Clinical features

Patients with varicose veins complain of a rather nebulous set of symptoms namely leg aches, swelling, restlessness and pain or itching over specific veins. These are difficult to quantify and correlate poorly with the visible extent and size of the varicosities, which causes a problem for health care providers who are increasingly encouraged to only intervene surgically for symptoms rather than for pure cosmesis. From the epidemiological data outlined above, it would appear that female caucasian legs are more susceptible to the skin changes brought on by venous hypertension; it would be reasonable to assume that they are also likely to genuinely suffer more symptoms from their varicose veins.

The skin changes occur in the gaiter region, between the knee and the malleoli, and may consist of venous eczema and/or lipodermatosclerosis. These are often a prelude to venous ulceration and are an indication for intervention.

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