You Ask , They Answer
Q
: What are varicose veins and their telltale signs ?
A
: They are enlarged veins that are typically visible just beneath the skin ’ s surface in the legs . Size determines their type . Telangiectasia ( spider veins ) are small , thin , red or blue veins resembling spider webs , whereas varicose veins are larger , twisted , and protruding .
Patients with varicose veins may experience aching , heaviness , or discomfort in the legs . An itchy or burning sensation may be present , as well as muscle cramps or restless legs at night .
In more severe cases , the patient may develop eczema and thickening of the skin on the ankle , which may progress to skin ulceration .
Q
: Should people with varicose veins always see a doctor ?
A
: Not all cases require treatment . If you do not have significant discomfort or symptoms , you may not have to see a doctor or receive treatment . Spider veins are mostly a cosmetic concern , not a severe medical condition .
However , if you experience aching , tired legs , swelling , itching , or night cramps , especially if these symptoms become frequent or severe , you should consult a doctor . In some cases , if the veins become inflamed and painful , developing redness , tenderness , and warmth around the affected area , you should seek medical attention as soon as possible .
Patients with large varicose veins , which are bulging , twisted , and ropey and protrude under the skin , should see a doctor . These can progress over time , becoming increasingly painful and unsightly . Left untreated , they may cause skin eczema , ulcers , or bleeding , requiring more extensive and invasive treatment later on . It is crucial to monitor and treat any symptoms or complications that may arise .
Q
: What are the treatment options ?
A
: Treatment depends on the size and type of veins . For smaller spider veins , injection sclerotherapy may be the best option , which involves injecting a small amount of a specialised medicine directly into the affected veins to destroy their inner lining , causing them to collapse and be reabsorbed by the body . It ’ s relatively quick and comfortable , taking only around 10-20 minutes per session . Patients may require several sessions spaced several weeks apart , and the treated veins will gradually fade over time .
For larger varicose veins , endovenous closure techniques are an excellent option as it ’ s minimally-invasive , meaning no surgical incision , general anesthesia , or hospitalisation . It involves introducing a fine wire into the affected vein through a small puncture in the skin . The wire is then used to cauterise the vein with either laser or radiofrequency . Alternatively , physicians may use medical glue to seal the vein by introducing a small catheter directly into it .
Effective , quick , and hassle-free , these treatments allow most patients to return to daily activities the same day or one day later . Although risks and side effects are minimal , patients may experience some mild swelling , bruising , or redness around the treated area .
Q
: Can people prevent varicose veins ?
A
: While not always be possible , simple lifestyle changes and preventative measures can potentially delay their onset .
• Regular exercise will strengthen veins and improve circulation , especially leg-focused exercises , such as walking and running .
• Observe your weight . Obesity can exert significant pressure on the legs and is known to result in spider veins .
• Avoid crossing your legs while seated .
• Raise your legs while sleeping or resting .
• Avoid sitting or standing for extended periods . When you must sit for an extended period , get up and take a periodic walk .
• Wear elastic support stockings whenever possible .
• Avoid restrictive clothing and heels .
• Consume a balanced diet rich in fibre and limit your sodium intake .
Dr John Tan
Dr John Tan is a vascular surgeon expert in the treatment of varicose veins and the director of The Vein Clinic & Surgery in Singapore .
8 ISSUE 2 | 2023 GlobalHealthAsiaPacific . com