Sievering Clinic

Competence Centre for Minimally Invasive Medical Services

Varicose Veins

What are the symptoms?

The symptoms of varicose veins don’t necessarily match their size, and sometimes there are no symptoms at all apart from the veins being unsightly. Most people will not have symptoms but may be concerned about the appearance of the veins.

If symptoms occur, they may include:
  • Swollen legs
  • Muscle cramps, soreness or aching in the legs
  • Tiredness, burning, throbbing, tingling or heaviness in the legs
  • Soreness behind the knee
  • Itching around the vein
  • Brown discoloration of the skin, especially around the ankles

Symptoms often worsen after prolonged standing or sitting. In women, symptoms may be worse during menstruation or pregnancy. Occasionally varicose veins can form a painful blood clot, referred to as superficial phlebitis (inflammation of a vein).

Chronic non-healing leg ulcers, bleeding from varicose veins, and recurrent phlebitis are serious problems that are caused by venous insufficiency and can be relieved by the correction of venous insufficiency.

More severe symptoms are usually associated with the complications of varicose veins. In some cases, varicose veins can be harmful to your health because they may be associated with the development of:

Chronic venous insufficiency

The poor flow of blood in the veins can interfere with the way the skin exchanges oxygen, nutrients and waste products with the blood. When this happens over a long period of time, venous insufficiency can cause a number of problems including the following:

Varicose eczema brown or purple discolouration of the skin that can become permanent
Venous stasis ulcers ulcers (open sores) that result when the enlarged vein does not provide enough drainage of fluid from the skin. As a result, an ulcer may form.
Fungal and bacterial infections may occur as the result of skin problems caused by fluid retention (oedema) in the leg. These infections also increase the risk of tissue infection (cellulitis).
Phlebitis veins close to the surface of the skin can become painful and reddened due to inflammation or blockage of the vein. This is different to the more dangerous blockage of the deeper veins, known as deep vein thrombosis (DVT).
Thrombosis blood clots that form in the dilated vein
Bleeding varicose veins near to the surface can bleed if the leg is cut or bumped. This bleeding might become a medical emergency if it can’t be stopped. If a varicose vein in your leg is bleeding, you need to lie down, raise your leg and apply pressure directly to the bleeding area. Then seek medical help.
Skin changes The first sign of venous insufficiency is the formation of oedema and bothersome skin alteration.

Complications are more common when varicose veins are the result of a problem or disease in the deep veins or in the perforating veins, which connect the deep and superficial veins. These underlying conditions may include deep vein thrombosis or chronic venous insufficiency. Having varicose veins does not mean that you will definitely get complications or chronic venous insufficiency. And although they won’t usually get better without treatment, varicose veins only get worse slowly.

Contributing factors

Multiple factors can cause the development of varicose veins:
Age
the development of varicose and/or “spider” veins can occur at any age, however, they most commonly begin between the ages of 18 and 35 years, and peaks between 50 and 60 years.
Heredity
there is a significant relationship between heredity and the development of varicose and “spider” veins. If your mother or father has varicose or “spider” veins, there is a greater chance that you will develop these abnormal veins.
Gender
approximately four females are affected to every one male.
Pregnancy
Approximately 8 to 20% of pregnant women will develop varicose veins, however, some may disappear shortly after delivery. Both hormonal changes during pregnancy and compression of veins by the enlarged uterus can contribute to varicose or “spider” veins.
Lifestyle or occupation
People who are involved in prolonged periods of sitting or standing are at increased risk for developing varicose veins. Blood tends to collect in the veins putting pressure on the valves, thus causing the vein to distend.