Varicose veins are some of the most common blood circulation problems doctors encounter in Kenya. Most of us walk around without thinking much about the veins on our legs. However, when varicose veins develop, they can cause significant physical and emotional distress.
A little anatomy
There are two major types of blood vessels – arteries and veins. Arteries carry blood away from the heart to the rest of the body.
Veins carry blood from the different parts of the body towards the heart. Veins in the legs carry blood in an upward direction towards the heart. To prevent blood from flowing backwards (that is, back into the foot), the veins have little gates known as valves.
Think of the veins in your leg as a highway in which cars can only travel in one direction. To ensure that the cars do not change direction, the highway has motion sensor activated gates which can only open if a car hood is detected.
This is exactly how veins work. Once the blood reaches the valves (gates), they open and allow the blood through preventing it from stagnating or flowing backwards.
What exactly are varicose veins?
Varicose veins are dilated veins that can occur on the legs and genitals (externally) or internally on organs like the food pipe or stomach.
In the leg, they appear as big, winding blood vessels (like a river) which can be easily seen and felt.
They usually occur when the valves in the veins in the legs do not work properly and, therefore, blood does not move efficiently to the heart.
Do varicose veins cause symptoms?
Usually, they are not a major cause of health complications but they can cause significant cosmetic concern. In fact, most people visit the doctor because the varicose veins are preventing them from wearing shorts/skirts and other clothing items that expose their legs.
When symptoms occur, they include:
Leg swelling – especially towards the end of the day.
An achy or heavy feeling in your legs (sometimes even muscle cramps).
Leg pain after sitting or standing for a long time
Itching around the varicose veins.
Varicose veins are usually very near the skin surface and are very delicate, therefore, they can bleed easily if you are hit or if you scratch them too enthusiastically.
The vein can become painful and hard (needs immediate medical attention as this is normally associated with a clot in the vein).
The skin around the ankles can become dark and in some cases, ulcers may develop (must be reviewed by a doctor as there are usually other issues contributing to this complication).
What to do
To reduce the symptoms caused by varicose veins, a few things can be done.
Lifestyle changes: Exercising, losing weight, elevating your legs (when seated and even when sleeping) and avoiding long periods of standing can all improve the symptoms of the varicose veins.
Compression stockings: Wearing compression stockings all day is often the first approach to managing varicose veins.
They continuously squeeze your legs, helping veins and leg muscles to move blood more efficiently.
But these are only effective if worn regularly (daily). They can reliably avoid the need for surgery in the majority of patients and are helpful in preventing skin complications.
Who gets varicose veins?
Anyone can get varicose veins but they are more common among certain population groups:
Women: This is thought to be related to female hormones. Pregnancy is associated with an increased risk of varicose veins.
Taking hormone replacement therapy or birth control pills may also increase your risk of varicose veins.
Elderly: As we age, our veins become ‘weaker’ and the wear and tear of the valves causes them to ‘leak’ resulting in varicose veins.
Family history: Just like with most health problems, if other family members had varicose veins, there’s a greater chance that you will too.
Prolonged standing: You are at an increased risk of getting varicose veins if your job involves standing for long periods of time. Your blood doesn’t flow well if you’re in the same position for long periods.
Obesity: Overweight people have a greater risk of getting varicose veins than their ‘normal’ weight counterparts.
Prior surgery or injury to the leg: This can disrupt the normal blood flow channels and result in dilated veins.
Vein blockage: Sometimes, the blood flow from the veins in the leg can be blocked by a problem inside the belly (e.g. a tumour, abnormal veins in the belly etc.)
If you don’t respond to compression stockings, you may be a candidate for one of the following procedures:
Injection therapy (Sclerotherapy): In this procedure, your doctor injects the varicose veins with a solution that scars and closes the veins.
Laser therapy: In this case, special beams of light are used to fade away small varicose veins. No incisions or needles are used.
Heat therapy: Here, the doctor uses ultra sound to insert a special tube into the vein. The tip of the tube is heated and the heat is used to destroy the inside of the vein causing it to collapse and seal shut.
Surgery (vein stripping): In this case, the doctor ties off the offending vein and removes it. Scarring is generally minimal.
Treat any vein blockage: If you have any blockage to your venous circulation, doing the above procedures will not help. You must manage the cause of the blockage in order to treat the varicose veins (for example, if you have a tumour, it must be removed in order for the varicose veins to ‘shrink’).
Pregnancy: Varicose veins that develop during pregnancy generally improve without medical treatment within 3 to 12 months after delivery. For this reason, avoid doing any of the above procedures during pregnancy.
All the treatment options for varicose veins are currently available in Kenya.