From Prevention Methods to Treatment: 25 Questions about Varicose Veins!
Varicose veins are a nightmare especially for us women! The veins popping out of the legs not only create an extremely uncomfortable appearance, but also reduce our quality of life with the pain they cause. It is actually not difficult to get rid of varicose veins, which can cause serious health problems when treatment is late!
Varicose veins is a disease whose history is equivalent to the history of humanity. It can be recognized even in sculptures dating back to 400 BC. Varicose veins refer to superficial veins that are elongated, curved, and enlarged. This disease, which is mostly seen in the legs due to gravity, occurs in approximately 25 out of every hundred people in the world, in other words, in one out of every 4 people. Although there is no clear figure on the frequency of varicose veins in our country due to the lack of a healthy statistical study, it is estimated that 10 million people suffer from this disease to varying degrees. However, it is possible to get rid of varicose veins in a short time, which can cause serious health problems when treatment is delayed. She answered the most curious questions about varicose veins, which is a common problem especially for women.
How Varicose Veins Occur?
Varicose veins occur when the veins that collect dirty blood from the body and carry it to the heart cannot perform their duties sufficiently. Inside these veins are valves that allow the blood to flow in one direction towards the heart. (How many veins are there? Where are the heart valves located in these veins?) Several factors may damage the valves, leading to leakage. When the veins are unable to function properly due to problems with the valves, blood pools in the veins in the legs. When the increase in pressure inside the veins as a result of the accumulation of blood becomes chronic, the veins lose their elasticity, expand and become visible from the outside.
What Kind of Symptoms Does It Give?
Varicose veins are manifested by visible prominence and tortuosity in the veins, swelling in the legs, pain that increases later in the day, a feeling of heaviness, fullness and cramps, itching, burning in the soles of the feet and edema in advanced periods, skin discoloration and wounds.
Which Health Problems Does It Cause?
Varicose veins are generally seen only as an aesthetic problem. However, it is a disease that can cause serious health problems if treatment is delayed. Varicose veins can cause wounds that are difficult to heal when measures are not taken in the early period, and more importantly, although rare, it can cause blood clots in the veins. As a result, even a fatal picture can develop. Therefore, it is essential to prevent the formation of varicose veins and to have it treated early if the problem has started.
Who Is at Risk for Varicose Veins?
Those who have a family history of varicose veins, overweight people, those who are constantly exposed to gravity because they work in a fixed position, those who use drugs containing estrogen hormone, those who have a difficult or frequent pregnancy period, those who often wear heels higher than 5 centimeters in their daily life, those who work in professions in the risk group (such as teachers, bankers, hostesses, hostesses, hairdressers, sales staff, clerks, health personnel) and those who have congenital partial or complete absence of intravascular valves are at risk for varicose veins.
Why Is It More Common in Women?
The most important reason for this is hormonal factors. The female hormone estrogen causes dilation in the veins. In addition, pregnancies and long-term use of birth control medications also cause varicose veins to be more common in women. After delivery, most of the varicose veins formed during pregnancy regress within 1 year as the amount of blood decreases, the obstacle in front of the flow disappears and the hormonal balance is restored. However, a second pregnancy during this period causes varicose veins to reappear again and permanently. Therefore, it is beneficial for women to take a 2-year break between pregnancies.
What Are the Behaviors to Avoid?
It’s important to avoid weight gain, maintain an active lifestyle, refrain from smoking, and limit alcohol intake. Bathing with very hot water may enlarge veins due to heat, slow blood flow, and increase blood volume in the vascular system. As a result of these effects, varicose veins progress faster. Therefore, it is beneficial to stay away from hot places such as saunas and spas, sun and hot sand. Since it makes blood flow difficult, too tight clothes should not be worn, belts should not be tightened too tightly and care should be taken that pantyhose should not squeeze the waist. Again, office workers or housewives should avoid sitting with crossed legs. Otherwise, varicose veins, which are frequently seen behind the knees especially in women, occur.
Is There a Relationship Between Varicose Veins and Nutrition?
Varicose veins or vein insufficiency is also related to nutrition. For vein health, animal fats should be avoided or their consumption should be reduced. Fruits and vegetables should be consumed at least 5 times a day, and at least 2 liters of water or unsweetened tea (preferably green tea) should be drunk daily. Rice, pasta, muesli, alcohol and coffee should also be limited.
Which Methods Are Used for Diagnosis?
Only visual examination can be incomplete. For this reason, it is absolutely necessary to use the 'color doppler ultrasonography' technique for accurate diagnosis. With Doppler ultrasonography, it is checked whether there is an increase in the diameter of the vessels and whether there is a loss of function of the existing valves. If this is the case, it can be determined whether the loss of function is mild, moderate or severe. In addition, it can be determined whether there is a problem that prevents blood flow, such as congenital lack of intravascular valves or underdevelopment of some vessels. Depending on these, the degree of venous insufficiency is graded. Depending on the results of the Doppler ultrasonography examination, the type of treatment is decided.
When Are Varicose Veins Socks on the Agenda?
Compression stockings are divided into 3 types: knee-high, knee-high, knee-high, panty; and pressure type: low, medium and high pressure. In positions directly exposed to gravity during the day, it prevents the veins from expanding too much in diameter and accumulating dirty blood in them. In this way, it prevents complaints such as pain, swelling and fullness that occur in varicose veins. Compression stockings should be used as a preventive method by those who have visible varicose veins on their legs, who have been diagnosed with dysfunction in the deep or superficial main vein systems by ultrasonography, and who are at risk, especially those who work all day standing. When used correctly and regularly, compression stockings are an effective and useful method. During the period when stockings are used, the progression of existing varicose veins stops and complaints are significantly reduced. However, stockings do not have the effect of eliminating varicose veins and when the use of stockings is stopped, complaints and varicose veins reappear.
Can Stockings Be Taken Indiscriminately?
Compression stockings should be purchased from people or businesses that have been trained on the recommendation of a doctor and the correct selection of socks, taking into account a number of factors such as the patient's existing varicose veins, ultrasonography results. Otherwise, when the socks are given in a small size according to the patient's leg size, they squeeze and cannot be worn, and when they are given large, they are loose and cannot create the desired effect.
How Often Should Socks Be Changed?
Since studies have shown that even the best quality compression stockings do not reflect the desired pressure ratios from the 3rd month onwards and lose pressure in the 6th month, it is recommended to renew the regularly used socks every 6 months.
What Are the Treatment Methods for Varicose Veins?
Not all varicose veins are the same. For example, in some patients, the problem is limited to capillaries, while in others, the veins can protrude in the shape of fingers. Therefore, the type of treatment is determined according to the stage of varicose veins and the complaints it causes to the patient and the effect on the quality of life. The treatment can be applied only to the superficial vein on the skin, to the deeper main systems or to both. Radiofrequency, laser, sclerotherapy and, if necessary, surgery are used in the treatment.
What Are the Treatments Performed Externally Through the Skin?
It can be performed by using radiofrequency waves and laser beams or by “sclerotherapy”, which is known as injecting a drug into the varicose veins to dry them out.
In Which Cases Are Laser Beams and Radio Waves Effective?
It is beneficial for blue and red colored capillaries with a diameter of less than 1 millimeter. With laser, existing capillary varicose veins are burned with the help of laser beams. In the radiofrequency method, a radio wave is given to the varicose vein with the help of a needle thinner than 1 millimeter and again a kind of burning process is applied. Depending on the prevalence of the problem, 3-4 sessions are usually sufficient for this treatment. The sessions last around 30-45 minutes on average and although they vary according to the skin structures of the people, an average of 60-80 percent success is achieved. Patients who undergo laser treatment should not go out in the sun for 6-8 weeks to avoid skin discoloration in these areas. The radiofrequency method does not require such a restriction.
How Is Sclerotherapy Applied?
If the diameter of the vein is 1-2 millimeters or thicker, the sclerotherapy method is used. This method is based on the principle of blocking the vein by administering medication to the problematic vein with very thin needles. Although the duration of the treatment varies from person to person, it usually consists of 3-4 sessions, each lasting 30 minutes. After the procedure, a compression pressure is created with an elastic bandage or compression stockings applied to the medicated area for 10 days. After the procedure, the person can continue his/her daily life. In the 'foamy' sclerotherapy method, which has become increasingly popular in our country in recent years, the drugs to be injected into the vein are used after a process to form foam. The superiority of the method over the classical method is that more effect can be achieved with less medication and the side effects are much less.
Do Treatments Applied on the Skin Offer a Permanent Solution?
Although the success rates after sclerotherapy are high, one of the main things to be considered is to identify the cause of varicose veins and to know whether this cause can be eliminated before starting such skin-based treatments. Because superficial treatments applied without any research or treatment for the cause of varicose veins seem to be successful at first. However, due to the continuation of the existing causes, the veins that are intact during the treatment period are deformed in a short period of time and the patient may have similar varicose veins after a short period of 6 months to 1 year after the procedures. Therefore, it is very important to have an examination and some treatments for the cause, if any, before these treatments.
When Are Surgical Treatments Necessary?
When there are disorders in the superficial main vein system and their branches, which are located a few centimeters below the skin that form superficial varicose veins, they constitute treatment methods that are absolutely necessary to be added to superficial treatments. Surgical treatment can be performed in several ways, sometimes separately, most of the time they need to be applied as a combination of several of them.
In Which Situations Is Stripping Operation Performed?
In the congenital anatomical structure of human beings, there are superficial main vein systems called long and short “saphenous vein” running between the ankle and groin and between the ankle and knee socket. These veins are the veins that are removed to be used as bypass material in both coronary bypass surgery in the heart and bypass surgery in the treatment of diseases characterized by arterial occlusion in the legs, and are known as reserve veins among the people.
This superficial main system is responsible for 40 percent of the evacuation of dirty blood in the legs, while the deep main vein system, which runs deeper, is responsible for 60 percent. All surgical interventions and operations applied in varicose veins can be applied to this superficial main system and its branches extending to the skin. As a result of the expansion and loss of function of these main systems due to various reasons, these main veins turn into structures that accumulate dirty blood in them instead of moving the dirty blood to the body, which is their main task, and they need to be deactivated in some way. (I ask you to reduce the section I marked in red by at least half... How do these veins look from the outside?)
Until 10-15 years ago, small incisions were made in the groin and ankle, and the vein was removed by pulling the vein from bottom to top or top to bottom with wire or plastic catheters passed through the vein. This method was called “Stripping operation” and was applied all over the world. After the technological developments in recent years, the frequency of this operation has gradually decreased, but it still needs to be performed in some patients. The patient stays in the hospital for 1 night after the operation and may need to wait 10 days to return to work.
How Are Mini Phlebectomies Performed? (How Are They Performed?)
Nowadays, this surgical operation is performed by removing varicose veins through very small 1-2 mm holes in such a way that there is no scar that will cause cosmetic problems afterwards. This operation can be performed under local anesthesia alone or in combination with other surgical interventions.
What Does Perforating Vein Ligation Provide?
The superficial and deep vein systems run parallel to each other along the entire leg and in the groin area the superficial system connects to the deep system. They transmit the dirty blood they collect to the deep system and then continue as a single vascular system from the groin to the trunk. In addition to the main connection point in the groin area, there are more than 10 smaller connection points between the ankle and groin, through which the superficial system transfers the dirty blood to the deep system. When the valves in these connecting vessels malfunction, the flow turns in the opposite direction and an intense blood flow starts from the deep system to the superficial system. Therefore, the load of the superficial system increases and varicose veins form. (I ask you to reduce the part I marked in red by at least half. How do these varicose veins look from the outside?)
Once this abnormality is detected, what needs to be done is to disable these connection points whose structures are disrupted. These vessels, whose locations are marked with ultrasound guidance, can be located and connected under the skin through 1-centimeter incisions in the skin under local anesthesia and this abnormal flow can be eliminated. The procedure can be performed on an outpatient basis with local anesthesia without the need for hospitalization, or it can be combined with other operations and can be performed with 100 percent success. Patients can go to work the next day.
What Are Endovenous Surgical Interventions (EVRA, EVLA)?
As a result of technological advances, stripping operations, which have been performed only surgically for decades, are now performed using Radiofrequency and Laser technologies with much less side effects and very high success. In the past, short and long saphenous veins were pulled and removed. Nowadays, a needle and catheter system applied to the skin is inserted into the diseased saphenous veins without any incision. The veins are then burned using radiofrequency waves and laser beams with the help of sections at the end of the catheters, which are advanced to the groin area.
What Are the Advantages of This Method?
If this method is performed by trained people, it can be applied with nearly 100 percent success and very few side effects. Side effects such as infection, bleeding and bruising are almost never encountered in surgery. Another group that benefits the most from this method is overweight, potbellied patients. This method, which is applied without any incision, is the ideal treatment type for patients who are likely to experience serious problems such as infection or wound healing after the wound remains between the groin and belly layers and sweating. After the procedure, patients are discharged the next day and can return to work immediately.
Can Varicose Veins Treatment Be Performed in All Seasons?
Since most of the varicose vein treatments require the use of elastic bandages or compression stockings for a while after the treatments, and since it is necessary not to go out in the sun for 6-8 weeks after laser applications, it is recommended to perform the procedures in the cooler periods of the year, in the spring, fall and winter.
Will Varicose Veins Recur After Treatment?
Due to the fact that there are many factors that cause varicose veins and that there are parts that cannot be eliminated such as genetics, gender and type of work, other veins may be deformed and varicose veins may occur. In reducing this effect, the role of gaining protective habits such as moving a lot during the day, paying attention to nutrition, doing regular sports, avoiding lifting heavy things and using compression stockings is very important.
* Contents of this page is for informational purposes only. Please consult your doctor for diagnosis and treatment. The content of this page does not include information on medicinal health care at Liv Hospital .
