Your Guide To Healthy Legs
Know The Different Types
Unsightly veins in the legs are more common than you think, especially for women over the age of 55. Recent research shows 88% of women have thread veins, while 40% of the UK population has either varicose veins or hidden varicose veins, which can quickly develop into visible varicose veins due to their progressive nature. If you have veins on your legs, chances are you know which is which, but thread veins are small, thin lines that appear just under the skin, typically appearing in the calf and thigh areas. Varicose veins, on the other hand, are larger, lumpy blue or purple veins that often present as bulging at the skin’s surface. “A good way to distinguish between the two is to remember that varicose veins appear when you stand but disappear when you lie down and lift your legs up, whereas thread veins are visible almost all of the time,” says Professor Mark Whiteley, consultant venous surgeon and founder of The Whiteley Clinic. He adds there is a third type of vein which sits somewhere between a thread and varicose vein. “Reticular veins are green and appear on the surface of the skin. They tend to appear on the backs of the knees, on your inner thighs or near the ankles,” he explains.
Your Legs Are More Prone To Problems
If you’ve ever wondered why such issues are more likely to appear on the lower half of your body, know it’s all down to gravity. As Professor Whiteley explains, healthy veins take blood up from the feet to the heart – going against gravity. Blood will naturally try to flow backwards and is only prevented from doing so by tiny one-way valves in your veins that open and close to let it through. “Varicose veins occur when the small valves in your legs fail,” he says. “This allows blood to fall back down to the ankles and feet and collect in the veins.” Any vein can become varicose if the wall is stretched and the valve is weakened. Possible risk factors include ageing and obesity. Women are also more likely to get them, as it’s believed female hormones can relax the walls of veins, making the valves more prone to leaking.
The Two Tend To Be Linked
While thread veins don’t always lead to varicose veins, Professor Whiteley explains nine out of ten people with thread veins have them due to underlying varicose veins. “The blood that falls down a hidden varicose vein refluxes into a spider vein. In fact, only one out of every ten people has simple spider veins without an underlying cause.” It’s for this reason, he explains, that thread veins should never be treated on the legs unless an ultrasound scan has been performed by a vascular expert to confirm there aren’t any underlying varicose veins. “In the 90% of people who are found to have hidden varicose veins, these will deteriorate just as normal varicose veins do. Every year, approximately one in 20 patients with these veins will progress to the next stage of venous disease, which can lead to swollen ankles, skin damage and even venous leg ulcers,” he says.
Genes Play A Role
“In the case of varicose veins, family history is the biggest risk factor,” explains Dr Whiteley. “There is a stereotype that it is only the old and overweight who will suffer from varicose veins, although in reality the condition is familial and can strike at any time in life.” If either of your parents have, or had, varicose veins, your likelihood of developing the condition is far higher.
Know Your Treatment Options
Treating spider veins is considered a cosmetic procedure, so isn’t normally available on the NHS. But if you’re unhappy about the appearance of these visible veins, microsclerotherapy is a common and painless private treatment that involves injecting the veins to permanently destroy dilated blood vessels. Varicose veins, on the other hand, only require treatment if they are causing you severe discomfort, pain, swelling, pigmentation, eczema or an ulcer that’s lasted more than two weeks. In this case, you may meet the NICE guidelines for referral to an NHS vascular specialist. Treatment can include endothermal ablation, which uses heat to seal the affected veins; sclerotherapy, which involves special foam injected to close the veins; and ligation and stripping surgery, which removes the affected veins. Just be aware of the treatment plan you are offered, advises Dr Whiteley. “Your treatment should be performed by a team. For example, a doctor should not be doing their own scan followed by treatment as they cannot specialise in both. A venous specialist should work alongside a vascular technologist, who carries out the scan, which can then dictate the best form of treatment for you.”
New Technology Also Exists
Professor Whiteley was the first UK practitioner to offer Sonovein, a new non-invasive treatment that requires zero recovery time. Sonovein uses a high-intensity focused ultrasound beam to deliver thermal energy directly to a troublesome vein, causing it to shrink and seal. It’s currently the only treatment that can treat a vein from outside the body. “Unlike traditional varicose vein treatments, no incisions are required, meaning you’re left with no scars or risk of infection, and can return immediately to your normal daily activities,” Dr Whiteley adds. “Some women, however, will still need further foam sclerotherapy following a Sonovein treatment to treat residual bulging veins.”
Don’t Be Lured By Topical Treatments
Professional venous treatment can be daunting and costly (multiple treatments are often required and newer therapies can cost in the region of £2-3k), but the experts agree it’s the only long-term solution. “There are lots of products on the market claiming to treat varicose and thread veins, but none have been shown to work when scientifically tested,” says Dr Whiteley. “Indeed, if we understand that venous disease is caused by blood falling down the veins by gravity, then it’s no wonder rubbing a cream on the skin will have little effect.” If you’re looking for a quick fix, however, fake tan and tinted creams will temporarily cover thread veins.
Boost the circulation in your legs and limit the effects of varicose veins with these tips from Professor Whiteley…
EXERCISE REGULARLY: “Even a simple exercise plan can make a huge difference and keep your blood flowing – think a brisk walk outdoors or a basic at-home workout plan. Swimming also helps as the water acts like a compression stocking as well as allowing you to exercise the muscles.”
KEEP THE BODY MOVING: “It’s easy for a day to go by without much exercise or movement, but inactivity and being overweight are two of the key lifestyle factors which are often associated with venous complications. When you are inactive or lie down for long periods of time, your venous blood flow slows down and pools, causing an elevated risk of blood clots.”
STOP SMOKING: “Smoking destroys circulation. In fact, almost all arterial bypasses for blocked arteries in the legs are performed in smokers.”
ELEVATE YOUR LEGS: “Try placing pillows or a footstool underneath your legs when sitting to keep them elevated – this will improve venous circulation by raising your legs, which encourages blood to flow back to the heart.”
The Whiteley Clinic is running a Covid-secure service in Guildford, London and Bristol, as well as virtual consultations, for those who might need urgent care for their veins. For more information about treatments offered by The Whiteley Clinic visit TheWhiteleyClinic.co.uk
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