Symptoms

It is important to note that varicose veins are often associated with no symptoms whatsoever, even when quite large and unsightly. On the other hand, modest varicose veins can be associated with some of the following symptoms:

Ache

Aching legs at the end of the day is a common problem in the population at large, but the presence of varicose veins often exaggerates this phenomenon. This type of discomfort is alleviated by elevating the legs. It can also be improved by wearing compression stockings or socks.

Swelling

Swelling of the lower limbs from fluid accumulation (oedema), generally around the ankles.

Itch & Dermatitis

The interference of the circulation in the lower limbs by varicose veins often leads to skin changes, namely dermatitis (known as varicose dermatitis). The eczema from this can be very severe and disabling.

Easy bruising

High pressure in surface veins often results in more extensive bruising than one would normally expect from minor bumps.

Inflammation and pain

Some patients experience tenderness, bruises and pain. This can be due to high pressure in their venous system.

In severe cases, if left untreated, symptoms can progress to include:

Damage to the leg tissues

Pressure from veins can cause inflammation (cellulitis) and tissue hardening in the calf. This often looks like infection but is usually only inflammation from tissue damage. Damage to the fatty tissue causes permanent scarring around the ankles leading to hardening and can result in “Champagne Bottle” shaped legs.

Ulceration

Ulcer formation, especially around the ankles, is due to the poor skin circulation caused by varicose veins. Sores and ulcers may occur without injury and just appear spontaneously. They can be extremely painful and occasionally become very large requiring skin grafting. See examples to the left.

Bleeding

Bleeding from superficial varicose veins can be dramatic and can occur without warning. This phenomenon occurs with very superficial dark coloured blebs. Immediate treatment by pressure or elevation avoids massive blood loss and risk to life. The emergency treatment is by injection sclerotherapy and then later management of the larger veins. This complication is known to be life threatening especially in the elderly and infirm who may be unable to elevate the leg or press on the bleeding point.

Thrombosis

Surface clot formation in the veins themselves, causing lumps and inflammation under the skin, can be dangerous and needs review promptly if it occurs. Most episodes of surface thrombosis are managed with anti inflammatories. Although Deep Vein Thrombosis can occur subsequent to surface thrombosis, varicose veins represent only a modest predisposition to deep vein clots. Thrombosis close to the groin can result in serious complications and needs prompt management. Any clot formation causing a hard lump should be seen by your doctor promptly.