What are Varicose Veins?

The simple definition of varicose veins s that are bulging veins seen on the legs. They can appear blue of green if near to the surface - or just skin coloured bulges if they are deeper and have more skin covering them.

Most importantly, they get bigger on standing as they fill up with blood, and disappear or get much smaller on lying down with the feet above the level of the heart - as the blood drains out of them.

However this simple definition comes from times before we understood what varicose veins actually are and what cause them.

Nowadays research performed mainly using the new Duplex Ultrasound machines has helped us understand the underlying problems that cause the varicose veins which are then seen on the surface.

However we have also found that the same underlying problem can also cause other things instead of varicose veins -

• tired or tender legs
  
• swollen ankles
  
• red itchy skin (venous eczema)
  
• discoloured red or brown skin around the ankles (lipdermatosclerosis or haemosiderin)
  
• leg ulcers
  
• hard, tender lumps where the veins used to be (phlebitis)
  

Therefore the terminology has become a bit confused. As not many of the public know what is meant by 'thrombophlebitis' or Lipodermatosclerosis, doctors and nurses often tell them they just have varicose veins - even when the veins cannot be seen.

Although this might not be strictly correct, it does explain to the patient:

• That the underlying cause of their problem is the same problem that causes varicose veins
• It is curable using the same techniques that we use to identify and cure varicose veins

This last point has become very important. Up until we understood varicose veins as well as we do now, doctors and nurses used to tell patients with leg ulcers that they weren't curable, they used to treat phlebitis with antibiotics and venous eczema with steroid creams. Unfortunately many still do!!

However by understanding the underlying problem we can now cure most people suffering with these conditions using the new techniques of treating varicose veins.