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Varicose veins can be classified from stage 0 to stage 6 through ultrasound. Stage 1 is when blood vessels are visible, stage 2 if there are visible varicose veins, stage 3 if there is edema in the varicose veins, stage 4 if it is accompanied by skin diseases such as scleroder or eczema, stage 5 if there are signs of healing ulcers, and stage 6 if there are active ulcers.
Because the ulcers are itchy and skin diseases come up before they form, many people go to a dermatologist and sometimes the ulcers get worse and worse.
Varicose veins are caused by a wide variety of causes.
First of all, gender. It is reported that varicose veins are more than four times more common in women. This is because female hormones, which occur naturally in the body or are found in birth control pills, relax muscles and blood vessels. In particular, when you are pregnant, your body experiences hormonal changes, which increases the amount of blood in your body and your uterus gets bigger and bigger over time, which compresses the abdominal veins and makes it easier for varicose veins to occur.
The second is family history. Since varicose veins are inherited and genetic, family history is also checked when the hospital examines them.
The third is lifestyle. If you work standing for a long time, sit for a long time, or if you are overweight or lack of exercise, it is easy for blood to accumulate, and varicose veins will also appear. In fact, Japanese textbooks, which developed the overall medical care for varicose veins earlier than ours, explain that varicose veins occur later in many occupations that stand in a confined space, such as medical workers and sushi craftsmen.
The fourth is age. As age increases, blood vessels also age, and the occurrence of varicose veins increases.
The fifth cause is trauma. Varicose veins can occur when you have been severely injured in the past. In particular, severe fractures of the legs or pelvis can damage the veins or arteries around the muscles, which can lead to vascular malformations, or it can also cause varicose veins due to incorrect connections.
The last is a cardiac arrhythmia abnormality. Although it is not a common cause, it can be caused by a tumor or underlying disease in the body that causes blood clots to form and blockage of deep arrhythmias, resulting in secondary varicose veins. It can also occur if you have heart disease or liver disease.
If there are more than 3 of the following, varicose veins should be suspected.
□ Bulging blood vessels on the legs like worms
□ Less when waking up, but increased discomfort in the legs when walking
□ Pain in the calf area in the afternoon~evening
□ Lying down or elevating your legs relieves heaviness or pain
□ On days after a lot of walking, calf muscle cramps occur at night
□ The skin color of the legs changes to brown or black
□ Formation of skin ulcers around the inner peach bone
□ Discomfort in the legs, pelvis, and lower back that does not improve even with physical therapy or oriental medicine treatment for herniated discs
There are many ways to treat varicose veins.
First of all, conservative treatment. Conservative treatment is usually performed for the purpose of alleviating the symptoms of patients with mild disease stage 0~1 or slowing down the progression of the disease. You can think of it as a kind of lifestyle correction therapy. Exercise regularly, stretch and massage, wear medical compression stockings as needed, and prescribe vinifera-based medications.
However, if the symptoms do not improve despite these conservative treatments, surgery or procedural treatment is necessary. In particular, it is a common principle to completely remove the underlying blood vessels inside and proceed with fundamental treatment to prevent recurrence.
Among the fundamental treatments, surgical treatment is a traditional method that involves the removal of the problematic superficial veins in batches through instruments. The advantage of surgical treatment is that it is the only one of the treatments for each generation that is covered by health insurance and the root junction can be removed. However, since the blood vessels are removed by making an incision in the skin, it is inconvenient to use a buffer due to the need for pain and wound recovery periods, as well as the possibility of damage to the surrounding nerves and ligaments.
Then there's thermal therapy, which belongs to the second generation. The first is a method of inducing fibrosis after removing the blood vessel wall through a laser. Thermal treatment compensates for the shortcomings of first-generation treatments, resulting in less pain, scarring, and bruising, and the advantage of less likely recurrence. It also causes less damage to the surrounding tissues, so it's safe to use. However, the disadvantages include thermal damage, which limits the scope of treatment, and fibrosis can cause bandages to form and cause pulling. Cushions are also used to reduce heat damage.
The second is the method of using high frequencies. Radiofrequency therapy causes less pain and scarring than laser, so you can return to your daily activities faster. Compared to lasers, it has the advantage of being able to treat larger blood vessels. However, radiofrequency therapy also shares the disadvantages of laser treatment, as it eventually uses thermal energy.
Then there is the third generation of non-thermal treatment. The first is percutaneous mechanochemical vein occlusion. Thermal treatment is safer than surgical treatment, but there is a risk that thermal energy damage may occur, but percutaneous mechanochemical vein occlusion eliminates this thermal damage, making it minimally invasive and faster to recover. However, compared to the 1st and 2nd generations, the cost of treatment is higher and the drug may cause pigmentation. In addition, there are limitations in the dosage and concentration of the drug, so it can be difficult to treat varicose veins if they are severe or spread across multiple locations. Since the drug itself is hepatotoxic, caution is required in patients with liver disease.
The second is vein occlusion using cyanoacrylate, which is widely used in recent years. Cyanoacrylate is, to put it simply, a harmless bioadhesive. Because it is a non-thermal treatment, there is less heat damage like percutaneous mechanochemical vein occlusion. And cyanoacrylate has the advantage of not having to wear medical compression stockings because the blood vessels are glued immediately after the procedure. The disadvantages are the high cost of treatment and temporary allergic reactions. It has been observed that there are a small number of cases of allergic reactions to the ingredients of the drug after an average of 2~3 weeks after the procedure.
It seems safe to think that the way to prevent varicose veins is prevention and care before and after treatment.
First of all, it's a good idea to avoid standing or sitting for long periods of time. If you stay in the same position for a long time, your blood will stagnate, so you need to move your legs frequently. Regular exercise such as swimming, walking, or cycling is recommended, but strenuous exercise that puts a lot of pressure on the abdomen or lower body can cause varicose veins.
Do you often go to the sauna or steam room? Some people think that entering hot water relieves varicose veins, but it is quite the opposite. Heating up the body causes the blood vessels to dilate excessively and increase intravenous pressure, so it is best to avoid excessive saunas, steam rooms, and half-body baths.
It is also recommended that you keep your legs above your heart level when resting or sleeping. Keeping it around pillow level will help blood circulation and reduce swelling.
Avoid tight-fitting clothing, boots, stockings, and high heels. Some of you may be wondering about the difference between these clothes and medical compression stockings worn after varicose vein treatment. In the case of medical compression stockings, the pressure on the ankles, calves, and thighs is different and can help blood circulation, while in the case of leggings and boots, the pressure is uniformly tightened on the legs, which can be considered to hinder blood circulation.
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