Varicose veins are a common health problem that affects more than half of the population[1]. They’re predominantly a cosmetic issue, but symptoms of varicose veins can include pain, swelling, and discomfort for some people. So, are uncomfortable or itchy varicose veins dangerous?
While not inherently dangerous, varicose veins can lead to complications like blood clots, bleeding, or skin ulcers if left untreated. Sometimes, they may indicate underlying circulatory issues that warrant medical attention. Pregnant women, individuals with a family history of varicose veins, or those who stand or sit for long periods are at higher risk.
If you have varicose veins, it’s important to be aware of the potential health risks. Proper monitoring and treatment can help you prevent or manage complications at their earliest stages.
Understanding Varicose Veins
Varicose veins are bulging, enlarged veins that typically appear on the legs. They develop when the vein valves weaken or aren’t functioning properly, which causes blood to pool and veins to become swollen and twisted. There are many potential varicose vein causes.
Common risk factors in the development of varicose veins include:
- Genetics or family history
- Advancing age
- Hormonal changes, such as during pregnancy or menopause
- Excess body weight
- Gender, as women are at a higher risk than men
- Jobs that require prolonged sitting or standing
- Sedentary lifestyle
- A history of deep vein thrombosis (DVT), a condition of blood clots forming deep in the leg
Lifestyle Tips for Managing Varicose Veins
If you have varicose veins that are mildly annoying but overall manageable, it can be helpful to incorporate some self-care practices at home to alleviate symptoms.
Some of the everyday things you can do for varicose veins at home include:
- Elevating your legs when at rest
- Participating in regular physical activity, including walking, swimming, biking, jogging, or working out
- Avoid sitting to standing for prolonged periods without a break
- Avoid wearing high-heeled shoes
- Achieving and maintaining a healthy weight
- Avoid smoking
- Use compression stockings, especially for activities that exacerbate symptoms, like traveling on an airplane
Potential Health Risks Associated With Varicose Veins
While the primary complaint about varicose veins is that they can be unsightly, they can also lead to discomfort, aching, and swelling in the legs. However, sometimes serious health risks can occur that make varicose veins dangerous, including:
- Blood clots
- Bleeding
- Skin ulcers
- Chronic venous insufficiency, where the veins in the legs struggle to return blood to the heart, leading to poor circulation
So, are varicose veins dangerous? Not always, but it’s important to be aware that they can become dangerous in certain situations and to monitor your vein health. Let’s expand on some of the potential complications of untreated varicose veins.
Bleeding Veins
Varicose veins have a weakened structure and are prone to rupture, which can lead to bleeding. This becomes more likely when venous insufficiency causes high blood pressure, causing additional stress. Though varicose veins occur more frequently in women, both men and women are equally at risk for bleeding varicose veins[2].
When varicose veins rupture, it typically happens in one of two ways:
- Pressure from the enlarged vein causes the fragile, overlying skin to break down, exposing the vein, which leads to rupture[3]. Once the skin is broken, an open wound (a venous ulcer) develops[3]. The skin around the ruptured vein becomes hardened and becomes dark-colored due to leakage and breakdown of blood cells[3].
- An existing venous ulcer worsens, eroding a surrounding varicose vein and causing it to rupture[2].
Ruptured varicose veins can be life-threatening, particularly for the elderly or anyone who suffers from dementia, is socially isolated, has restricted mobility, or has suffered a recent trauma[3].
Individuals with varicose veins who also have cardiovascular disease and use blood thinners are at increased risk for severe blood loss when veins rupture[2]. A varicose vein that is located over a bony area, such as a knee or ankle bone, may also be more prone to rupturing and bleeding[2]. Additionally, excess alcohol consumption dilates blood vessels and can complicate bleeding varicose veins by increasing the speed of blood loss[2].
Deep Vein Thrombosis
Deep vein thrombosis (DVT) is a serious complication of varicose veins in which sluggish, turbulent blood flow triggers the formation of a blood clot. Symptoms of DVT include swelling, warmth, or pain in the affected leg.
The risk for DVT is slightly higher among men than women[4]. Risk is also higher in the elderly, increasing rapidly after age 45, and elderly patients with DVT are more likely to experience complications.
Additionally, certain ethnic groups are more prone to developing DVT, with rates highest among African Americans and lowest among Asians and Hispanics[4]. Other risk factors include being overweight or obese, undergoing surgery or being hospitalized, having trauma to the legs, pregnancy, use of oral contraceptives, using post-menopause hormone replacement therapy, and long trips involving lengthy transportation[4].
Four major complications arise from DVT:
- Post-Thrombotic Syndrome (PTS): This is the most common complication of DVT and is thought to occur from increased venous blood pressure[5]. PTS occurs in up to 50% of DVT patients[6]. Symptoms include leg pain, swelling, redness, and sensations of heaviness and fatigue in the legs[5]. Symptoms can be constant or intermittent and tend to worsen with standing or walking. They improve with rest and elevation of the legs.
- Pulmonary Embolism (PE): DVT can become fatal if a blood clot travels to the lungs, which is known as a PE. This can be difficult to detect in the early stages, and, as a result, the risk of death from pulmonary embolism is significant, ranging from 10% to 30%[4].
- Recurrence: DVT can develop into a chronic condition with recurrence rates of 5% to 7% per year[4]. The risk of recurrence is higher in those who are elderly or obese, and men are reportedly 60% more likely to experience recurrence than women[4]. The risk also increases if the original clot is higher up in the leg, if the original clot develops into a PE, or if any portion of the blood clot remains after treatment[4].
- Increased Bleeding: Blood thinners are used to treat and manage DVT, and this increases the risk of excessive bleeding.
Venous Ulcers
Venous hypertension causes fluid and blood cells to leak from the veins, which causes swelling, pressure, and inflammation in surrounding tissues and starves the skin of oxygen. Eventually, the skin breaks down, resulting in open wounds called venous ulcers.
Advanced age increases risk, with 4% of U.S. adults over age 65 suffering from venous ulcers[7]. Other risk factors include a family history of varicose veins, being overweight or obese, being sedentary, or having multiple pregnancies[7].
Venous ulcers are slow and costly to heal, taking many months and thousands of dollars in additional medical expenses as well as lost workdays and productivity[7]. They can also develop skin cancer, adding to their danger and the need to address them as quickly as possible[7].
Lipodermatosclerosis
This painful condition occurs when the layer of fat directly below the skin becomes inflamed, causing swelling, redness, and hardening[8]. Women are at greater risk for developing lipodermatosclerosis (LDS) than men, potentially because estrogen plays a role[9]. Excess weight is also another major risk factor, with about 2/3 of instances occurring in obese patients[9].
As LDS progresses, the skin around the ankles contracts and tightens. This causes the leg to develop a characteristic appearance described as that of an inverted champagne bottle.
Venous ulcers may develop in LDS due to the hardening and weakening of the skin. Additionally, small blanched areas of scar tissue may arise on the lower leg or foot due to poor blood supply and slow healing[8].
In the initial stages of LDS, a type of blood thinner that breaks down the clotting protein fibrin may be prescribed[10]. Steroids may also be recommended[10]. Chronic LDS is usually managed conservatively with compression stockings or compression wraps[10].
When to Seek Varicose Vein Treatment
It’s a good idea to seek varicose vein treatment when your symptoms are interfering with your ability to engage in daily activities, you’re experiencing complications from them, or they’re affecting your overall quality of life. If you’re wondering when varicose veins are dangerous, it’s always best to practice caution and reach out.
For instance, consult your healthcare provider if you have persistent pain, swelling, heaviness, or discomfort in your legs. If you notice changes in your skin, such as ulcers or bleeding from the veins, it’s important to seek medical attention right away.
Individuals who have a family history of varicose veins, are pregnant, or have a history of blood clots should also consider seeking professional guidance to prevent potential complications. Early intervention can prevent varicose veins from progressing and help reduce the risk of associated health issues.
There are things you can do to manage mild discomfort at home, but it’s important to pay attention to your symptoms and seek medical care if concerned. A vein specialist can provide a comprehensive exam and provide personalized recommendations, including an appropriate treatment plan tailored to your needs.
Empire Vein & Vascular Specialists provide simple in-office procedures that can resolve your varicose vein problems and significantly decrease your risk of complications. We are the top provider of VenaSeal®, the leading outpatient varicose vein treatment in the USA. All of our physicians are board-certified vascular surgeons who specialize in helping people like you.
To learn about these treatments, schedule a free consultation with our team by calling 1-800-827-4267.
References
- What to Know About Varicose Veins. Available from:
https://health.usnews.com/health-care/patient-advice/articles/what-to-know-about-varicose-veins. - Haemorrhage from varicose veins and varicose ulceration: A systematic review – Serra – 2018 – International Wound Journal – Wiley Online Library. 2022
https://onlinelibrary.wiley.com/doi/10.1111/iwj.12934 - Unusual death due to a bleeding from a varicose vein: a case report. BMC Research Notes, 2012. 5(1): p. 1-3
https://link.springer.com/article/10.1186/1756-0500-5-488 - Epidemiology and risk factors for venous thrombosis. Seminars in hematology, 2007. 44(2)
https://www.ncbi.nlm.nih.gov/pubmed/17433897 - The post-thrombotic syndrome. Hematology. American Society of Hematology. Education Program, 2016. 2016(1)
https://www.ncbi.nlm.nih.gov/pubmed/27913509 - (PDF) The Post-thrombotic Syndrome-Prevention and Treatment: VAS-European Independent Foundation in Angiology/Vascular Medicine Position Paper. 2022
https://www.researchgate.net/publication/358831551_The_Post-thrombotic_Syndrome-Prevention_and_Treatment_VAS-European_Independent_Foundation_in_AngiologyVascular_Medicine_Position_Paper - Venous Ulcers: Diagnosis and Treatment. American Family Physician, 2022. 100(5): p. 298-305
https://www.aafp.org/afp/2019/0901/p298.pdf - Lipodermatosclerosis | Genetic and Rare Diseases Information Center (GARD) an NCATS Program. 2022; Available from: https://www.ncbi.nlm.nih.gov/pubmed/.
- Lipodermatosclerosis. Dermatologic therapy, 2010. 23(4)
https://www.ncbi.nlm.nih.gov/pubmed/20666825 - Atrophie blanche | DermNet NZ. 2022; Available from:
https://dermnetnz.org/topics/atrophie-blanche.