Varicose veins, the bulging and often twisted veins on the legs of many people, may be seen as a cosmetic concern by some. Yet varicose veins can sometimes signal more significant issues beneath the surface. This article sets out when to worry about varicose veins, and when it is time to take action.
What varicose veins are, and why they form
Varicose veins are enlarged, twisted veins that often appear swollen and raised on the surface of the skin, commonly in the legs. These veins develop when the one-way valves within the veins, responsible for regulating blood flow back to the heart, weaken or fail. As a result, blood pools in the veins, causing them to swell and become visibly pronounced.
Varicose veins can appear as large, thick cords on the thighs, calves, and feet. They are noticeable to the touch as they bulge under the skin, and may be purple, green or blue in colour with significant knots.
When to worry about varicose veins that bleed, harden or become painful
The appearance of varicose veins does not commonly indicate a serious issue.
However, when coupled with other symptoms, they can sometimes indicate a more concerning issue.
Pain
Though varicose veins can sometimes cause pain, persistent or unbearable pain may result from inflammation or blood clots within the veins.
A vein that turns hard, red and tender
A varicose vein that becomes hard, red and tender to touch may hold a blood clot, known as superficial vein thrombosis. It needs a doctor's assessment and a scan, because the clot can sometimes extend into a deep vein.
Bleeding
A varicose vein can bleed after even a small knock, and this often happens during a warm shower. Raise the leg and press firmly on the bleeding spot.
If the bleeding is heavy, or does not stop with firm pressure, call 995 or go to the nearest A&E now.
Skin changes and sores around varicose veins at the ankle
Itching
Varicose veins may cause poor blood circulation, which can bring persistent itching in the affected areas.
Discolouration
Similarly, skin changes such as discolouration, often around the ankle, can result from poor blood circulation and chronic venous insufficiency.
Thickening
If the skin around varicose veins begins to thicken, it may be a sign of tissue changes and chronic inflammation.
Ulcers
Advanced complications can lead to ulcers, open sores that most often form near the ankle. Venous ulcers can form, especially in the lower leg, due to increased pressure in the affected veins and poor circulation.
These ulcers can be painful and, when combined with poor circulation, take a long time to heal, which increases the risk of infection. A wound near the ankle that has not healed within two weeks needs a doctor's check. Ulcers require medical attention to prevent further issues.
Infections
Skin changes like dry skin due to varicose veins may lead to small wounds through which bacteria can enter and cause infections. Infections can then lead to cellulitis, skin abscesses, and systemic infections, increasing the risk of sepsis.
Varicose veins with sudden leg swelling, a sign to act on the same day
Significant swelling in the affected areas or the legs, ankles and feet may indicate a more advanced stage of venous insufficiency.
But if your whole leg swells suddenly, or your calf becomes severely painful, see a doctor the same day.
These can be signs of deep vein thrombosis (DVT), a serious condition in which blood clots form in the deep veins. These clots can travel through the veins to the lungs, and may be life-threatening.
If you also become short of breath or have chest pain, call 995 or go to the nearest A&E now.
Varicose veins are considered only a minor risk factor for DVT, and most people with varicose veins never develop one.
When to worry about varicose veins, and when to see a vascular surgeon
Even with no other symptoms, some people with varicose veins choose treatment because of how the veins look.
However, if you experience persistent pain, cramping, or itching, especially if these symptoms worsen, seeing a vascular surgeon is advisable. Skin changes like dryness, discolouration, or thickening may indicate underlying issues, warranting evaluation by a professional.
Bleeding and ulcers, the most concerning symptoms, require immediate attention to prevent infection and address potential deeper issues. Early detection and proper treatment are key to reducing the risk of complications associated with varicose veins.