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What are the risks of untreated varicose veins?

This question was asked in Beltsville, Maryland and has 9 answer(s) as of 05/17/2013.
What will happen if I don’t have my varicose veins looked at? I'm wondering what will happen if I don't go to a doctor about my veins. They are large and sometimes painful but I don't want to undergo surgery. Will they get worse over time?

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Doctors Answers (9)

Veins are not only important in re-circulating blood to the heart, but in removing cellular waste from the tissues. Chronic venous insufficiency from poorly functioning veins leads to a poor clearance of cellular waste and resultant changes in the skin of the lower legs, purple ankles, spontaneously bleeding veins (usually a bulging vein around the ankle) and can contribute to an increasing number of varicose veins, reticular veins, and spider veins. Varicose veins on the legs may increase the risk of phlebitis (superficial blood clots) which is a limited but often recurrent condition producing tenderness and swelling over the area of the clot and usually lasting for several weeks or more. Many people with varicose veins have minimal symptoms with normal activities while others commonly have sore aching legs making it difficult to stand for long periods of time. You can optionally wear medical-grade compression hose on your legs to improve venous circulation (this was the main treatment used 20 years ago). Treating varicose veins is now done in the office and surgical vein stripping procedures are considered obsolete. Modern treatment procedures are comfortable, minimally invasive and there is no change from normal activities. The results are excellent in removing the varicose veins and preventing further progression of chronic venous insufficiency.

Varicose veins always worsen over time. Leaving your veins untreated exposes you to a six-fold increased risk of deep vein thrombosis (DVT) and the eventual possibilities of skin pigmentation, leg ulcers, and debilitating symptoms. DVT can be devastating and is usually unpredictable; the other problems usually develop slowly over years. Like "Dirty Harry" once said, "Do you feel lucky?"

Yes the varicose vein will likely get worse over time. The pain you experience will probably get worse slowly. There are other medical conditions that may occur including hardening of the skin and possibly sores or ulcers. However, they may not occur.

Yes, varicose veins will get worse over time. If not treated they will get larger and the symptoms will intensify over time. People with varicose veins have a 25% chance of developing venous ulcerations, a break down of the skin around the ankles, over their lifetime. If you do not want surgery you should at minimum wear graduated compression stockings. These will help slow the progression of the venous disease. The procedures have advanced greatly over the last 5 to 10 years. It would be beneficial for you to visit with a vein specialist to discuss potential treatment options before you rule out any procedures to fix your problem.

Untreated varicose veins will get worse over time. Even with proper treatment and conservative measures, all of us will experience progression of the effects of age and gravity upon our veins. The rate of progression is determined largely by genetics, obesity, and inactivity. Institution of a weight management program (if needed), routine daily use of elastic support hose, moderate exercise, and avoidance of prolonged sitting or standing will slow down the progression of venous insufficiency. Treatment of significant varicose vein problems will improve the quality of life and it will slow down development of new varicose veins. Untreated venous insufficiency and varicose veins will progress in some individuals to chronic edema (swelling) of the legs which increases the risk of infection (cellulitis), a rash or brown discoloration of the skin near the ankles and, in some cases, venous stasis ulcers. Enlarging varicose veins are prone to form clot in the varicose veins called superficial thrombophlebitis. About 20 percent of cases of superficial thrombophlebitis will extend into the deep veins inside the muscles (deep vein thrombosis). Deep vein thrombosis is the dangerous kind of clotting in the legs since large clots in the deep veins of the muscles may move through the bloodstream to the lungs, a process called pulmonary embolism. Pulmonary embolism can be fatal if it blocks the flow of blood through the lungs. Most of the complications of venous insufficiency can be prevented with proper treatment and lifestyle changes.

Varicose veins with symptoms progressively get worse. Treatment is quite simple these days and you can return back to work the same day in most cases. Most procedures to close (not remove) these veins only take about one hour. Venous ulcers can occur as well as painful thrombosis (blood clotting) in the superficial and deep systems.

You run several risks by not treating your varicose veins, especially if they are large and bulging:

1. The condition worsens with time.
2. You can develop superficial thrombophlebitis, a very painful inflammation resulting from spontaneous clot formation, which may spread into the deep veins and the clot may break away and lodge into your pulmonary blood vessels (Pulmonary Embolism). This is a medical emergency and can kill you.
3. They can rupture when you're showering, or shaving your legs.
4. Skin color changes, cellulitis, and brown discoloration around the gaiter area.
5. You can develop cellulitis, eczema, and skin ulcers.

The risks of untreated varicose veins are the possibility of developing a painful blood clot (superficial thrombophlebitis), a dangerous blood clot (deep vein thrombosis - DVT), discoloration of the skin, leg swelling, and gradual enlargement of the varicose vein. They will get worse over time. While varicose veins and the underlying problem of venous insufficiency are not life threatening conditions, it is advisable to have your legs evaluated by a vein specialist - ideally a doctor with a background in surgery and certified by the American Board of Phlebology. You want to be treated by a doctor that can offer all the minimally invasive modalities of treatment, including endovenous ablation and ambulatory micro phlebectomy. Vein stripping is an obsolete procedure - thank goodness! State of the art treatment of large varicose veins is done under local anesthesia or light sedation, performed in the office, has minimal or no post-procedure pain, and immediate return to normal daily activities.

The answer is yes. Once you have varicose veins, they won't disappear on their own or if left untreated. The dreaded consequence of varicose veins includes infection and skin ulcers.

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