They’re unsightly, ache and tire you out: vein problems in your legs – specifically varicose veins and ulcers, both of which are caused by poor circulation. And because you constantly stand on your legs, which are a fair distance from the heart to pump, they are particularly vulnerable. In the case of varicose veins, the tiny valves inside leg veins can stop working properly and, instead of flowing smoothly to the heart, the blood becomes trapped and pools in those veins, eventually causing them to be swollen (varicose).
Although more women than men are affected, it’s far from an exclusively women’s problem – in fact, men with varicose veins tend to visit their GP or specialist at a later stage of the condition than women, putting them at a higher risk of developing more serious vein problems.
Varicose veins are relatively common, affecting three in 10 adults, usually older people. The swollen veins are blue or purple and look lumpy, bulging or twisted – and if they’re bad, they hurt. However, they’re often not bad enough to require any treatment beyond your GP’s advice to wear compression bandages/stockings and to elevate the leg.
If more serious, it may be necessary to seal off the affected veins and have the blood flow down healthy ones. This will require surgery, of which there are several options, the most effective being Endovenous Laser Ablation (EVLA) with a success rate of more than 95%.
Other methods include:
SCLEROTHERAPY which involves injecting them with a solution that destroys them so they disappear.
LITIGATION AND STRIPPING is a procedure for surgically removing the affected veins.
Even though any of these operations may prove effective at the time, varicose veins recur in one in 15 patients over a 10-year period, so further treatment may be required.

TYPES OF VARICOSE VEINS
TRUNK Near the surface of the skin, these are thick and knobbly. They are usually visible and often quite long.
RETICULAR These are red, sometimes grouped close together in a network.

TELANGIECTASIA Also known as thread or spider veins, these appear as small clusters of blue or red veins on the legs (and sometimes face); they are harmless and do not bulge beneath the skin’s surface.

TREATMENTS FOR ULCERS
With leg ulcers, the culprit is usually an infected wound, and that pooling of blood in the veins is followed by red blood cells leaking into the surrounding tissue, causing a build-up of pressure and finally breakdown and ulceration.
Again, the initial treatment is compression bandages – once your doctor has ruled out artery disease and rheumatoid arthritis– but this may not be enough. Leg ulcers can take months to heal and you may be referred to a specialist.
He or she may then try such treatments as introducing larvae that feed on the dead tissue and clean the wound, or electroceutical devices that deliver low-level impulses to the skin to improve cell migration around the ulcer, which, in turn, helps repair the tissue.

PREVENTION, NOT CURE
Sadly, you cannot totally eliminate the risk of getting varicose veins or leg ulcers, but improving circulation can reduce your chance of developing them.
Other things that may help include:
Exercising
Losing weight
Eating a high-fibre, low-salt diet
Avoiding high heels and tight hosiery
Elevating your legs whenever possible
Changing your sitting or standing position regularly.


AFTER EVLA
You will have to wear compression stockings for two weeks, but should be able to go back to work straight away.

REAL PEOPLE

‘Doctors advised the best aid to recovery was to get moving’

Dave Elsworth, 33, is a professional photographer. He comes from York but now lives with his fiancée in harpenden, hertfordshire, and travels all over the world snapping marathons. This involves a lot of sitting on planes and standing still – a possible cause of his varicose veins…

I was never concerned by how the varicose veins on my legs looked; but over the past seven years, they’d been getting bigger. They’d also become quite uncomfortable – my legs felt heavy and almost restless.
‘My work as a photographer requires lots of plane travel and sitting for long periods, so I felt this might be causing even more damage and decided I’d better get the veins checked.
‘Initially, I visited my doctor, who saw at once that they were more severe than I thought and required further attention.
‘I was then handed over to the vascular department at the local hospital, where I had an initial consultation and an ultrasound scan on both legs. This was for the specialists to check the state of the veins and locate the ones that were the problem. It also ensured that deep vein thrombosis (DVT) wasn’t an issue.
‘It was decided that radio-frequency ablation was the best course of action for me and I was put forward for this treatment.
‘It involved making a tiny cut in each leg through which a catheter was inserted into the vein and a probe was then used to heat the vein’s walls. The heat seals those walls shut and, as a result, the blood flow goes to a different, healthier vein in the leg.
‘The operation took about half an hour and, as soon as the procedure was finished, the doctors put a very stylish pair of compression tights on me – the same pair of tights that were to become part of me for the next three to four weeks.
‘Walking wasn’t easy for the first 24 hours but, after that, the doctors had advised the best aid to recovery was to get moving as much as possible. So that’s what I did. My compression
tights weren’t allowed to come off (apart from when showering), so I started to limp around a three-mile loop of our local town for the first week, slowly building up the distance. My legs felt lighter and easier every time.
‘The only other restriction was that I couldn’t fly for six weeks (which was actually quite nice!), but otherwise I was back to my usual life within a few days of the operation.
‘Unfortunately, varicose veins can come back or new ones can form after surgery. I can feel one building up again in my left leg (three years after the op). I am prone to them, but I will continue to try preventative methods and monitor them.’

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