Varicose veins are very common universally. Women tend to be more frequently affected by varicose veins than men. However, not all individuals with varicose veins have symptoms. There is no correlation between the severity of varicose veins and symptoms. Some women have severe varicose veins and do not have many complaints. Others have mild disease but have numerous complaints. Subjective symptoms are usually more severe early in the progression of disease, less severe in the middle phases, and worse again with advancing age.
The most common symptoms of varicose veins are:
Pain: The majority of individuals with varicose veins complain of an odd ache in the legs. The ache is generally worse at the end of the day; usually after a long day of standing and walking. Others may complain of throbbing near the calf or ankle area. Still others may complain of cramping in the legs which commonly occurs at night. All individuals mention that the symptoms subside when they rest and elevate their legs.
Itching: The majority of individuals with varicose veins will complain of itching. With varicose veins, the blood pools in the superficial veins and this is believed to cause the dryness and itching of the skin. The itching is most common around the ankles.
Skin discoloration: When varicose veins have been left untreated for years, the blood in the veins starts to collect around the ankles and leaks out into the tissues. The leaked blood then mixes with the surrounding skin and tissues- eventually this leads to a dark pigmentation around the entire ankle. The pigmentation initially starts out as a brown color but gradually turns in a dark grey color. Unfortunately, this pigmentation is not reversible.
Skin ulcers: When varicose veins are left untreated for prolonged periods, the blood leaks out of the veins at the ankle and leaches out into the skin and surrounding tissue. Over time the skin near the ankle becomes friable and an ulcer develops. These venous ulcers are painful and always drain fluid. In the majority of cases, they take a long time to heal and many never do.
Swelling: With time, most individual with varicose veins will develop swelling of their ankles and feet. The swelling is worse at the end of the day. After lying down at night, the swelling always disappears.
Tenderness: In some individuals the varicose veins become "thick and rope like". They are easily seen and can be felt near the thigh. Some may develop tenderness along the entire length of the swollen vein. At this stage the vein appears very unattractive and is a major source of embarrassment.
Phlebitis: In some individuals the varicose vein will start to develop blood clots and the vein will become inflamed (phlebitis). At this acute stage, the skin along the vein will appear red and there will be pain. Walking may be difficult and some may develop a low grade fever. The condition can be severe enough to require pain medications and even antibiotics.
Paresthesias: Some individuals may complain of nerve problems which may include tingling or numbness along the leg. These symptoms are most common at night and are believed to be due to the irritation of nerve by the engorged veins.
Burning: Burning in the feet is also a common complaint which is most common at the end of the day. Upon resting, the burning sensation disappears.
What conditions can make symptoms worse?
- menstrual cycle
- taking the birth control pill
- prolonged standing
- weight gain
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