First there is pain and swelling – that’s what we get used to and somehow live with it. We ignore the tiny spider veins on the skin of our legs. Only strongly marked and highlighted skin changes become our nuisance. Varicose veins – the aesthetic nightmare of women.
Every year in the spring, the subject of varicose veins returns like a boomerang. Also in magazines. The cause is not hard to guess. After months of hiding your legs under thick tights or pants, it’s time to uncover them. And that’s when we remember a problem that, nome omen, we also remembered the previous year, but we did nothing or little about it. Let’s explain at the beginning – it will get worse each year. The changes that are already visible will not go back, on the contrary – they will deepen. In the case of varicose veins, the problem is twofold – both aesthetic and health. The first one, not the most important, is extremely offensive to us women. Cracked vessels on the calves and lower legs, or, even worse, purple curved protrusions are not necessarily what we want to show. The second problem is much more important and carries with it a serious danger in the long run. Because pain, swelling, and a feeling of heaviness – if ignored – can lead to serious complications.
Also read: From vein to varicose veins
The sin of neglect
Flebolologists, doctors involved in the diagnosis and treatment of veins, see many more patients in the spring. Mrs. Anna (45) is one of those women who were mainly prompted by aesthetic problems. – It all started in my second pregnancy. It was then that I saw a web of visible spiders – red, purple. I ignored it. From year to year there were more of them, a strongly marked vein appeared on the right leg, which more and more often bulged under the skin. It pulsed unpleasantly. It’s standard now. The “protruding”, sinuous veins below the knees encompassed the other leg as well. Even though I know I have neglected my legs, I want to do something about it. Better later than never, right? – he ends questioningly. Spider veins are the first symptom of venous insufficiency. A signal that the blood in the legs is not circulating properly. Lack of action and classic mistakes mean that sooner or later varicose veins will appear on the legs. How to avoid it? Prophylaxis: avoiding a sedentary lifestyle, giving up tight pants and socks as well as narrow and high-heeled (more than 5 cm) shoes, not putting your feet on the leg (all this hinders blood flow) and avoiding high temperatures – hot baths, saunas, solariums (they expand veins). The formation of varicose veins is significantly influenced by weight (and thus also pregnancy), taking medications (e.g. estrogens), and smoking (nicotine affects the narrowing and calcification of the veins). And genes too. Unfortunately, the tendency to varicose veins is hereditary. – I should have taken action sooner. My mother also has varicose veins. Although she underwent surgery, more appeared. It was the same with Grandma, says Anna.
What do legs want?
Regardless of the disease, remember – prevention is better than cure. Better, easier and cheaper. If Ms Anna had taken preventive measures at the right time, she would probably have avoided, at least partially, the problems with varicose veins, and would certainly have slowed down their appearance. Briefly – there is no single cause of varicose veins. With age, the walls of the veins lose their elasticity and thicken. Additionally, venous valves may be damaged. They control the blood flow so that it flows upwards towards the heart. If they do not work properly, the blood flows back to the limb and accumulates there, creating an irreversible change. Before it happens, however – without any visible symptoms – the legs “send” signals that things are not going well. Pain, swelling, throbbing, cramps, a feeling of “heaviness” after a whole day …
And here again, a set of recommendations repeated like a mantra: during the day, to avoid blood stagnation in the legs, move them at every opportunity – while sitting at the desk, tighten the calf muscles, take a walk, use the stairs – pump blood. However, when leg fatigue and swelling appear, give them rest – raise them, preferably above the line of the heart. Then the blood will drain by itself, without straining the muscles. By sleeping in this way, we will prepare our legs for the effort that awaits them the next day.
– It is true that the legs enjoy either being active or relaxing. Movement facilitates the outflow of blood from the limbs, reducing its retention, while the high position promotes the gravitational displacement of blood. The worst thing we can do for them is staying in a sitting or standing position for a long time – emphasizes the vascular surgery specialist from the Medicover Medical Center, Dr. n. med. Maciej Kielar. What else? Use cool showers, and if there are no such possibilities – cooling creams and deodorants (the latter even work through tights). At this stage, it makes sense to apply ointments and creams or swallow tablets containing, among others, horse chestnut extract, routine. They strengthen the walls of blood vessels, which actually delays the formation of varicose veins. Unfortunately, when these appear, the creams will no longer help. – The actual usefulness of topical agents is low. Rather, they are used to prevent or reduce the symptoms of venous insufficiency, but do not treat existing pathologies. Visible varicose veins require medical intervention – admits Dr. n. med. Maciej Kielar. Let’s also use compression therapy – it is a treatment with pressure, thanks to which the correct blood pressure in the legs is maintained. Special tights and stockings support the calf muscles and facilitate the drainage of blood from the legs. Yes, they are not cheap, and their selection requires individual consultation with a doctor, but such an investment really pays off.
Also read: Varicose veins – a problem not only cosmetic
Eliminate the problem
The first visit to a phlebologist is primarily a diagnosis of the venous system. – The doctor interviewed me, asked about ailments and diseases in my family. Later, he examined my legs closely and did a Doppler examination – remembers Anna. Doppler ultrasound is one of the basic tests to assess blood flow through the veins and arteries (i.e. valve function) and the overall health of blood vessels. Indicates damage and allows you to choose a treatment method. Additionally, some vascular surgeons perform photoplethysmography to determine the strength of the leg muscles.
– The doctor left no illusions. Nothing but surgery will change the look of my legs. He offered me to undergo sclerotherapy, which I used without hesitation – says Anna. Sclerotherapy consists in precise administration of drugs that cause fibrosis to the site of damaged veins, and then exclusion of the damaged vessel from the venous system. Selected places are punctured with a very thin needle. The procedure is short and painless. The leg doesn’t look good at first. Immediately after the procedure, a pressure dressing (stockings or a special bandage) is put on, which should be worn, depending on the recommendations, for 5-14 days. During the first weeks, there are bumps under the skin that hurt when touched. Bruising is inevitable, but the changes are self-limiting. If small spider veins were removed, it takes about 2 weeks for full recovery, while removing wider vessels, this time is longer. It is unlikely to end with one treatment. To achieve a satisfactory effect, 3-4 will be needed (at the earliest two-week intervals).
The second method, which can also complement the first one, is the use of a laser which, thanks to the emitted light with specific parameters, closes the dilated blood vessels. Here, it will not end during one visit, because it is not possible to close all the vessels during one treatment. Remember, however, that removal of spider veins only gives aesthetic results, it does not eliminate diseases of the venous system in any way. The procedure is safe and usually leaves no visible changes on the legs. If they do occur, they should disappear in the next few weeks. Which method is worth using? – Usually, the method chosen is the one with the lowest risk for the patient and the most useful in a given case. Each of the methods has its own indications and the possibility of side effects. Typically, transdermal procedures, such as radiofrequency (RF) or laser ablation, are used first. In case of their ineffectiveness, you can opt for sclerotherapy. We should remember, however, that the treatment plan is established after a clinical evaluation preceded by a Doppler USG examination of the venous system – says Dr. n. med. Maciej Kielar. Unfortunately, each of these treatments will burden our pocket. The National Health Fund does not refund sclerotherapy or laser therapy.
Read also: Legs without varicose veins