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Varicose veins are enlarged, twisted or swollen veins, that usually appear on the legs or feet, just beneath the surface of the skin and are commonly caused due to defect in the valves within the veins that allow blood to flow in the wrong direction, often appearing in blue or dark purple. Varicose veins can occur in any part of the body but most commonly affect the legs. Legs are generally affected by varicose veins because of the pressure that is exerted on the legs due to prolonged sitting and standing hours or due to obesity. Every year, more than 23 percent of adults are estimated to be affected by varicose veins.
Varicose veins is a medical condition that takes place when veins in any particular part of the body are under increased pressure and blood is pushed back towards the heart. The increased pressure and force in blood flow results in the damage or weakening of the valves that lie within the veins, causing the blood to pool and even flow backwards which leads the veins to bulge out and become visible through the skin.
Test
Self-diagnosis
If you are suffering from a condition of varicose veins, the bulging veins will generally appear to be visible at the calf of the leg, but they can also show up on the thigh, knee, foot, or ankle, when you stand up and place your leg in a particular position for one or two minutes. You will possibly feel pain and heaviness in your legs, followed by burning, itching, throbbing, muscle cramp and swelling in your lower legs. You will also experience severe pain after sitting and standing for a long time.
Diagnosis by doctor
If you consult a vascular surgeon for a diagnosis of your condition, the doctor will first carry out a physical examination and check for swelling in your legs while standing and ask you to describe the discomfort or pain you are experiencing. Once the doctor is done diagnosing your condition physically, they might ask you to go for an ultrasound test in order to look for the evidence of a possible blood clot.
Grade I: (Spider veins)- In this stage, small, thin damaged veins appear on the surface of the skin, usually in the legs and face. Usually, they do not cause any harm and are painless.
Grade II: (Reticular veins)- In this stage, blue or purple-colored veins start appearing below the skin on the inner thighs, back of the knees, or around the ankle. Usually, these veins do not protrude, although they can cause pain and discomfort.
Grade III: (Venous nodes or varicose veins)- This is the stage, in the veins appear in dark blue or purple color as the superficial veins become enlarged or twisted causing the veins to protrude above the surface of the skin, leading to symptoms like pain, burning, itching, swelling, and spasms.
Grade IV: (Chronic venous insufficiency)- At this stage, black spots start appearing near the ankle due to ineffective functioning of the blood vessels or valves located in the leg veins, making it difficult for blood to flow up to the heart, causing the blood to pool or be collected in the veins.
Grade V: (Trophic ulcers or varicose eczema)- This is the stage where the skin starts decomposing and can lead to a non-healing ulcer. If proper treatment is not received on time, the entire skin is damaged, resulting in longer duration of treatment as well as recovery.
During the surgery
If left untreated
If a condition of varicose veins is left untreated, it can lead to several complications such as:
Although there are no proven ways to prevent the formation of varicose veins, there are a number of measures that one can take up in order to prevent an existing condition of varicose veins from worsening which includes avoiding prolonged sitting or standing, exercising regularly, maintaining a healthy lifestyle by having a proper diet that is rich in fibre, losing weight, not wearing tight-fitted clothes or high heels for a long period of time, wearing compression stockings, and keeping the legs elevated.
Celebrities diagnosed with varicose veins
Varicose veins might not be a medical emergency and most of the cases go untreated until it leads to complications like blood clots or thrombophlebitis, bleeding around the skin and non-healing ulcers around the ankle that cause decomposition of the skin. It is important to seek medical assistance if you notice signs like sores or ulcers, bleeding, feeling of pain and heat around the veins, and swelling, as it can cause deep vein thrombosis (DVT) and can also lead to potentially life-threatening conditions like pulmonary embolism.
Non-surgical
Sclerotherapy: This non-surgical procedure involves the injecting of a solution directly into the veins. This medical procedure helps in eliminating varicose and spider veins by making them collapse and forcing the blood to reroute to flow in healthier veins. Once the veins are destroyed, they disappear over time. This process is typically used in treating spider veins and helps in improving the appearance of the skin that is affected. Whereas, in case of larger veins, a procedure called foam sclerotherapy is used, where the sclerosant solution is turned into a foam before injecting it into the veins as foam can cover a larger surface area, compared to liquid.
Radio frequency Ablation: Radio frequency ablation (RFA), also known as fulguration, is a medical procedure that involves heating a part of the pain-transmitting nerve with a radiofrequency needle to create a heat lesion. This resulting lesion prevents the nerve from sending pain signals to the brain. Generally, a patient can go home on the same day after undergoing this procedure.
Surgical
Endovenous laser therapy ablation: Also known as endovenous laser treatment or EVLA, this is a minimally invasive ultrasound-guided procedure that involves the use of ultrasound images and laser fibre in order to kill the delicate lining of the veins. After a few days following the procedure, the body absorbs the dead tissues, closing off the abnormal veins with minimal or no discomfort. This is one of the most commonly preferred methods as it involves far fewer complications and the recovery time as well as success rate of this method is much faster and higher than that of any surgical process.
Vein ligation and stripping: This is a surgical procedure that is done in order to remove a damaged vein and prevent future complications like ulcers, clotting, etc. in the affected vein. During the surgery, two to three incisions, each ranging around 5 cm in diameter are made over the damaged veins and the veins are tied off or ligated. Normally, the recovery time in this procedure is longer than that of the minimally invasive techniques. This method is usually preferred in treating people who are suffering from trophic ulcers or varicose eczema as it is in this stage that skin starts decomposing and develops into a non-healing ulcer.
Transilluminated powered phlebectomy: This is a vein removal procedure that makes use of a bright light, which is known as an endoscopic transilluminator to illuminate the vein. During the process, a number of incisions will be made on your leg and the surgeon will place the transilluminator underneath your skin so they are able to see the veins that need to be removed. As soon as the veins are identified, they will be cut and will be removed through the incisions using a suction device.
Surgery preparation
Before the surgery, the doctor will carry out a physical examination in order to determine the location of the nonworking valves.
You might be required to go through certain tests like an ultrasound test and a duplex/doppler test so that the surgeon can determine the amount of blood flow, and have a detailed assessment of the varicose veins.
Before the procedure, it is important to discuss any prescription or over-the-counter medications that you are taking as it would eliminate the risks and possibilities of any complications.
If there is a possibility of having any allergic reaction to the anesthesia, you should inform your doctor before going for the surgery.
Like any other surgical procedure, you will be required to refrain from consuming any food or liquids as your body might react to the anesthesia, which can lead to choking out stomach contents during the surgery.
It is advisable to avoid taking certain medications like aspirin, blood thinners and other nonsteroidal anti-inflammatory drugs in order to rule out the possibility of any complications.
You should take a shower before the surgery as the doctor would ask you to keep the surgical area dry in order to eliminate the risk of any infections after the surgery.
What to expect during the surgery?
Based on your doctor’s recommendation and depending upon your condition, you will be put under the influence of either general anesthesia or spinal/local anesthesia.
If you receive general anesthesia, you will be asleep during the surgical procedure, while, in case of spinal anesthesia, the lower part of your body will be numb and you will stay awake during the procedure.
If you are put under the influence of a spinal anesthetic, the doctor might give you anti-anxiety medicines in order to make sure that you don’t feel anxious or nervous during the surgical process.
During the surgery, the doctor will make several cuts, or incisions around the top and bottom of the damaged vein. One of the incisions will be near your groin and the other will be in your lower leg, either in your calf or ankle.
The surgeon will then insert a flexible, thin plastic wire into the vein through the incision made around the groin and then, the wire will be tied to the damaged vein and pulled out through the incision in the lower leg.
Once the damaged vein is removed, the doctor will close the cuts or incisions with stitches and place bandages and compression stocking around the surgical area.
After the surgery
After the surgical procedure is completed, you will be put under observation until the reaction of the anesthesia wears off.
Once you are fully awake, you will be shifted to the ward, where the surgeons will monitor your health conditions.
You might experience some sort of stinging or burning in your leg as soon as you are awake. However, there will be no pain or discomfort and you will be able to consume food and other liquids within a few hours.
During the first few days after the surgery, there might be some bleeding and it is best to keep the surgical area covered with bandages or compression stocking for the first few days.
Depending upon your overall health conditions, you will be prepared for a discharge from the hospital.
You will be advised to keep the surgical area dry and clean for a few days post the surgery in order to prevent the possibility of any infections around the wound.
There is a possibility that you might experience some bleeding and it is best to keep the surgical area covered with bandages or compression stocking for the first few days.
Cost of a varicose vein treatment in India with Pristyn Care
The cost of a Varicose Veins treatment in India with Pristyn Care may range anywhere between Rs 50,000 to Rs 70,000. However, this cost varies from person to person depending on multiple factors such as:
Severity of the condition
Cost of medications
Amount to be paid for diagnostic tests and lab tests
Type and location of the hospital chosen to undergo the the treatment
Consultation fee of the doctor
The treatment of varicose veins and certain other vascular problems can be covered under a health insurance policy at Pristyn Care in India. You can get in touch with our medical coordinators to gather more information and related queries for getting your varicose veins treated in the most efficient and cost-effective way.
The process of recovery depends upon the severity of the condition and method of treatment. It usually takes two to four weeks to recover from a varicose vein surgery. During the initial days of the surgery, the doctor will advise you to stay off of your feet and it is important for you to keep your legs elevated while you are in a sitting or sleeping position as much as possible. You should avoid heavy lifting and refrain from performing any strenuous activities during the initial few weeks after the surgery.
The doctor will ask you to walk and pump your ankles as much as possible as it will help in keeping the blood flow intact in your legs during the process of recovery. The surgeon will prescribe certain medications, in order to help you manage any sort of pain or discomfort. With the introduction of advanced minimally-invasive procedures, the recovery as well as success rate of certain vascular diseases like varicose veins has been reduced to a greater extent over the due course of time.
About 23% of all adults have varicose veins and the condition is more common in women than men.
Drinking water and staying hydrated can help in improving the strength of the muscles that support the veins.
Exercises like walking, cycling, biking, swimming and running help in building the calf muscles, which help in proper blood circulation in the legs.
Massage can provide temporary relief from the pain and discomfort. However, intense pressure from a massage can end up worsening the condition because the exerted pressure can cause the already weakened veins to burst and increases the risk of pulmonary embolism.
Yes, laser treatment for varicose veins is 100% safe, efficient, and effective. People belonging to any age group can undergo the procedure. However, in severe cases of varicose veins, where the person has developed ulcers, caused by skin decomposition, laser treatment is not applicable and surgery is the only option.
Foods such as oats, apples, flaxseed, carrots, berries, and barley, that are rich in fibre, are good for fighting against varicose veins and help in keeping veins healthy.
Foods that contain high amounts of salt, sugar and carbohydrates must be avoided if a person is suffering from a condition of varicose veins.
No, spider veins do not cause varicose veins and there is no connection between both the conditions. Spider veins do not protrude as significantly as varicose veins and are barely painful.
Compression stockings can help in relieving the symptoms of varicose veins as these garments stimulate blood flow in them, reducing inflammation and preventing blood from accumulating. However, it is best to consult a doctor to find out the type of stocking that is right for you.
Creams, lotions and other products can help in the healing process after the surgery. Although creams cannot help in treating varicose veins, they can give temporary relief by minimizing the inflammation, and swelling.