Overview of Varicose Veins

Varicose veins, also known as varicose or varicosities are enlarged, dilated veins that are filled with blood. Varicose veins generally affect legs and feet. There is another variation of varicose veins, known as spider veins. The varicose veins appear swollen or bulged out with a bluish-purple or red color.

The prevalence of varicose veins globally is estimated to be around 5%-30% among adults. Unfortunately, there is no data that can state the prevalence percentage in India.

In addition to a network of veins on the surface of the skin, there is a venous network deep inside the leg muscles. You might develop varicose veins in these also. These deep varicose veins are not visible to the eyes but can cause swelling or aching throughout the legs. In severe cases, blood clots may also develop.  

Facts on Varicose Veins 

• Age can make the condition of varicose veins worse. But young people who have to sit or stand for long hours without any break can also get varicose veins. 

• Varicose veins can develop due to genetic factors.

• Varicose veins are not only a cosmetic issue. On the contrary, most people feel heaviness, cramping, swelling, dryness, itchiness which are symptoms of skin discoloration, ulcers, bleeding, etc.  

Causes of Varicose Veins

Blood circulates throughout the body via a network of blood vessels. This network is known as the vascular system. This system consists of arteries and veins that carry blood throughout the body, providing oxygen and nutrients to the tissues and collecting waste matter. 

But carrying the blood from the legs and various parts of the body to the heart against gravity is an uphill task. Veins rely on a network of cup-like valves that push the blood towards the heart. When blood flows through the vein, these valves open to allow blood through in one direction and closes to prevent backflow.

In people with varicose veins, these valves do not function properly. This leads to the pooling of blood in the vein rather than flowing of blood towards the heart. This blood pooling increases pressure inside the veins.  This makes the veins enlarged and twisted. 

There is no scientific evidence that clearly states the reasons behind the valves to stretch/weaken. However, there are several potential risk factors that can increase the chances of getting varicose veins. Some of them are discussed below-

• Menopause

• Pregnancy

• People who are above 50 years 

• People who have to stand for long periods 

• Obesity

• A family history of varicose veins 

There are some factors that can worsen the condition of already developed varicose veins. These are explained below-

• Pregnancy is one of the major factors that can aggravate varicose veins. During pregnancy, the baby inside the uterus keeps on growing and the vein walls relax due to changes in estrogen and progesterone levels. Due to both of these reasons, there is added pressure on the veins in the legs. This gives rise to either the development of varicose veins or the worsening of an already developed one. 

• People who stand for long hours also put extra pressure on the veins in the legs.

• Straining for prolonged periods due to chronic constipation, urinary retention results in increased forces transmitted to the leg veins and leads to varicose veins. 

• Any prior trauma/injury to the leg can also restrict to the normal blood flow. 

Signs and Symptoms of Varicose Veins

Some common symptoms of varicose veins are discussed below-

• Dark purple or blue blood vessels that are visible on the thigh and calf

• Veins that look twisted, swollen, and lumpy 

• The legs ache or feel heavy, especially after exercising or at night

• A minor injury to the affected area can lead to bleeding

• Swelling of the ankles

Conditions that require immediate doctor consultation-

• Dermatitis-

  The symptoms of this condition are flakiness of 

• the skin, skin discoloration, and ulcers..

• Phlebitis-

  The symptoms include redness, warmth, and tenderness of varicose veins. This can be due to blood clots in the veins. 

• Atrophie Blanche-

  The symptom include whitish patches that look like scars 

Types of Varicose Veins

The types of varicose veins are listed below-

• Trunk varicose veins- These veins are near the surface of the skin which appears thick and knobbly. These are unpleasant to the eye. 

• Reticular varicose veins- These are red in colour and often are grouped together in a network. 

• Telangiectasia varicose veins- These are known as spider veins that can form on the face or legs. These are small clusters of blue or red veins that are usually harmless and do not bulge like other varicose veins.

Diagnosis of Varicose Veins

The diagnosis of varicose veins generally starts with a physical examination. After having a glimpse at the affected area, the doctor confirms if those are  varicose veins. To confirm the initial diagnosis, the following tests are recommended-

• Doppler test-

  This test measures the amount of blood flowing through the arteries and veins with the help of high-frequency sound waves. 

• Color duplex ultrasound scan-

  This combines the traditional ultrasound and the doppler test to measure the speed and other aspects of blood flow.

Treatment of Varicose Veins

Ayurveda for Varicose Veins

According to Ayurveda, there are herbs that can help in curing varicose veins. The herbs are:

• Amalaki

• Arjuna

• Ashwagandha

• Brahmi

• Guduchi

• Guggul 

• Shatavari

• Brahmi

• Garlic

• Ginger

• Onion

For temporary relief, there are some Ayurvedic oils for local applications. Some of them are-

• Prasarini taila

• Chandanabala taila 

• Mahanarayan oil

• Brahmi oil

• Carrot seed essential oil

• Sahacharadi oil 

Surgery for Varicose Veins

• Vein ligation and stripping- This procedure involves cuts and incisions hence, it is performed under the influence of anesthesia. The doctor makes cuts into the skin and then the varicose veins. Through this incision, the varicose veins are removed. With the emergence of minimally invasive surgical options, vein ligation and stripping have become less common.

• Radiofrequency ablation- The treatment option uses heat to destroy the vein. The whole procedure takes only 30 minutes to complete and performed under the influence of local anesthesia. Although, the results are short-termed.

• Laser surgery- This has emerged as the most-effective treatment option for curing varicose veins. Performed under the influence of anesthesia, this is a 30 min procedure. In this procedure, the doctor passes a small laser with the help of an ultrasound machine. The laser fires beam which blocks the varicose vein. This day-care treatment option offers faster recovery and incurs minimal pain. This surgical option ensures a minimum risk of complications also.

• Sclerotherapy- In this procedure, the doctors inject a solution into the affected veins that causes it to scar. This redirects the blood to flow through healthier veins. The blocked veins are reabsorbed. When this is done to block smaller veins, the process is called a microsclerotherapy. 

Home remedies for Varicose Veins

Diet for Varicose Veins

Sodium-rich or salty food leads to water retention. So, cut down on the daily consumption of salty food. Instead of those, incorporate food which are rich in potassium such as-

• Almonds

• Pistachio nuts

• Lentils and white beans

• Potatoes

• Leafy vegetables 

• Fish such as salmon and tuna 

Excessive straining due to chronic constipation can worsen the damaged valves. To prevent constipation, eat food that are high in fiber so that there are smoother bowel movements and prevent constipation. High fiber food are-

• Nuts, seeds, and legumes

• Oats, wheat, and flaxseed

• Food prepared by whole grain

Flavonoid-rich food are recommended by doctors to improve blood circulation throughout the body. This type of food also reduces blood pressure in the arteries and relaxes them. Some of them are-

• Vegetables such as onions, bell peppers, spinach and broccoli

• Citrus fruits as well as grapes, cherries, apples, and blueberries

• Cocoa

• Garlic 

Exercises for Varicose Veins

It is recommended to indulge in any type of physical activity for 30 minutes on a daily basis. Some of the exercises for curing varicose veins are-

• Walking

• Bicycling

• Leg lifts

• Lunges 

• Rocking the feet

• Elevating the legs 

Complications of Varicose Veins 

Although on rare occasions, the complications of varicose veins may be any one of the following-

• Ulcers- It starts as a discolored spot on the skin which can further complicate into an ulcer. These ulcers can develop near the ankles which can be painful.

• Blood clots- There can be formation of blood clots in the affected veins when it is left untreated. The blood clots are more likely to develop in deep veins within the legs. This results in a persistent leg pain or swelling. 

• Bleeding- Any injury to the affected varicose veins can cause bleeding. In severe cases, the skin may burst. This requires immediate medical attention.

Prevention of Varicose Veins

A healthy diet and lifestyle are important to prevent the occurrence of varicose veins. Some of the healthy tips you can follow are mentioned below-

• Eat a balanced diet which includes low fat and carbohydrates. This should also include fresh fruits and vegetables.

• Make sure you take a daily dose of vitamin C as this strengthens the blood vessel walls.

• Consume a high-fiber diet to lower the risk of constipation.

• Avoid sugary, fried, junk foods as much as possible. Make sure you also limit the consumption of tobacco, salt, alcohol, processed and refined food.

• Exercises such as walking, swimming and bicycling on a daily basis in order to maintain a healthy weight.

• When you are diagnosed with varicose veins, do not wear tight clothes.

• Avoid standing/sitting for long periods of time to ensure smoother blood flow.

• Do not lift heavyweight or put any unnecessary pressure on the legs.