Definition

Varicose veins or what is called varicose veins are dilated veins (venous blood vessels) that are twisted, which usually occur in the limbs and legs. Any vein that is close to the skin surface can become varicose (varicose veins).

Cause

Varicose veins arise due to interference from small valves in the veins. In healthy veins, blood flows to the heart without hindrance. Venous blood from the limbs that flows to the heart must fight gravity. The movement of the leg muscles is a pump for blood to rise upwards. Small valves in the veins will open and close to prevent blood from flowing back. If these valves are weak or damaged, blood can flow back and accumulate in the veins causing the veins to stretch and twist (varicose).

Risk Factors

You have a higher risk of varicose veins if:

• Old age. Aging causes a weakening of valve function in venous vessels
• Women. Hormonal changes before the menstrual cycle, during pregnancy or menopause can increase the risk because existing hormones tend to make the walls of the vein vessels weaker. In addition, hormonal therapy such as birth control pills can also increase the risk of
• Having a family history of varicose veins
• Pregnant. During pregnancy, the volume of blood in the body increases to meet the needs of both the mother and the fetus. This can cause dilation of venous vessels in the legs
• Excess weight or obesity. This adds pressure to the veins
• Suffering from deep vein thrombosis (the presence of blood clots in one of the veins located deeper than the skin surface)
• Have a history of injury to the limb (for example, have a history of broken leg)
• Having a job that requires sitting or standing for long periods. Movement helps to facilitate blood flow, so if you stay too long it will increase the risk of varicose veins.

Symptoms

Varicose veins can appear bluish or dark purple and are often bulging or winding.

Symptoms of varicose veins are:

• A sense of pain, heaviness, and discomfort in the legs. However, varicose veins can cause no pain
• Swollen feet
• Burning or throbbing sensation in the limbs
• Muscle cramps in the limbs, especially at night
• The skin over the affected area becomes dry, itchy, and thin

Symptoms usually get worse during warm weather or after standing for a long time. Symptoms may be reduced by walking or resting and raising the legs higher than the heart.

In mild cases of varicose veins it is called spider veins, or veins that look like spider legs. Spider veins it is closer to the surface of the skin and is red or blue, and not prominent. This only causes cosmetic problems.

Diagnosis

Varicose veins can be diagnosed based on the symptoms that arise and their appearance. The doctor will examine your legs while lying down and standing to check for swelling when standing. The examination used for varicose veins is a duplex ultrasound (USG) examination. This tool uses high-frequency sound waves to produce images of the veins in the legs. The image will show the blood flow and help the doctor find the location of the valve damage in the vein.

Procedure

Varicose veins are a relatively minor condition and usually do not require therapy, especially if they do not cause discomfort. Therapy for varicose veins is usually given for:

• Reduce symptoms, if varicose veins cause pain or discomfort
• Handling complications such as wounds, swelling or skin abnormalities on the limbs
• Cosmetic reason

If you need therapy, usually therapy will start with things you can do at home, namely by wearing stocking compression. Before using this, the doctor will check your blood circulation first to make sure this therapy is safe for you. Stocking compression is designed to press the limbs so as to facilitate blood circulation. The pressure is usually strongest on the ankles and gets looser upwards. This will facilitate blood flow upwards towards the heart. The use of stocking this can reduce pain, discomfort, and swelling. Stocking compression is also useful for varicose veins in pregnant women because it can be used during the duration of pregnancy. This item has several different sizes, lengths, and compression pressures that will be adjusted to each person's condition. You may need to wear stocking life-long compression if you have valve problems in veins located far from the skin surface. It is not known whether its use can prevent worsening of varicose veins or prevent the formation of new varicose veins.

Stocking compression is worn immediately after waking up and removed when going to bed. Sometimes wearing it causes discomfort, especially when it's hot, but it's important to keep wearing it to get the maximum therapeutic benefits. Wear stocking correctly, do not roll on the top so that the resulting emphasis is correct. If the use causes the skin to become dry, you can use a moisturizing cream before going to bed to keep the skin moist.

Stocking Compression usually needs to be replaced every 3 to 6 months or if it is damaged. It is best to have two so that they can be washed. Wash with warm water and do not expose it to direct sunlight to dry it.

Other things you can do at home are:

• Regular exercise
• Avoid standing for too long
• Lift your feet higher when resting.

If the above method is not able to reduce symptoms or if complications have occurred, the next therapy will be determined based on your general health, as well as the size, position, and severity of varicose veins. The options for further therapy are:

• Endothermal ablation. This therapy is a follow-up therapy that is usually recommended first. This therapy uses the energy of high-frequency radio waves or lasers to close varicose veins.
• Sclerotherapy. The doctor will inject varicose veins with a liquid that can cause the formation of a wound that can close varicose veins.
• Varicose vein removal surgery.

Complications

Varicose veins can cause complications due to blood flow disorders. Most people with varicose veins do not experience complications. If complications occur, they usually only appear several years after the first varicose veins.

Complications that can occur are:

• Bleeding. Varicose veins that are close to the surface of the skin can sometimes bleed due to scratches or bumps on the legs. If bleeding occurs, lie down and raise your legs higher and press the injured area
• Blood clots. If a blood clot forms in a vein near the skin's surface, inflammation and swelling of the vein can occur. If a blood clot forms in a deeper vein, it can cause pain and swelling in the leg. The clot can also travel to the lungs and block the pulmonary artery (pulmonary embolism)
• Skin wounds. Painful wounds can arise on the skin near varicose veins, especially the ankle. Usually the onset of the wound is preceded by a change in skin color

Prevention

To prevent varicose veins, what can be done is:

• Avoid standing or sitting for long periods. Try to move or walk every 30 minutes
• Regular exercise. Exercise can improve blood circulation and keep your weight at an ideal level.
• Avoid wearing high-heeled shoes.
• Eat high-fiber and low-salt foods

This can also be done to reduce existing varicose symptoms.

When should you see a doctor?

If you have varicose veins and do not feel bothered, then you do not have to consult a doctor.

You should consult a doctor if:

• Varicose veins cause pain, discomfort, swelling, heaviness, or itching
• Change in skin color of the limbs
• There is a skin disorder over the affected area, for example, eczema 
• There were wounds on the limbs.

If you experience bleeding from varicose veins and it does not stop immediately, immediately go to the nearest health facility because this requires immediate therapy.

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