This is dangerous. Varicose veins are a sign that the pressure inside your veins is higher than normal, and if one of them starts bleeding things could get out of hand quickly. If this happens, get your leg higher than your heart immediately by lying down with your legs raised and resting on a stool. Put lots of pressure on the area until the bleeding stops. Then get to your GP for an urgent referral.
Thrombophlebitis is when the wall of the enlarged vein becomes inflamed and a blood clot forms inside it. The skin over the vein can get red, and the vein itself feels hard, lumpy and painful.
Antibiotics won’t help, but you can take some anti-inflammatory medicines to help ease it. The inflammation usually settles in about a month, but the tender lump and skin discolouration can remain for longer. There’s a small risk of having thrombophlebitis again, and even deep vein thrombosis if this happens in a varicose vein, so make sure you see your GP. They may refer you to a vascular surgeon.
Ulcers are wounds which take a long time to heal, and problems with your veins are just one cause. If you have varicose veins, you may notice that small cuts or knocks take longer to heal on your legs than in other areas of your body. If one of these doesn’t heal after a few weeks, it’s worth seeing your GP. They should assess you for other causes of ulcers, and may recommend treatments such as compression stockings or special dressings. They can also refer you for surgery to help heal the ulcer and prevent more ulcers forming.
Rashes or colour change in the lower legs
Varicose veins are only one sign of high pressure in your veins. This high pressure can also affect the skin of the lower leg, causing poor healing (such asulcers, mentioned above), varicose eczema and colour changes to your skin called haemosiderin deposition.
Swelling and discomfort
Although varicose veins aren’t in themselves painful, the pressure in the vein system can cause swelling in your legs which can be extremely uncomfortable. People often describe heaviness, aching and throbbing. If you’re symptoms are stopping you from going about your everyday life, see your GP. They may recommend compression stockings and keeping your feet up as much as possible. If this doesn’t help, they may consider referring you for treatment.
Taking care of your legs
Varicose veins aren’t in themselves dangerous, and if they aren’t causing any of the above problems, treatment isn’t necessary. But if you have them, it’s a sign that the pressure in your veins is increased, and you might need to take care of your legs to stop problems happening in the future. This includes:
- keeping your legs elevated (raised) as much as possible to reduce pressure in the veins
- taking great care of your skin and moisturising after every shower or bath
- avoiding bumps and cuts to the legs which could turn into an ulcer
- consider compression stockings if you have trouble with swelling or discomfort
What happens if my GP refers me to a vascular surgeon?
If you see a vascular surgeon, they’ll be able to arrange an ultrasound scan of your legs to see where the problem in your veins is. They’ll also make sure that there aren’t any reasons not to treat your varicose veins (such as deep vein thrombosis). They’ll then discuss all the options with you. These include the following.
- Conservative management – this involves making some changes to your lifestyle, elevating your leg and wearing compression stockings
- Endovenous management, which is a day-case procedure done under local anaesthetic (so you stay awake but won’t feel anything). There are several different types of endovenous management, but all involve placing a tube inside the problem vein and closing it off using a special foam, heat treatment or glue.
- Open surgery, which can be under local or general anaesthetic. It isn’t used as often these days, but your surgeon might recommend it if you’ve had previous surgery or your veins aren’t suitable for endovenous treatment.
See our full topic on varicose veins for more information about the condition.