Varicose veins are a result of dilation of the veins that results in incompetency of the venous valves. This results in stasis of the blood, swelling and increased pressure within the veins that results in fluid leakage into the soft tissues around the veins (known as edema). Their appearance is often unpleasant to the patient and if untreated can result in various complications. It is notable that embolism from superficial varicose veins is very rare and are usually a result of deep vein thrombosis instead.
Stasis Dermatitis
This presents with dry, red, itchy skin that is obviously irritated and occasionally has oozing lesions or erosions. The skin irritation and breakdown is a result of the buildup of fluid underneath the skin.
Thrombophlebitis
This is a result of a blood clot in your veins causing swelling, redness and discomfort. Clots tend to form in conditions where stasis of the blood is present, such as varicose veins. Often the clot can be seen and felt as a red, tender cord just underneath the skin.
Atrophie Blanche
This is a characteristic scar that is usually characterized by atrophic plaques with red dots within the scar and surrounding pigmentation of the skin. This is a result of skin injury, often when the blood supply is poor. Increased fluid in the skin from varicosities can increase the pressure, causing a decrease in capillary blood flow that in turn compromises flow to the skin affected by fluid buildup.
Lipodermatosclerosis
This condition is characterized by tight, discolored, painful skin usually around the ankle area. Its mechanism of development is not clearly understood but the main cause is increased pressure in the veins of the lower leg. This is exactly the mechanism behind varicose veins, and thus they are frequently associated with each other. Sadly, these changes are permanent and referral to a vascular surgeon is necessary to prevent further progression and complications.
Venous Ulceration
This complication is also a result of the increased pressure in the skin around varicose veins as a result of increased fluid buildup in those tissues. It results in tissue breakdown, and since the increased pressure results in decreased capillary flow, the tissue healing process is slowed down considerably and chronic ulceration can result. These are hard to treat and recur frequently, making them a feared complication of varicose veins.
References
- "Ferri's Clinical Advisor 2010, 1st Edition;" Ferri 2009
- American Family Physician. "Management of Varicose Veins." Jones R, Carek P. Volume 78, Issue 11 (December 2008)
- "Sabiston Textbook of Surgery, 18th Edition;" Townsend; 2007
