Varicose Veins, Throbbing Ankles/feet, What Can I Do?

Question

I'm 22, wear xompression stockings, no kids, not overweight, constantly having legs elevated. They are causing a lot of discomfort, throbbing, numbing, heavy feeling. Turn purple/blueish when standing. Had scelratherapy last year for spider veins, more have returned in the area. I don't want the varicose veins to continue to grow and lengthen up my leg nor the spider veins to spread. Does this mean I'm not healthy? If I have treatment, what are options? Will they return? Is my circulation bad?

Joel Gotvald, MD, FACS · Answer

In viewing your photographs, it looks like you are definitely suffering from a vein circulation problem known as venous reflux disease or venous insufficiency, which is the main cause for varicose veins of the legs.  The cause of your symptoms is increased pressure buildup in the abnormal veins of the legs.  The condition is the result of a genetic weakness in some of the vein valves in the legs, which leads to inadequate return of blood out of the legs and to the heart.  The valves normally wounld "fight against" gravity by pushing the blood upwards.  When the valves fail, gravity wins and the blood travels down, causing uncomfortable pressure buildup in your legs. The condition is curable, and you should see a board-certified vein specialist (vascular surgeon) to perform a vein reflux ultrasound.  This typically diagnoses the problem. It is usually treated with endovenous laser (EVLT) or radiofrequency catheter (Venefit), and typically can be done in a doctors office.  Dramatic improvement in symptoms is almost immediate.

Hratch Karamanoukian, MD, FACS · Answer

Board Certified Phlebologists recommend a formal evaluation for venous insufficiency even if you present with C1 venous disease (CEAP C1 = spider veins) in order not to miss underlying venous insufficiency, especially if you present with an ankle flare - corona phlebectasia. A significant percentage of patients with spider veins at the ankles (> 40%) have associated truncal venous insufficiency which should be treated BEFORE sclerotherapy to ensure success, reduce likelihood of early recurrence. Read the article below for the scientific reference to your question.

John Landi, MD · Answer

You are doing all the right conservative measures to treat varicose veins without response. The next step would be to have a venous reflux ultrasound to evaluate the valves in your saphenous system of veins.  If the valves are leaking (refluxing), then the best treatment for varicose veins and refluxing valves is to close the leaking valves with either a laser or radiofrequency catheter.  Since you have had sclerotherapy with return of veins and now have varicose veins, this suggests that you have malfunctioning valves and does not mean that you are unhealthy. A vein specialist can evaluate your circulation and answer all of your concerns.

Varicose Veins, Throbbing Ankles/feet, What Can I Do?

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Varicose Veins, Throbbing Ankles/feet, What Can I Do?

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