Varicose veins are a common disease

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13. November 2015

International comparison: Growing awareness of healthy legs

Conspicuous features such as spider veins and varicose veins may considerably affect self-confidence and enjoyment of life. But hardly anyone in the western world – whether in Europe or the USA – is completely free of vein problems. Bluish or reddish-purple spider veins can be seen clearly, winding along in the skin of the legs. In most cases, spider veins and small varicose veins are initially only a cosmetic problem, but they can also be the forerunners of a deeper-seated vein disease. Anyone who thinks that varicose veins are primarily a disease of the elderly is mistaken. Young people can also be affected by this very common disease. Many studies carried out in countries throughout the world have shown that chronic weakness of the veins is a global health problem. Tried-and-trusted treatment with sclerotherapy is particularly effective in removing spider veins and all other types of varicose veins in a gentle but cost-effective manner.

More than half the global population is affected

Thanks to extensive studies that have been carried out over the years, data are available on the occurrence of chronic vein disease in highly developed industrial nations, including Germany, Italy, and the USA. The renowned Bonn vein study showed that about 60% of adults in Germany are affected by spider veins or reticular varicose veins. On examining the legs, spider veins can already be seen in the 20-29 age group. Those young people understandably find it difficult to cope with such changes. And vein weakness is not just an issue for women. Approximately one in five men suffers from varicose veins that need to be taken seriously. Only one out of ten people in Germany does not have a vein problem of some sort.1,2

In Italy, about half the population has varicose veins in need of medical attention, while the figure for both the USA and Germany is approximately one-third.3,4 In the first two countries mentioned, 50-60% of the population have spider veins, making the prevalence similar to that which we see in Germany. Recent studies have shown that, contrary to common belief, vein disease is widespread in Eastern Europe, South and Central America, and the Middle and Far East. It appears that the later serious stages of vein diseases, such as chronic inflammation of the skin and venous leg ulcers, occur more frequently in developing countries. The reason for this may be that little significance is attached to vein disease in these countries and the lack of medical care.5 Taken overall, more than 60% of the population worldwide show signs of venous insufficiency (vein weakness), which makes vein disease a global health problem that should be taken seriously. 

Prevention is gaining in importance

The number of doctors specialising in vascular diseases and vein disorders has been increasing steadily over recent years, as has the number of patients.2 Compared with the rest of the world, the relatively small number of severe conditions and complications in Germany clearly illustrates that vein disease is being taken more seriously. Dr Stephan Guggenbichler, a phlebologist (vein specialist) from Munich with many years’ experience in clinical practice, confirms these suspicions. “More patients with varicose veins are coming to my practice now than they did 10 or 15 years ago,” he says. “I think it reflects a growing awareness of the dangers of vein disease. But more emphasis is also being placed on the aesthetic appearance. Younger people in particular find spider veins and varicose veins to be unsightly and therefore have them removed.” According to experts in neighbouring European countries such as France and Italy, the general awareness of the importance of healthy legs is even more pronounced than it is in Germany. 

Sclerotherapy offers a patient-friendly treatment option

Using a fine needle, the doctor injects a special liquid or a foam of a substance called polidocanol into the affected veins. This causes the vein walls to stick together, blocking off the veins, which are then gradually broken down by the body over the following weeks. The treatment of spider veins or varicose veins usually takes only 15-20 minutes, although in some cases several treatment sessions may be needed in order to obtain the best results. Sclerotherapy is the treatment of choice for spider veins and small varicose veins, as it is a particularly gentle method.2 When used for small veins it is often called micro-sclerotherapy. Numerous clinical studies have shown that sclerotherapy of large varicose veins is safe and effective, and this method is now recommended in preference to surgical procedures for the treatment of trunk varicose veins.6,7,8 Millions of people throughout the world have already benefitted from the advantages of minimally invasive techniques that make an operation for varicose veins unnecessary. The advantages of sclerotherapy over other methods include the fact that it can be performed as an outpatient procedure, without the need for an anaesthetic or surgical incisions. In addition, it is almost painless – but still gives excellent results. “The treatment of varicose veins has been revolutionised by sclerotherapy, becoming more cost-effective but less invasive and almost pain-free,” concludes Dr Guggenbichler. “In addition, treatment can be carried out on an outpatient basis, so that admission to hospital is no longer required and patients can resume their normal daily activities immediately; these aspects of treatment are greatly appreciated.” Anyone who wants to show their legs with confidence should therefore not delay in consulting a phlebologist or vein specialist for advice and treatment.6

[1] Rabe E et al. Bonner Venenstudie der Deutschen Gesellschaft für Phlebologie. Epidemiologische Untersuchung zur Frage der Häufigkeit und Ausprägung von chronischen Venenkrankheiten in der städtischen und ländlichen Wohnbevölkerung. Phlebologie. 2003;32:1-14.

[2] Robert Koch-Institut (Hrsg.): Venenerkrankungen der Beine. Gesundheitsbericht-erstattung des Bundes, Heft 44, Mai 2009.

[3] Chiesa R et al. Chronic venous disorders: correlation between visible signs, symptoms, and presence of functional disease. J Vasc Surg. 2007 Aug;46(2):322-30.

[4] Criqui MH et al. Chronic venous disease in an ethnically diverse population: the San Diego Population Study. Am J Epidemiol. 2003 Sep 1;158(5):448-56.

[5] Rabe E et al. Epidemiology of chronic venous disorders in geographically diverse populations: results from the Vein Consult Program. Int Angiol. 2012 Apr;31(2):105-15.

[6] Shadid N et al. Randomized clinical trial of ultrasound-guided foam sclerotherapy versus surgery for the incompetent great saphenous vein. Br J Surg. 2012 Aug;99(8):1062-70.

[7] Rasmussen LH et al. Randomized clinical trial comparing endovenous laser ablation, radiofrequency ablation, foam sclerotherapy and surgical stripping for great saphenous varicose veins. Br J Surg. 2011 Aug;98(8):1079-87.

[8] National Institute for Health and Care Excellence: Varicose veins in the legs, 2013

Author: Sophia Post