Probably in the early stages of the varicose veins can represent a predominantly aesthetic problem, even if in reality always represent a functional problem.
Certainly treating them in the initial phase makes easier the task of the phlebologist and allows better results; on the other hand, there is no getting away from the common complications of the varicose disease: as thrombophlebitis, ulcers, Hypo-dermatitis post phle-syndrome.
It is not demonstrated a precise inheritance but is certainly recognized a familiarity; it is very likely that in a family in which the mother is suffering from varicose veins some of the children can submit a varicose situation and even if the father is suffering from similar pathology, then the possibilities will certainly increase.
It is useful to check with a Doppler the boys that have most chances to be affected by a disease of the veins; even if this issue affects more girls that could then discover in the course of pregnancy to be suffering from a varicose disease.
Pregnancy represents one of the main risk factors for varicose disease: the hormonal changes and the increase in volume of the uterus can determine a significant worsening of the varicose pathology, that is why the patients with this problem must be followed up at the end of gestation.
Obesity, sedentary lifestyles and the hormonal imbalance, hormone replacement therapy in menopause and a family thrombophilia are all factors that must always be kept in great consideration.
No, but each case must always be carefully evaluated through a careful history of personal and family life, on instrumental exams and blood chemistry changes; it must then be always kept in mind the importance of a hormonal therapy that many times represents a cure for gynecological pathologies and not only an object a contraceptive. It is always very important that there is a continuous exchange of views between the gynecologist and the phlebologist but this also applies to all the other problems that can affect a patient and involving the phlebologist.
Varicose veins are dilated and winding veins in which the venous pressure increases for a malfunction of the valves that fail to retain the blood, consequently instead of flowing by foot toward the heart tends to run back down.
In a certain sense yes, very often in reality the valves are not sick or absent, but it is the wall of the vein that tends to expand and therefore no longer allows the mate of the fins of the valves. The idea of replacing the valves is not new, since already many years this procedure has been using. Nowadays there are also many interventions which propose a reconstruction of the main valves.
In reality there are two pathologies that are distinct and separate even if very often you can easily find them in the same women, but also we often see women with varicose veins without capillaries, as well as women with numerous arborizations but without varicose veins. The capillaries, in the technical jargon telangiectasias represent one of the main reasons for which women come to phlepologist; are certainly in relation to hormones (progesterone and estrogens) but it is not clear with certainty the cause that determines them. It has been hypothesized a damage of the micro-circulatory system but in reality this is not certainly identified; in the majority of cases it represents only a cosmetic damage without any functional event. Obviously excluded those diseases that may submit telangiectasis in kit symptom.
I think that each case should be assessed individually. The current technology is whether surgical and sclerotherapeutic that allows to obtain excellent results both aesthetic and functional without need for general anesthesia or hospitalization and with risks almost zero; this allows to widen the field of indications also to patients that ten years ago we would have excluded for age or for associated risk factors. You should always consider the psychological implications; very often these are very young girls who heavily suffer of imperfections that afflict them, although these imperfections do not represent a functional issue, they have to be considered from the phlebologist to be possibly treated. A similar example is represented by the elderly women who increasingly often turn to phlebologist to improve the appearance of their legs and also in this case we must not underestimate the importance of a request for care. The development of techniques always more conservative and executable as day surgery allows to treat older and older patients who were once intended to medical care exclusively of a conservative type; today we can quickly resolve a problem of ulcer with a skin graft under local anesthesia or a thrombophlebitis always with an intervention under local anesthesia.
Absolutely no, the surgery should be reserved to those cases in which the situation is at a very advanced stage and there is no possibility of recovery with medical therapy and the sclerotherapy.
Also in this case, significant progress has been made as regards the pharmacological therapy; today we have at our disposal phlebotonic that give excellent results in reducing the sense of weight, burning and edema; in particular flavonoids are very effective and all those drugs that fluidify the blood.
On the contrary I think that herbal medicinal and homeopathy, cypress, blueberries, hamamelis, arnica are very active and indicated in venous disease. Lately some magazines of high scientific importance have submitted studies on the effects of some herbal medicinal, the results of the effects of Gingko biloba and Hypericum were presented and have demonstrated that the first is effective as a vasodilator and antiaggregant and the second as antidepressant. But also the herbal medicinal must be used only by specialists.
If it is correctly performed and on a patient who is well studied both as haemodynamic and as laboratory testing it presents no particular risks other than rare, of an inflammatory reaction localized or an allergic reaction. The sclerotherapy, contrary to what you think, is not absolutely painful, it requires no rest period and the contraindications are very rare.
Every two or three years are being proposed new laser that promise amazing results in the treatment of the capillaries and the small varices but the results, in reality are still very poor and decidedly lower than those obtainable with a good sclerotherapy. New drugs at our disposal can still improve the results of a sclerotherapy, as sometimes the laser can represent a good complementary method to integrate the sclerotherapy.
The elastic stockings represent, in the case of varicose veins, a very important therapeutic garrison; they are obviously required in relation to the clinical and haemodynamic situation and of the patient. There are no absolute contraindications but the phlebologist must choose the type of compression, the level of the same, the fabric and exclude the possible presence of a concomitant arteriopathy. Also in this case in recent years there has been a flourishing of elastic stockings ever more effective and more beautiful.
First of all, a correct diet which is rich in fibers and vitamin C, and a lot of attention to the weight: obesity is one of the main risk factors. You must always check the rest of the foot that represents a pump device of which the efficiency is particularly important for the wellbeing of the veins; therefore, all those shoes, very fashionable now, which do not allow to correctly flex the foot must be avoided. The ideal shoe is the classic woman moccasin with a heel of about 3 - 4 centimeters. The best advice is to walk as much as possible.
There are several factors to assess: for example, if a slim person is wearing wide boots there are no problems because it does not increase the temperature of the leg to a significant extent on the contrary in an overweight person things change as it determines an increase of the local temperature.
