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Varicose veins

Take the first symptoms seriously

Aus unserer Serie »English Lesson«: Varicose veins and vein changes are widespread. According to the German Society for Phlebology, 20 to 30 percent of adults in Germany have varicose veins that require treatment. In addition, there is a large proportion who show slight vein changes such as spider veins.
Marta Campbell
22.06.2022  16:00 Uhr

Varicose veins (varices) develop when the valves of the superficial venous system no longer close properly. Instead of flowing exclusively upwards, towards the heart, the blood in the affected vein can now also flow downwards, towards the foot. For the vein walls, the unaccustomed backflow represents an enormous strain that they cannot withstand in the long run. The walls expand, and as a result other valves become leaky and also allow the blood to pass in the opposite direction. A domino effect develops that gradually affects the entire vein. When a vein becomes a varicose vein, the total diameter of the vein increases. It curves and twists. Classic varicose veins on the leg are easily visible from the outside. Other varicose veins lie deeper in the tissue and are not visible from the outside.

Not only the optics

When varicose veins develop, phlebologists distinguish between primary and secondary varicose veins. While the latter are usually the result of deep vein thrombosis, no concrete triggers for primary varicose veins have yet been clearly identified. However, there are a number of factors that favour varicose veins. These include a genetic predisposition to a weakness of the venous valves. For example, the risk of developing varicose veins is 90 per cent for people with two affected parents and 45 per cent for people with one affected parent. If neither parent is affected, there is a basic risk of 20 percent. Age also plays an important role. With increasing age, the connective tissue and the superficial veins lose elasticity, which promotes the development of varicose veins. In addition, lack of exercise and being overweight are considered risk factors.

Many people initially consider varicose veins to be a visual problem. This is mainly because they are often visible for some time before symptoms first appear. The first sign of a venous circulatory disorder is oedema in the legs. They usually appear around the ankles and become more pronounced towards evening. Those affected now complain of feelings of heaviness, tiredness and tension in the legs, which ease when the legs are elevated or when they are moved. Sometimes there are also cramps in the feet or calves at night. Warm weather can make the symptoms even worse.

If varicose veins remain untreated, serious secondary diseases can develop. These begin with chronic skin changes in the area of the lower leg and foot, which become visible as brownish discolouration. They are caused by iron pigments that enter the skin from the congested blood. The insufficient blood flow causes the skin to thin and the connective tissue to harden. Affected areas may itch and feel warm. The open leg is eventually characterised by ulcers in the lower leg and ankle region. The formation of blood clots in the varicose veins is also possible. These manifest themselves as local pain, reddening of the skin, a feeling of heat, leg swelling and palpable stiff vein strands. In addition, varicose veins tend to become inflamed, which can be painful, and to bleed profusely if they are injured.

No self-healing

As a general rule, varicose veins cannot heal by themselves. Early therapeutic intervention makes sense and not only alleviates discomfort, but can also prevent the progression of the disease and the onset of complications. Doctors and patients have various methods at their disposal for this purpose. Compression bandages and medical compression stockings are an important pillar of basic therapy. They exert targeted pressure on the leg veins, which improves the function of the valves and the muscle pump. Exercise is also part of the therapy. It activates the muscle pump, promotes the return flow of blood to the heart and should be incorporated into everyday life as often as possible. The treatment is supplemented by regular elevation of the legs. In addition, those affected should not stand or sit for long periods of time, avoid hot baths and saunas.

Herbal vein medications are also available for oral use against unpleasant symptoms such as pain, heaviness and tightness. According to the current guideline »Diagnosis and therapy of varicosis«, there is currently evidence-based proof of efficacy for red vine leaf extract, horse chestnut extract and oxerutin. They exert their effect on the vessel walls, reduce their permeability, prevent fluid accumulation in the tissue and thus support or complement the effect of the basic therapy of compression, exercise and elevation. Many patients also find the application of gels, creams, ointments and sprays with extracts of horse chestnut or red vine leaves pleasant. 

German English
Adern veins
Bindegewebe connective tissue
Blutgefäß blood vessel
Elastizität elasticity
Extrakt extract
Knöchel ankle
Kompression compression
Kompressionsstrümpfe compression stockings
Krampfadern vericose veins
Muskelpumpe muscle pump
Ödem oedema
Phlebologe phlebologist
Rosskastanie horse chestnut
Roter Weinlaub red vine leaves
Schmerzen pain
Spannungsgefühle feeling of tension
Varikose varicose
Venen veins
Wadenkrampf calf cramps

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