
The Muller method is a technique to remove small, superficial varicose veins through minimal incisions.
These surgeries are performed under local or general anesthesia and often require wearing elastic stockings for several weeks afterward. Sometimes surgeries are combined with endovenous treatments for optimal results.
The role of movement and prevention in varicose veins
Movement plays an important role in reducing varicose vein complaints. Staying active stimulates blood circulation, prevents blood from pooling in the legs, and helps the valves in the veins function better. Conversely, sitting or standing still for long periods increases pressure on the veins and can cause or worsen complaints.
Small adjustments such as regularly changing positions, walking, and exercises that engage the calves contribute to prevention. Compression stockings can also be used preventively, for example during pregnancy or if there are known risks due to family history.
When should you consult a doctor?
Some signals require professional assessment. This applies to increasing pain, swelling of the leg, discoloration of the skin, or the development of sores or an open leg. These are signs that the varicose veins may be causing complications.
Early diagnosis and treatment are essential to prevent more serious problems such as thrombosis or a leg ulcer. Therefore, it is wise to contact a specialist as soon as skin changes or pain worsen.
Frequently asked questions about varicose vein treatment
Can I get rid of varicose veins? Yes, with the right treatment, varicose veins can be effectively removed or reduced. However, the severity and type of varicose vein will determine which treatment yields the best results.
What does treatment cost? Costs vary by treatment method, clinic, and any insurance. A consultation with a ZKN certified specialist can provide clarity on the options and any potential reimbursement.
Are varicose veins dangerous? Usually, varicose veins are harmless, but they can cause discomfort and in some cases lead to complications. Therefore, it is wise to take complaints seriously and consult a doctor if in doubt.
For personal advice and treatment, patients are best advised to contact a specialized phlebologist or vascular specialist.