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Varicose veins are caused by abnormal valves in deeper veins. These abnormal valves allow the blood to flow back down the vein instead of the correct way which is back up the leg to the heart. Varicose veins appear as bulges above the skin and are often blue in colour. The best way to think about varicose veins is that they are ‘escape routes’ for the underlying back pressure that results from deeper veins having faulty valves. This back pressure pushes on the vein wall and where there is a weakness in the vein wall the pressure pushes out as a varicose vein. The absence of good valve function appears to be a genetic weakness so there are not many people can do about it. There are however exacerbating factors like pregnancy and being overweight that people do have some control over!
There are a variety of treatments available for varicose veins. Standard sclerotherapy for surface varicose veins has been used since the 1930s. This treatment has developed into a procedure called Ultrasound Guided Sclerotherapy (or UGS) where deeper varicose veins can be treated without the need for surgery. (You do not need surgery to treat your varicose veins!) These two treatments are suitable for those with moderate varicose veins. Sufferers of larger varicose veins will benefit more from a treatment called Endovenous Laser Ablation (or ELA). This procedure involves the use of a local anaesthetic to numb the leg prior to a needle with a very fine laser fibre being inserted into the problematic vein. Once inserted, the laser fibre is moved up through the varicose vein where it heat seals the vein. Patients should experience little to no pain during the procedure but are expected to experience mild pain over the days following treatment. All treatments require no downtime, loss of work time or disruption to your everyday activities. All patients walk out on the same day!
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