Durban — It has been said that thousands of South Africans yearly develop a condition known as varicose veins, which are twisted and enlarged veins.
The condition is common among the population as any vein close to the surface of the skin (superficial) can become varicosed.
Leading South African vascular surgeon Dr Vinesh Padayachy said varicose veins most commonly affect the veins in the legs because standing increases the pressure in the veins of the lower limb.
For many people, there are no symptoms, and varicose veins are simply a cosmetic concern, but in some cases, they cause aching pain and discomfort or signal an underlying circulatory problem.
“Varicose veins can present in a multitude of ways,” Padayachy said.
“The common signs and symptoms a patient can experience would be obviously visible varicosities, but that happens very late in the disease. With early symptoms, one would experience heaviness of the legs towards the evening, especially swelling of the legs again worsened towards the evening. They can develop an eczema in the leg, with a worst-case scenario being an ulcer on the leg and darkening of the skin around the ankle and foot.”
Padayachy said that if left untreated, varicose veins will continue to progress with a large ulcer forming around the ankle area.
He operates from the Lenmed eThekwini Hospital and Heart Centre.
“Fortunately, it is extremely rare that patients would end up losing their limb from varicose veins. However, these ulcers are very morbid and can cause a tremendous amount of pain. They are often wet and weep and can be very distressing to patients,” Padayachy said.
The surgeon, who specialises in non-invasive surgery, said that treatment for varicose veins had advanced tremendously over the years, and doctors no longer had to perform high ligation and stripping of the affected area, which often meant prolonged hospital stays.
“We now have various minimally invasive options, including radio frequency ablation, endovenous laser ablation and mechanical ablation of the varicose veins. Basically, this entails using special catheters and devices to go in and seal off the veins. The advantage of these minimally invasive devices is that patients can be treated in the rooms and do not have to be admitted into hospital and taken to theatre. It is often done as a day procedure, and patients do not need to stay over,” explained Padayachy.
He said there are a multitude of causes for varicose veins, but the most common cause is hereditary.
“It is worsened in patients that stand a lot. It is worsened during times of pregnancy. It is more common in females, and obviously, as you age, the symptoms worsens. Obesity is another contributing factor to varicose veins, and obese patients have quite significant symptoms,” Padayachy said.
He said since people do not experience pain from varicose veins, they often ignore it, which could later lead to problems that could include severe pain and ulcers.
Padayachy advises people with varicose veins to seek help when it becomes a problem.
“When you start to see your skin discolour, when the varicose veins cause symptoms of pain, swelling or bleeding, then one should seek help. Once the patient has their veins dealt with surgically, their ulcers and pain is often relieved. The ulcers that they have been dealing with for years start to heal and make a remarkable difference to their lifestyle,” Padayachy said.
Daily News