Complications of Untreated Varicose Veins

Why do untreated varicose veins cause complications?

Varicose veins are a chronic, progressive disease. Leaking valves keep pressure high in the lower leg day after day. Over time this pressure damages the skin and tissue, slows blood flow so clots form more easily, and stretches veins so thin that they can bleed. Not everyone develops complications, and many people live with varicose veins for years without them. But the risk grows the longer the disease goes untreated.

What are the skin complications?

Swelling and chronic venous insufficiency

The first stage is usually ankle swelling. As pressure continues, the skin becomes inflamed, darkens and hardens. This is chronic venous insufficiency , which covers CEAP stages C3 to C6.

Venous eczema and pigmentation

Red, itchy, flaky skin and brown patches around the ankle are common. Scratching can break the skin and lead to infection. See skin darkening and lipodermatosclerosis .

Venous leg ulcers

Damaged skin can break down into an open sore, usually above the inner ankle. Ulcers heal slowly and often come back unless the underlying reflux is treated. LEDAS notes that once skin necrosis or ulcers develop, surgery becomes harder, so non-surgical ultrasound-guided sclerotherapy is recommended first. See venous leg ulcers .

Can a varicose vein bleed?

Yes. A varicose vein just under thin skin, often near the ankle, can bleed heavily after a small knock or scratch, sometimes in the shower. If this happens:

1. Lie down and raise the leg above the level of your heart.
2. Press firmly on the spot with a clean cloth for at least 10 minutes.
3. Seek medical care. If bleeding will not stop, call emergency services.

A vein that has bled once is likely to bleed again and should be treated.

What is superficial thrombophlebitis?

This is a blood clot with inflammation in a surface vein. The vein becomes a hard, red, warm, tender cord. It is usually not dangerous by itself, but it can extend into the deep veins, so it should be checked with ultrasound. See superficial thrombophlebitis .

What is deep vein thrombosis?

Deep vein thrombosis (DVT) is a blood clot in a deep vein, most often in the leg. Clots form more easily in the legs because they are furthest from the heart and blood pools when leg muscles are inactive. Risk factors include long periods of immobility, long flights, oral contraceptives, inherited clotting tendencies and worsening chronic venous disease.

Warning signs, usually in one leg:

• Pain or tenderness, often in the calf
• Swelling, sometimes with a dent that stays when pressed
• Warmth, and red or bluish skin
• More prominent surface veins

See deep vein thrombosis and varicose veins .

What is a pulmonary embolism?

A pulmonary embolism happens when part of a deep vein clot breaks away and blocks an artery in the lungs, reducing oxygen supply. Symptoms include sudden shortness of breath, chest pain that worsens with breathing, coughing up blood, a racing heart or fainting. It can be life-threatening and sometimes occurs without earlier warning signs. Call emergency services immediately if you notice these symptoms. See pulmonary embolism risk .

How can complications be prevented?

• Have symptomatic varicose veins checked with duplex ultrasound .
• Treat the leaking veins before skin damage develops. At LEDAS this is EVLT and sclerotherapy under local anesthesia.
• Walk daily, raise your legs when resting and avoid long periods without moving.
• Wear compression stockings when advised, especially on long flights.
• Keep up follow-up ultrasound every 1–2 years after treatment.

Complications: signs and urgency

Varicose vein complications – frequently asked questions