Varicose Veins

The varicose vein is a disease in which the veins of the person get twisted and enlarged. This condition is also known as varicose or varicosities. Generally, the appearance of the varicose veins are swollen and raised and may also appear slightly bluish or red in color. Any veins that are close to the surface of the skin can be varicose. The veins of the legs (mostly lower leg) are most likely to get affected by the varicose veins. It is because movements like standing and walking create more pressure in the veins of the lower body. It is a very common medical condition, especially among women. Almost 25 percent of all adults have varicose veins.

1. Highly visible veins (usually on lower legs)
2. Feeling of pain and swelling around the varicose veins
3. Feeling of heaviness in lower legs
4. Veins become dark, purple, or blue
5. Veins may appear twisted and bulging
6. Cord like the appearance of the veins
7. Experiencing muscle cramps around the varicose veins
8. The pain may get worse after standing and sitting for a long time.
9. The skin color alters around the varicose veins.
10. Aching legs
11. The ankle may be swollen.
12. Nighttime leg cramps
13. Itching around the vein or veins
14. Venous ulcers or sores

1. The valves inside the veins are one way. It facilitates the one-way flow of blood through the veins. But, if the wall of the veins becomes flexible and elastic, it may allow the backflow of the blood. It will eventually lead to the accumulation of blood inside the veins. It causes the enlarged and swollen appearance of the veins over the skin.
2. Any conditions that increase the pressure on the abdominal region can cause varicose veins. Some of them are:-
   1. Pregnancy
   2. Menopause
   3. Standing for a long time
   4. Being overweight
   5. Having a family history of varicose veins

Certain risk factors are seen to increase the risk of development of varicose veins are:-

1. Obesity: Being overweight increases the risk of varicose veins because it increases the pressure on the veins of the legs.
2. Genetic: If there is a family history of varicose veins, it is more likely to transfer to the next generations.
3. Gender: Both men and women can get affected by the varicose vein. But, it is more likely to affect women than men. It may be because the female hormone relaxes the veins. 
4. Age: The risk of varicose veins increases with age because of the wear and tear in the veins.
5. Menopause: It may increase the risk of varicose veins due to reduced levels of hormones.
6. Other factors: Other factors that increase the risk of varicose veins include smoking, pregnancy, and taking hormone therapy or oral contraceptives.

1. At first, the doctor will do a Physical examination to determine the presence of the varicose veins. In the physical examination, the doctor will mainly visually inspect the varicose vein.
2. For visual inspection, the patient is asked to stand, and then the doctor will check for the presence of the swelling in the legs.
3. The doctor may also order a test known as venous doppler ultrasound of the legs to confirm the cause of the varicose veins. 
4. The venous doppler ultrasound is a non-invasive test procedure that detects the flow of blood through the valves of the veins. It is done by using soundwaves. 
5. A venogram may also be performed depending upon the location of the varicose vein. It is done for further assessment of the veins. In this test, the X-ray is taken after injecting a dye into the legs of the patient. 

1. Lifestyle changes:-
   1. Avoid standing for a long time
   2. Do regular exercise to improve your circulation
   3. Use compression socks
2. Medical interventions:
   1. Sclerotherapy: In this approach, the doctor will inject either a solution or a foam into the varicose vein. It will then block the veins, and after a few weeks, the varicose veins start to fade away. 
   2. Laser treatment: A strong burst of light is sent to the varicose vein in laser treatment. This light makes the vein fade away and disappear after some time.
   3. High ligation and vein stripping: This procedure includes tying the veins before it meets the deep vein. Then it is removed by making a small cut on the skin. Removing the superficial veins does not affect the blood flow in the legs.
   4. Endovenous ablation therapy: Ablation of the varicose veins is safe, less complicated than surgery, and without leaving any scars. In this procedure, the doctor reduces varicose veins through the heat from a laser. Varicose veins is shrunk and scar tissue is formed within the vessel. This results in the sealing of the varicose veins. 
   5. Ambulatory phlebectomy: It is an outpatient procedure. During this procedure, the superficial veins are removed by the surgeon by making slit-like, small incisions in the skin. 
3. Compression stocking:- It is the very first approach to be tried to treat the varicose vein. We must wear compression stockings all day. It will squeeze the leg and help the vein and the muscles of the leg to move blood more effectively. The compression stocking can be purchased from almost all the pharmacies.

There are six stages of the chronic varicose vein. They are:-

Stage 1: The spider vein is the first stage of the varicose vein. In this stage, the veins are small and may appear reddish-purple.

Stage 2: Enlarged, ropy varicose veins are the second stage. It is when the person first becomes aware that they have vein disease. 

Stage 3: There is swelling in the veins at this stage, but there is no pain in the veins. At this stage, the ankle may also become swollen. 

Stage 4: At this stage, swelling and discolouration of the skin start. 

Stage 5: There may be a colour change at the site where ulcers are to be formed.

Stage 6: At this stage, the ulcers are formed, and the colour of the skin changes.