Underlying causes: Varicose veins are not just a cosmetic problem

hat are varicose veins from a medical point of view?
Dr. Salama: The venous system consists of superficial and deep veins. The superficial veins, which we can see as varicose veins, are only part of a complex network that also includes the deep veins located in our muscles. These deep veins play a central role in transporting blood back to the heart and work with the help of valves that ensure a one-way flow against gravity. When these valves fail - a condition known as venous reflux - this leads to blood stasis, mainly affecting the superficial veins and resulting in the characteristic appearance of varicose veins. Recent medical findings have shed light on the crucial relationship between deep vein reflux and superficial varicose veins. It is now known that what appears on the surface may be symptomatic of deeper problems. Varicose veins are far from just a cosmetic problem; if left untreated they can lead to a range of health problems such as swelling, skin damage or even venous leg ulcers.

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Does elevating the legs help?
Dr. Salama: The progression of varicose veins usually worsens over time. They are not static but dynamic indicators of an underlying venous insufficiency that can extend from the superficial to the deep venous system. Recognizing this connection is critical because it emphasizes that these veins, often dismissed as merely unsightly, can have serious implications for overall vascular health.
What helps the doctor to understand the venous system better?
Dr Salama: Modern diagnostics such as colour-coded duplex sonography have revolutionized our ability to visualize and understand the venous system. It enables the identification of both superficial varicose veins and hidden varicose veins that are not immediately visible.

What helps the doctor to understand the venous system better?
Dr Salama: Modern diagnostics such as colour-coded duplex sonography have revolutionized our ability to visualize and understand the venous system. It enables the identification of both superficial varicose veins and hidden varicose veins that are not immediately visible.

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What are the treatment options for varicose veins?
Dr. Salama: Treatment has also evolved. Procedures such as endovenous thermal ablation have become the gold standard for treating the cause of varicose veins and offer a permanent solution to what was once considered irreversible. By treating the underlying venous reflux, we can prevent the deterioration of vein health and avoid potential complications. The high recurrence rate of varicose veins treated for cosmetic reasons indicates that in many cases a full diagnosis was not made at the outset. Superficial treatment without thorough investigation and treatment of the underlying venous reflux may result in temporary cosmetic improvement, but leaves the root cause untreated. Therefore, a high recurrence rate could be seen as an indicator that the initial treatment was too focused on the superficial aspects rather than being based on a comprehensive understanding of venous health. In summary, we can therefore conclude that A holistic venous proper and professional examination and evaluation is absolutely necessary prior to any cosmetic treatment of varicose veins.

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