Varicose veins: More than a cosmetic problem

According to epidemiological studies, more than 80 percent of adults suffer from small varicose veins called spider veins. Up to 30 percent show large varicose veins, also known as truncal varicosis. The first damage can occur as early as 20 years of age, and the frequency of the disease increases with advancing age. The superficial venous system, which runs in the fatty tissue under the skin, is particularly affected. This is because the strength of the muscles that surround the deep vein system as a so-called muscle pump is lacking here.

Far-reaching consequences

If the superficial veins can no longer do their job, the deep veins must take over the transport of blood back to the heart. This extra work also threatens to cause irreparable damage to their valve system sooner or later due to overload. However, a valve disorder in the deep venous system can no longer be treated surgically. Instead, chronic venous insufficiency (CVI) develops with correspondingly serious and permanent consequences. Typical symptoms of CVI are pain after standing for a long time, heavy and tired or restless legs, itching, calf cramps at night or a feeling of pressure and tension.

The path to edema

The increase in volume in the deep veins leads to an increase in pressure in the vascular system, which in turn affects the skin in the lower leg area. As the disease progresses, it often becomes darker, develops pigment deposits, more vein markings and appears firmer overall. This is referred to as dermatoliposclerosis. Individual areas may later become more sensitive, resulting in edema, stasis dermatitis and ulcers. Medicine refers to this as “open leg” (ulcus cruris). At the same time, the risk of thrombosis increases, especially if the patient does not move, for example on long-distance flights.

Better sooner than later

The current guidelines of the German Phlebological Society recommend minimally invasive measures to treat varicose veins as early as possible. If symptoms appear on the leg, one should not wait for complaints. Many venous diseases can be detected just by looking at and feeling them. The gold standard in diagnostics today is ultrasound. In Doppler sonography – or even more comprehensively in modern color-coded duplex sonography – flow obstructions such as thrombosis as well as flow reversal and valve leakage can be precisely localized and assessed.

Learn more:
Spider veins: Diagnosis and treatment