Varicose veins are very common in the population. About thirty percent of people develop varicose veins at some point in their lives. Varicose veins occur due to flaws in the valves within the veins that regulate blood flow towards the heart. When these valves fail to function properly, some of the blood heading towards the heart accumulates in pools below the venous valve. It is these pools of blood that grow into varicose veins. Varicose veins are almost never dangerous but can cause mild pain and other problems such as a person finding the varicose veins unattractive, they might feel mild pain in the legs which can also feel thin, and if the varicose veins grow, skin discoloration and hard-to-heal leg ulcers may occur. The extent of varicose veins is classified by doctors into different levels of severity.
Grades of Varicose Veins Severity
The reason for the development of a grading system for varicose veins is that since the symptoms of varicose veins vary in type and extent, it became difficult for doctors to discuss differences and similarities between different patients. To more easily understand the type and extent of a varicose vein being discussed, a system for assessing varicose veins was developed.
The levels of varicose veins are governed by assessments of the patient's skin and veins. Doctors study what the patient’s veins look like - a clinical assessment, they further examine if there are hereditary factors behind the varicose veins since heredity is the largest cause of varicose veins development. This is called etiology, which is the study of causation or causality. Then, they look at the anatomy to assess which veins are affected by the varicose veins. Finally, pathophysiology, the study of disease mechanisms, is used for the assessment. This involves examining the direction in which the blood flows and whether this flow is normal or abnormal and whether the blood flow is blocked anywhere.
This assessment system is called the CEAP system after its different parts - clinical, etiology, anatomy, and pathophysiology.
The CEAP system for classification describes what the doctor sees when an examination is conducted to find the cause of the varicose veins, where in the leg they are located, and what mechanisms are causing the problem in the vein. The CEAP system is a tool for the patient and the doctor to jointly decide if treatment for the varicose veins should be carried out.
Grades of Varicose Veins According to CEAP
The most common tool according to CEAP is the clinical part, C, where the varicose veins are divided into seven severity grades. C0 - zero C - is the lowest grade and it means that there are no traces of either spider veins or varicose veins on the legs.
The following six grades of varicose veins are as follows:
C1: There are traces of spider veins on the legs. Spider veins are superficial blood vessels that are visible through the skin without being felt. Spider veins do not cause any other symptoms for the patient.
C2: Varicose veins are present and visible on the legs.
C3: The varicose veins have caused one or both ankles to swell. The swelling is often best seen from the back of the leg rather than the front.
C4: The varicose veins have caused the skin on the lower legs to darken partially, eczema causing itching occurs where the skin is dark, and the skin tissue has become harder.
C5: At this level, there are traces of sores caused by the varicose veins that have healed, and the traces of these healed sores are visible on the skin.
C6: At the most severe grade of varicose veins, in addition to all the signs above, there are also open and weeping sores on the legs.
Before potential treatments for varicose veins, the grades of varicose veins described above are often divided into groups as a basis for assessing whether surgery of the varicose veins should be performed.
At severity grade 1 and 2, the degree of varicose veins is considered mild and treatment is therefore classified as a cosmetic procedure. Grades 3 - 6 are considered severe medical conditions and grades 4 - 6 of varicose veins also mean that treatment for these varicose veins is funded through public health insurance.
Varicose veins often develop and worsen over time. It is therefore recommended to treat them before they become serious medical conditions.
How can you affect the degree of varicose veins?
Since varicose veins are almost entirely hereditary, one might be led to believe that there is nothing one can do to influence their occurrence and development. However, this is not the case. The development and spread of varicose veins are largely affected by a person's blood circulation, which can be influenced. Good blood circulation facilitates blood flow towards the heart and compensates for the damaged valves in the veins, which both delays the onset of varicose veins and the degree of varicose veins. Existing varicose veins can also be alleviated by measures that increase blood circulation.
Some measures a person can take to increase blood circulation include losing weight, becoming more physically active, avoiding standing or sitting still entirely, elevating the legs - higher than the heart, avoiding wearing clothes that are tight over the hips and thighs, quitting smoking, and more.
At what degree of varicose veins should they be operated on?
At what degree of varicose veins it is appropriate with surgery or other treatment is something that the patient should discuss and come to a conclusion in consultation with a vascular surgeon.
There can be a multitude of reasons to remove varicose veins at all the different grades of varicose veins described above. It has, for example, become generally accepted to treat varicose veins for cosmetic reasons since varicose veins that are perceived as ugly constitute a restriction in everyday life.
The modern methods used to treat varicose veins are very gentle, can be performed under local anesthesia at a clinic outside a hospital in just an hour, and the patient can then return directly home.
