About 30% of all women and men suffer from larger varicose veins
Here you find more information about the different types of varicose veins, their symptoms, and the complications
Complications of untreated varicose veins
Untreated varicose veins often lead to complications
Anyone who has varicose veins should take them seriously, as vein disease always tends to get worse and does not go away on its own. Even when the symptoms of varicose veins initially seem to be trivial, the situation can change rapidly and greatly reduce the quality of everyday life. And not only that – varicose veins can also lead to serious complications. All varicose veins, whether they are painful or not, represent a disruption of the normal circulation. If varicose veins remain untreated for a long time, the skin may become discoloured and chronic inflammation or severe nutritional disorders in the tissues can develop. These changes are seen especially around the ankles and on the lower leg as hardening, brownish discolouration, or a loss of pigment of the skin. Without the proper treatment, thrombophlebitis, thrombosis, or venous leg ulcers may occur in the later stages, which are significantly more difficult to treat. Patients with severe complications tend to become resigned to them, so that many people with leg ulcers suffer for some years before they finally seek help.
Complications can be prevented if varicose veins are diagnosed promptly and treated correctly! So take even minor changes seriously and go and see a doctor sooner rather than later.
Complications of untreated varicose veins
- Oedema (fluid accumulation)
- Skin discolouration
- Eczema, chronic skin changes
- Phlebitis (inflammation of the veins)
- Bleeding from blow-out varicose veins
- Venous leg ulcers (ulcus cruris)
- Deep vein thrombosis and pulmonary embolism
The term chronic venous insufficiency (CVI) encompasses the previously described changes and complications of long-standing stasis (pooling) of blood in the legs due to leaky valves. CVI is frequently the result of untreated varicose veins, but may also be due to deep vein thrombosis or congenital vein disease.
Swollen legs due to oedema
The fluid (oedema) that typically collects around the ankles does so because the return flow of blood to the heart is not functioning properly. This permanently increases the blood volume and raises the pressure in the pathologically dilated leg veins. As a result, watery fluid leaves the blood vessels or lymphatic system and accumulates in the tissues. The swelling is painless and “pitting” (indentation) on applying pressure is typical. This means that when a finger is pressed firmly into the tissues, the skin retains the impression of the finger for some time.
The oedema is worse in the summer months depending on the weather and initially often only becomes apparent through a conspicuous groove that is left around the leg when the socks are taken off in the evening. However, the swelling is frequently not taken seriously until it is discovered that the shoes that fitted perfectly in the morning are clearly too tight in the evening. With time, there are inflammatory changes in the skin with itching (eczema).
Such oedema should not be allowed to persist for a long time, as it can lead to chronic changes in the skin.
Skin discolouration, chronic skin changes
Oedema causes serious circulatory and nutritional disorders in the skin. If stasis of the blood persists over years, the skin can no longer cope with it. Components such as iron pigment leaking into the tissues from defective veins may cause dark brown discolouration, known as hyperpigmentation. The skin changes are usually found in the lower leg, mostly around the ankle. Chronic inflammation develops with time and the constantly high pressure in the tissues causes changes in their structure. The skin becomes hardened – a condition called dermatosclerosis. Repeated inflammation may also cause painful scarring (atrophie blanche).
These serious complications increase the risk of venous leg ulcers.
Inflammation of the veins (thrombophlebitis)
Thrombophlebitis is the technical term for painful inflammation of the superficial veins and often occurs with varicose disease. The surrounding tissues may also be inflamed. The inflammation causes local warmth, pain, redness, and swelling at the affected site. In some circumstances, the vein can be felt as a hard, tender thread or nodule.
Consult your doctor if you have any signs of thrombophlebitis, as it may lead to a dangerous deep vein thrombosis in the leg.
Varicose veins of the perforating veins are often characterised by balloon-like swellings, the blow-out phenomenon. Increased pressure in the vein due to the reversed blood flow causes the vein to dilate like a balloon, bulging out the overlying skin. The vein is then particularly close to the surface and bleeds easily after only minor injuries. This bleeding is not painful and is often not noticed immediately, which means that elderly people in particular are in danger of bleeding to death while they are asleep.
Venous leg ulcers (ulcus cruris)
Venous leg ulcers (ulcus cruris) are open, usually weeping wounds on the lower leg or foot, which do not heal on their own. Fortunately, this serious complication of vein disease occurs in only 0.7% of the adult population in Germany. In many cases, varicose veins that have been left untreated for a long time are responsible for the venous leg ulcers. The basic cause of the ulcers is the deficient circulation and poor supply of nutrients to the affected tissues due to vein disease. The acute trigger is often a minor injury to the previously damaged skin. Venous leg ulcers are usually colonised with bacteria and often show considerable signs of inflammation in the surrounding skin.
Deep vein thrombosis and pulmonary embolism
Deep vein thrombosis (DVT) is a blood clot in the deep veins of the leg. The vein may be completely or only partially blocked by the clot. DVTs can give rise to pain and swelling of the calf and leg, but they may not cause any symptoms. Thrombosis may occur in various medical conditions, such as heart disease or after operations.
When the vein wall is damaged and the venous flow is slow, platelets accumulate at the damaged site and clump together to form a blood clot (thrombus). Thrombosis may therefore develop especially easily in varicose veins and as a result of thrombophlebitis.
In the worst case scenario, thrombosis gives rise to pulmonary embolism, when a piece of the clot breaks off and is flushed away by the blood in the direction of the lungs, where it blocks some blood vessels. Pulmonary embolism is life-threatening if major blood vessels in the lungs are occluded.