Late-stage complications of lower extremity varicose veins

Written by Zhang Xue Min
Vascular Surgery
Updated on February 04, 2025
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In the advanced stages of lower extremity varicose veins, fixed ulcers can appear above the ankle in certain specific areas. These ulcers may improve or worsen intermittently and are long-lasting. The ulcers might gradually enlarge, and pigmentation can occur around them, with the skin gradually darkening, and even turning black. If these ulcers continue to remain unhealed for an extended period, there is a possibility of cancerous changes in some individuals. Therefore, it is essential to treat lower extremity varicose veins that have progressed to ulcers, with the primary treatments being compression therapy and medication, which can also be combined with surgical treatment.

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Written by Zhang Xue Min
Vascular Surgery
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Does varicose veins hurt when pressed?

In most cases, varicose veins are not painful on touch. However, if they are painful when pressed, there are several possibilities. One is that there is an obstruction at the proximal end of the varicose vein, which is closer to the heart. This results in high local tension in the varicose vein, and pressing on it can stimulate the nerves in the surrounding membrane, causing pain on touch. Another possibility is that a blood clot has formed inside the varicose vein. The formation of blood clots is often accompanied by some sterile inflammation. When there is inflammation, symptoms can include redness, warmth, pain, and localized heat. Pressing on such an area can intensify the pain. Additionally, it is particularly important to emphasize that if varicose veins are painful on touch, one must visit a hospital and not press on them themselves. If there is a blood clot, pressing it could dislodge the clot, causing it to travel to the lungs and lead to a pulmonary embolism.

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How should young people deal with varicose veins in the lower legs?

Firstly, for young people with varicose veins in the lower leg, it is recommended to go to the hospital for an ultrasound examination to check the condition of the deep veins. Additionally, consult a professional vascular surgeon to assess the severity. If the deep veins are unobstructed and the superficial varicose veins in the lower leg are not too severe, the doctor will suggest the patient wear medical compression stockings and continue with normal life activities. If the condition is more serious or there are certain issues with the deep veins, the doctor might recommend surgery. For such patients, it is important in daily life to avoid standing or sitting for long periods, and to avoid letting the legs dangle for too long. If standing, one can also step in place appropriately, which helps alleviate varicose veins. Also, when resting, take any opportunity to elevate the legs and avoid soaking feet in hot water.

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Vascular Surgery
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Why does varicose veins sometimes feel like needle pricks?

In cases of varicose veins, the blood flow in the varicose veins is relatively slow. This blood, having undergone gas exchange, contains less oxygen and more carbon dioxide. If such blood remains in a local area for an extended period, it can potentially stimulate the nerves to some extent. Sometimes, including in varicose veins, if the blood flow pressure within these veins increases, it can also stimulate the nerves in the outer membrane of the blood vessels, leading to abnormal nerve discharges. Such incidents can manifest as brief, pin-like pain, not particularly intense, resembling the sensation of a needle prick. This condition is quite common and generally holds no special significance.

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What are the dangers of bruising due to varicose vein rupture?

When varicose veins rupture and cause bruising, if the area is small, it may be absorbed on its own. If the area is large, or if there is a certain degree of fluid accumulation, this fluid can potentially lead to infection, especially if the patient has diabetes or is using steroids, which may cause the accumulated blood to become infected. Additionally, after the absorption of a bruise, some patients may experience local pigmentation. This occurs because the iron-containing hemoglobin from metabolized red blood cells remains in the area, leading to a change in color. In severe cases, if the discoloration recurs, it may darken, and further development in some people might result in the skin becoming rougher and potentially ulcerating.

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Vascular Surgery
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Will wearing compression stockings every day help with Grade 2 varicose veins?

In the grading of varicose veins, Grade II signifies that there are obvious superficial vein tortuosity and dilation, and some may even clump together, but without edema and pigmentation. For patients with such newly developed varicose veins, persisting in wearing compression stockings can possibly lead to improvement. The main principle here is that in patients with newly developed Grade II varicose veins, the damage to the venous valves may not be severe, but rather due to venous pressure causing vein dilation, resulting in the valves not closing tightly. In such cases, if we apply external force to ensure the valves close tightly, preventing further vascular dilation and reducing the force of damage to the valves, then there is a possibility of recovery to a certain extent. If the condition has been present for a longer time, and this valvular dilation has already resulted in long-term effects, wearing compression stockings might only help in reducing the potential for further progression, but it is unlikely to improve existing varicose veins significantly.