Phlebologist Questions Varicose Veins

What can happen if varicose veins are left untreated?

If I don’t get my varicose veins problem treated, what repercussions can it have?

7 Answers

It will depend on the reason you have those varicose veins, to begin with. In general though as long as you wear compression stockings daily- medical grade 20-30 mm Hg preferably thigh-high, symptoms will be stable. Also, consider leg elevation when resting, foot pumps while standing for long periods, and ambulate for 30 min twice daily. Without stockings, the disease can worsen to the point of developing heaviness, fatigue, and swelling in the legs. In extreme cases, one may develop ulcers or bleeding varicose veins.
In some cases, one is just left with the existing veins and symptoms remain the same over time. In others, the veins enlarge and become more symptomatic (throbbing, aching, itching, etc). Evaluation with a vascular surgeon is very helpful to determine severity.
Treatment of varicose veins should be directed towards symptoms that you are having now, such as leg swelling, heaviness, itching, pain, bleeding, or skin damage. Any of those symptoms could develop later from the veins you currently have, but it’s also entirely possible that you won’t develop any symptoms. So, take care of them if they are causing problems now, but don’t do it to you because you are worried about developing symptoms later.
Many people live for years without issues. I have had varicose veins myself for more than 20 years and had no surgery or other therapies - i wear compression hose fairly religiously though. If you travel where you will not be able to walk for long time periods, definitely wear compression and do movements with your legs to activate calf muscles and consider taking a baby aspirin on day of travel. People with varicose veins have higher than normal risk of forming clots in the legs
Varicose veins left untreated may sometimes not cause any problems other than getting bigger and unsightly however the long-term medical consequences of venous insufficiency, which varicose veins are just a symptom, is white significant. There is an increased risk for clots, swelling of the leg, brownish discoloration of the leg, and open draining wounds that are difficult to heal.
If venous insufficiency with varicose veins is left untreated it may progress to more severe manifestations of high pressure in the venous system such as swelling of legs, hyperpigmentation or thickening of your skin or even skin breakdown with painful ulcers. It is best to get an evaluation from a professional who specializes in vascular conditions and treats veins as and when it is necessary to treat them. Not all varicose veins need to be treated.
What can happen if varicose veins are left untreated?

1. Nothing
2. Enlargement
3. Edema - swelling
4. Pain/soreness/ aching
5. Discoloration
6. Inflammation
7. Thrombosis
7. Ulceration
8. Bleeding
9. Cancer - very rarely

Therefore, evaluation by a vascular specialist is essential.

Irwin M Best, MD, MBA,FACS