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Varicose veins

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Varicose veins

There are no precise figures about the number of people with varicose veins. Some studies suggest that 3 out of 100 people suffer from it at some point in their lives. Other studies suggest that this figure could be much higher. Most people with varicose veins do not have an underlying disease and they usually develop for no apparent reason. Varicose veins do not cause symptoms or complications in most cases, although some people find them ugly. If a treatment is advised, or for cosmetic reasons, a procedure is used that burns it down. There are several procedures: heating, laser techniques or injecting liquids into the varicose veins. These methods have largely replaced the old-fashioned surgical methods.

The normal veins in the legs

Veins are blood vessels that bring the blood back to the heart. Blood flows up through the leg veins in larger veins and toward the heart.

There are three types of leg veins:

Inside the larger veins there are one-way valves at various locations. These valves prevent the blood from flowing back in the wrong direction. When we are standing there is quite a height of blood between the heart and the legs. Gravity tends to pull the blood back down, but this is prevented by the artery valves and the normal flow of blood to the heart.

What are varicose veins?

Varicose veins are enlarged (dilated) parts of veins that are just below the surface of the skin, usually on the leg. They are often easy to see because they look thick and knobby. They can be less noticeable if you are overweight, because they are hidden by adipose tissue under the skin.

Other, smaller types of varicose veins that can become noticeable are:


What are the causes of varicose veins?

It is assumed that the wall of the vein becomes weaker in some places. These places broaden because of this and increase their presence. If this happens in the vicinity of a valve, the valve may leak and the blood may flow back. As soon as this happens on a single valve, extra pressure will be placed on the vein. This can ensure that more widening and leaking valves occur. Blood then clumps together (collects) in the enlarged vein and it can be seen on the surface of the leg.

Who develops varicose veins?

About 3 in 10 adults develop varicose veins at some point in their lives. Women are more susceptible to developing varicose veins than men. Most people with varicose veins have no underlying disease and they come for no apparent reason. However, the chance of developing varicose veins is increased by:

Sometimes an underlying disease causes varicose veins, for example:


What are the symptoms of varicose veins?

Most people with varicose veins have no symptoms. Some people are concerned about the appearance of the veins. Larger varicose veins can be painful, feel heavy or itch.

Can complications occur due to varicose veins?

Most people with varicose veins develop no complications, they only occur in a small number of cases. Complications can arise due to the higher pressure in the varicose veins, causing the small blood vessels in the nearby skin to change. If complications develop anyway, this is usually a few years after the varicose veins first appeared. However, it is impossible to predict whether complications will occur. The visible size of varicose veins is not a predictive factor or complications will occur.

Possible complications are:


Do I need a treatment or referral for varicose veins?

Most people with varicose veins do not need treatment. But you may want treatment for one of the following reasons:


Which tests for varicose veins exist?

If varicose veins are problematic, you are usually referred to a vascular doctor. It will use an ultrasound scan, such as a Doppler or a duplex scan, to see how the blood flows in the veins. It can show whether one of the valves is damaged, which is necessary to determine further treatment. Sometimes other tests are performed if the varicose veins turn out to be complex. If you have arterial disease in the legs (poor circulation, or peripheral vascular disease), or if an arterial disease is suspected, the arterial circulation must be measured. This must be done before the treatment starts, because the treatment exerts pressure on the leg, such as compression stockings. The arterial circulation is usually measured with an ultrasound machine such as a Doppler ultrasound, which is used to do a measurement called the ankle-armindex. This test can be performed in specialized clinics, as well as by some nurses and general practitioners.

What different treatments are there for varicose veins?

There are various possibilities. Traditional treatments such as vein stripping have largely been replaced by procedures with heat, laser techniques or the injection of liquids.

Self-help methods

Avoid standing or sitting for a long time. Try to get your feet up regularly (sit or lie down and lift the feet above the level of the hips.) For example, lying on the bed you can use extra cushions under the feet. This helps to reduce the clumping of blood in the varicose veins. Use a moisturizer or ointment to protect the skin if it feels dry, scaly or itchy.   It is unlikely that weight loss and physical activity will make spider veins disappear, but it can prevent them from developing at all.

Laser treatment

This method involves guiding a probe into one of the longer varicose veins by using ultrasound to guide the position. The laser or radiofrequency energy causes the vein to warm up, thereby sealing it.


Traditional surgery is recommended if treatment with heat, lasers or foam does not work. Different techniques can be used to remove the varicose veins, depending on their location and severity. A vascular surgeon will advise you on this. Usually the connecting veins (explained above) are tied off. Then the large varicose veins are removed or 'stripped' from the leg. Many people can be treated in one day. You may need to take one to three weeks of leave, depending on the work you do.


The varicose vein is injected with a chemical that can seal and seal it (sclerosing). It was once used as one of the most important treatments, but it became clear that it often causes stains and sores on the skin. It is now mainly used for small veins under the knee that have not been treated well or have come back after the operation. The vein must be compressed afterwards, so that support stockings have to be worn for several days or weeks.

Support stockings

These counteract the extra pressure in the veins. They can help to relieve symptoms such as pain. Support stockings with pressure class 1 (light) or pressure class 2 (average) are usually the most suitable. Ideally, they should be recruited immediately in the morning before you get out of bed and be pulled out again at bedtime. You can order the support stockings here at


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