Phlebology (varicose veins)

Some risk factors can contribute to the development of varicose veins and spider veins.

These factors can be divided into two categories: genetic factors and lifestyle-related factors.

Genetic factors:

• Family history: If close family members (parents, brothers, sisters) have a history of varicose veins, you may have a higher risk of developing the condition.

Lifestyle-related factors:

• Age: The risk of developing varicose veins increases with age. Venous valves can weaken over time, affecting blood circulation.
• Gender: Women tend to be more susceptible to developing varicose veins than men. Hormonal changes associated with pregnancy, oral contraceptive use, and menopause may contribute to this.
• Pregnancy: Increased pressure on the veins during pregnancy, due to the enlargement of the uterus, can raise the risk of varicose veins. Pregnancy-related hormones can also affect the function of venous valves.
• Obesity or overweight: Excess weight can put additional pressure on the leg veins, increasing the risk of varicose veins.
• Sedentary lifestyle: A sedentary lifestyle can lead to poor blood circulation, increasing the risk of varicose veins. Regular physical activity is beneficial for vein health.
• Prolonged standing or sitting: People who stand or sit for long periods without significant movement may develop circulation problems.
• Smoking: Smoking can impair vascular health, contributing to venous problems.
• Exposure to heat: Prolonged exposure to high temperatures, such as frequent hot baths or saunas, can dilate blood vessels and increase the risk of varicose veins.

Not treating a varicose vein over time can lead to several complications and health risks. Here are some of the potential long-term risks associated with untreated varicose veins:

• Worsening of symptoms: Symptoms such as pain, cramps, heaviness, and swelling in the legs can intensify over time. Untreated varicose veins may cause inflammation in the surrounding tissues, increasing discomfort and pain.
• Skin changes: Untreated varicose veins can lead to skin changes, including itching, darkening of the skin (hyperpigmentation), and potentially skin ulcers.
• Superficial vein thrombosis: Untreated varicose veins increase the risk of developing superficial vein thrombosis, where blood clots form in the superficial venous system.
• Bleeding: Variceal bleeding is bleeding caused by the rupture of an untreated varicose vein. Although relatively rare, this bleeding can be serious and requires immediate medical attention.
• Unsightly appearance: Untreated varicose veins can affect the appearance of the legs, causing visible, swollen, and bulging veins on the skin’s surface.
• Impact on quality of life: Persistent symptoms and complications from untreated varicose veins can reduce quality of life by limiting mobility and overall well-being.

It is important to note that each person responds differently to varicose veins, and risks vary depending on factors such as genetics, age, sex, and lifestyle.

Spider veins are small dilated veins visible on the skin surface, often appearing as fine red or blue lines.

Spider veins:

They often result from the dilation of very small veins with a diameter less than 1 mm. While they can be unsightly, spider veins are generally not painful.

Varicose veins:

Varicose veins, on the other hand, are larger, swollen veins. They can be felt under the skin and are often associated with a feeling of heaviness, pain, or fatigue in the legs. Varicose veins are the result of chronic venous disease, where the vein valves do not function properly and do not efficiently return blood to the heart.

This leads to blood pooling in the affected veins, causing vessel dilation. Varicose veins require more thorough medical attention and can be treated through various methods, ranging from sclerotherapy to surgery.

Here are some symptoms commonly associated with varicose veins:

• Enlarged and bulging veins:
  • Enlarged veins, especially those that are bulging or swollen, are a characteristic visual sign of varicose veins. They may appear bluish or purple beneath the skin.
• Pain and heaviness:
  • Pain, a feeling of heaviness, or discomfort in the legs are frequent symptoms linked to varicose veins, especially after long periods of standing or sitting.
• Muscle cramps or restless legs syndrome:
  • Muscle cramps, particularly at night, or restless legs syndrome may be associated with varicose veins.
• Itching:
  • Some individuals may experience itching around areas affected by varicose veins.
• Burning or warmth sensation:
  • A burning or warming sensation in the legs can occur, especially after prolonged standing.
• Swelling of ankles and feet:
  • Swelling of the ankles and feet, called edema, can be a symptom associated with varicose veins.
• Skin changes:
  • Skin changes such as redness or ulcers may develop in more advanced cases.
• Leg fatigue:
  • Fatigue in the legs may be felt, especially after prolonged activity or standing.

Conservative measures:

• Compression stockings: Wearing elastic stockings to reduce pressure in the veins and improve blood circulation.
• Leg elevation: Raising the legs to heart level to promote venous return.

• Visual sclerotherapy: Injection of a sclerosing solution into spider veins, causing them to close and gradually disappear.

• Ultrasound-guided sclerotherapy: Injection of a sclerosing agent (in liquid or foam form) directly into varicose veins under ultrasound guidance, allowing for more precise targeting of the treatment.

• Endovenous treatment: Laser or radiofrequency ablation: Minimally invasive procedures using a probe inserted into the affected vein that releases heat and causes the vein to close.

Venous surgery:

• Phlebectomy: Surgical removal of varicose veins through small incisions.
• Saphenectomy: Surgical resection of the affected saphenous vein.

Complementary approaches:

• Walking: Walking at least 30 minutes continuously every day to activate the leg muscles, which promotes blood circulation in the veins.
• Weight control: Maintaining a healthy weight to reduce pressure on the veins.
• Avoid prolonged standing: Taking regular breaks to reduce pressure on the legs.
• Monitoring and prevention: Venous disease is a chronic and progressive condition. Regular follow-up in phlebology is essential to assess the progression of venous disorders, adjust treatments if necessary, and prevent potential complications.

Preparation:

• Avoid applying cream or oil on your legs the day before and on the day of your appointment.
• Be sure to bring your compression stockings with you to every appointment.
• If you are sensitive to the treatment, you may take pain relief 1 to 2 hours before your appointment (acetaminophen or ibuprofen, if there are no medical contraindications).

After the Appointment:

After a sclerotherapy session, it is important to follow the recommendations of our phlebologist to ensure optimal healing and minimize the risk of side effects.

Here are some general recommendations after a sclerotherapy session (to be followed for the first 14 days after your sclerotherapy treatment):

1. Light walking: Walk at least 30 minutes continuously every day to promote blood circulation.
2. Wearing compression stockings: If recommended by our phlebologist, wearing compression stockings can help support venous circulation.
3. Avoid sun exposure: Avoid direct sun exposure on treated areas to prevent possible skin reactions.
4. Avoid heat: Avoid hot baths, saunas, hot yoga, laser hair removal, electrolysis, and prolonged exposure to heat.
5. Avoid intense exercise: Avoid intense physical activities or contact sports, and avoid weight training sessions.
6. Avoid long trips: Avoid long car or plane trips lasting more than 2 hours.
7. Avoid prolonged sitting or standing: Avoid sitting or standing for long periods. Take breaks to stimulate circulation.
8. Follow-up appointment: Schedule a follow-up appointment so our phlebologist can check the progress of the treatment and adjust if necessary.

If painful lumps appear along the treated varicose veins:

These are most likely local inflammatory reactions or nodules formed by the sclerotherapy itself. This reaction usually appears starting from the second week after treatment.

Here are some recommendations in these cases:

• Apply warm moist compresses for 15 minutes several times a day
• Apply Voltaren Emulgel locally on the hard lumps
• If you have no medical contraindications: take oral ibuprofen

• Pelvic pain: Persistent pain in the pelvic region is one of the most common symptoms. The pain can be described as dull, throbbing, or heavy. It is often associated with menstruation and/or ovulation.
• Pain during and/or after intercourse: Women with pelvic congestion syndrome may experience pain during and/or after intercourse (which can last for several days).
• Menstrual disorders: Pelvic congestion syndrome may contribute to heavy and painful menstrual bleeding.
• Sensation of pelvic heaviness: A feeling of heaviness or pressure in the lower abdomen is frequently reported.
• Lower back pain: The pain may sometimes radiate to the lower back.
• Worsening when standing or at the end of the day: Usually, the pain is more intense at the end of the day or after prolonged standing and is relieved by lying down.
• Vulvar and/or perineal varices: Varicose veins may be visible in the vulvar or perineal region.
• Varicose veins in the legs: Leg varicose veins may accompany pelvic congestion syndrome.