Mr Sanjay Patel's Q&A on the Effects of Varicose Veins

Consultant and endovascular surgeon, Mr Sanjay Patel here at the UK Vein Clinic answers a Q&A focusing on varicose veins and how they can affect anyone at any age.

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1.   What are varicose veins?

“Varicose veins are normal veins that over time have become large and twisted. They may become unsightly, throb and ache, which leads to physical harm and can potentially affect mental health. But it’s the underlying problem that caused the varicose veins that can lead to evenmore harm if left untreated.

“Normal veins contain one-way valves that move blood against gravity and back to the heart. Over time these valves may malfunction, which means that blood flows up and then straight back down again, leading to increased pressure in the veins. This increased pressure,which is called venous hypertension, leads to the development of varicose veins. It can also lead to the development of a number of other skin changes including dark, itchy, red and brittle skin, as well as potential swelling - if left untreated this can lead to ulcers. Therefore, varicose veins are just the tip of the iceberg when it comes to vein health.

“The good news is that getting your veins assessed and treated in a timely manner can prevent and treat the other problems caused by the underlying venous hypertension. The first step were commend at UK Vein Clinic is to get an ultrasound.”

2. Who can be affected? In particular, how likely are women under 30 to be affected?

“Varicose veins can affect almost anyone of any age. Whilst it is true that varicose veins become more common the older you get, they can and do affect people under 30. Men and women are overall equally likely to develop varicose veins, but women within the under 30 age group are susceptible because of pregnancy.

“With pregnancy, 80% of women will normally develop varicose veins. This is related to the additional pressure placed on the circulatory system caused by the baby in the uterus. The veins may disappear after childbirth, and even if they don’t, many of the symptoms significantly improve or disappear.”

3.   What are the factors that lead to the development of varicose veins?

“Varicose veins are primarily caused by genetic weaknesses in the valves but are exacerbated by lifestyle factors. This is why varicose veins are hereditary and also why it affects both young and old.  Other factors that can be related to the development of varicose veins include:          

· Occupation particularly ones that involve standing such as nursing,hairdressers and teachers. The standing itself won’t damage the valves in the veins, but if the valves aren’t working already, then standing exacerbates the symptoms and worsens the appearance of the varicose veins

· Being overweight

·  Medication such as the birth control pill or hormone replacement therapy

·  A history of clots, called deep vein thrombosis, which can disrupt the valves and lead to venous hypertension

·  Trauma or surgery which can physically disrupt the veins”

4.   Why do we think of varicose veins as being something that affects older people primarily?

“Patients perceive varicose veins in this way fora number of reasons. Older patients are more likely to develop varicose veins because the lifestyle factors have had a greater time to influence the development of the varicosities. In addition, there has been a longer period of time for symptoms to become known and more damaged. For example, the incidence of ulcers is much higher the older you are. The message therefore is not to wait until the underlying process has done the damage, act early to prevent problems now and later in life.”

5.   How has the pandemic affected people’s veins?

 “During the pandemic people have been stuck at home, and there is good evidence that people have been less active and doing less exercise. Being active and exercising is not only good for your health,but can also improve varicose veins. This is because exercise and movement increases activity in the calves, which in turn pumps blood back up to the heart and lowers the pressure in the veins. Therefore, the pandemic has generally made the symptoms of unhealthy veins worse.

“In addition to this, varicose veins can have a significant psychological impact on patients, often causing low self-esteem, and the stress associated with the pandemic has greatly exacerbated this element of varicose veins.”

6. Is there anything people can do to prevent the development of varicose veins?

“Overall, the biggest factor in the development of varicose veins is the genetic element we inherit from our parents. From this perspective you can’t do a great deal to prevent the valves in the veins from malfunctioning. Nevertheless, staying active and exercising regularly will help reduce the impact of varicose veins on your health.”

7. And what can you do to treat them if you develop them at a younger age?

“As explained, underlying valvular dysfunction does not only lead to varicose veins but can also cause many other related health problems. Once this happens, the longer you wait to treat your veins, the worse the problems become. Therefore, my advice is simple, once you develop varicose veins, it’s best to get the veins assessed and treated as soon as possible.

“There are a range of treatments available for patients with varicose vein or related vein issues – a consultation with vascular specialist will help you to identify a treatment that is best for you. At UK Vein Clinic, we specialise in minimally invasive treatments that don’t require general anaesthetic or the use of lasers, so the treatment process is as quick and comfortable as possible with lower risks of scarring.

“Due to the hereditary nature of varicose veins, most people's experience and understanding of treatment is through their parents or grandparents. Therefore, people may have heard stories of somewhat grotesque vein stripping, with trauma of recovery and in many cases, the unhealthy veins returning.  In contrast, modern treatments have advanced significantly - they are minimally invasive, walk in, walk out procedures with minimal recovery required and excellent success rates.”

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If you think you could be at risk of developing varicose veins, why not check out our FAQ's Page for more helpful advice.