Treating varicose veins
Lead vascular surgeon Mike Brooks on varicose vein treatment at the Nuffield Health Brighton Hospital
The Nuffield Health Brighton Hospital in Woodingdean offers a range of treatments for varicose veins. Mr Mike Brooks, lead vascular surgeon for the Brighton and Sussex University Hospitals Trust, consults weekly at the Nuffield Health Brighton Hospital. He says that varicose veins are common. They normally appear as bulging lumps on the calves or thighs which initially present a cosmetic problem but with time may become increasingly problematic, causing pain, itching and occasionally ankle swelling. More severe but less common symptoms include dry scaly skin around the varicosities (varicose eczema), skin pigmentation, bleeding, scarring of the skin and the underlying fat (liposclerosis), and more rarely still, break down of the skin and ulceration.
Varicose veins present more frequently in women and may be made worse by pregnancy. They seem to run in families so you may inherit the tendency to get them. Standing for long periods and being overweight may also increase your risk. Varicose veins tend to get worse with time but can appear at almost any age from teens onwards.
Veins are supposed to carry blood back to the heart. The problem in the legs (during the day anyway) is that it’s uphill all the way. The blood is pumped up the leg when the muscles in the calf and the thigh contract (when you walk or run), and there are small one way valves every few inches in the veins to prevent the blood flowing back down the leg when those muscles relax. Most of the blood gets out of the legs in large deep veins within the muscles in the calf and thigh, but a small proportion of the blood comes up through smaller superficial veins running just under the skin. There are two main superficial veins – the long saphenous vein on the inside of the calf and thigh, and the short saphenous vein on the back of the calf. It’s failure of the valves in these superficial veins that causes varicose veins. Every time you stand up, the blood rushes down the vein though the damaged valves and into the vein branches in the leg making them bulge, and that causes the pain and damages the skin resulting in the eczema, pigmentation and ulceration.
“If they become more prominent and more troublesome it may be worth discussing them with your GP”
Treating varicose veins
Many people live in peace with their varicose veins and don’t seek any treatment but if they become more prominent and more troublesome it may be worth discussing them with your GP. Treatments range from wearing support stockings, which squeeze on the veins reducing symptoms (but that’s not a cure), to injections of a chemical into the veins causing them to shrivel up (sclerotherapy), endovenous treatment which works by destroying the veins with heat using a laser or radiofrequency catheter, through to surgical removal of the veins which has the advantage of removal all the varicosities in one go but involves a general anaesthetic and sometimes considerable bruising which always disappears, but that may take a few months.
The advantage of the endovenous treatments is that they can be done under local anaesthetic as an outpatient procedure with less discomfort and less bruising. However not all varicose veins are suitable for this sort of treatment. Therefore it’s very important that everyone seeking treatment for their veins has a clinical examination and an ultrasound scan of their legs to see which is the best treatment for their varicosities. Sometimes a combination of treatments is appropriate and the options should always be discussed before embarking on treatment to ensure the best results.
At the Nuffield Health Brighton Hospital in Woodingdean, there are specialists, including Mr Brooks and his colleagues Mr Karim El Sakka and Mr Matthew Button who are only too happy to consult and help with any varicose vein issues you may have.
Nuffield Health Brighton Hospital, Warren Road, Woodingdean, 01273 936948, www.nuffieldhealth.com/brighton, www.sussexvascular.com
