Varicose Veins: Natural Solutions for Better Circulation

What are varicose veins, and how do they form?

Varicose veins are permanent and irreversible dilations of the superficial veins in the lower extremities, resulting from the failure of venous valves and the loss of parietal tone. They correspond to stage C2 of the CEAP (Clinical-Etiology-Anatomy-Pathophysiology) classification, which ranges from C0 (asymptomatic) to C6 (active venous ulcer). A vascular evaluation is essential as soon as symptomatic varicose veins appear. Venous care products are available in the “heavy legs ” and “venous circulation ” sections of the store.

• Pathophysiological mechanism: venous valve insufficiency → retrograde blood reflux → chronic venous hypertension → progressive dilation of the venous walls → self-perpetuating vicious cycle
• Clinical forms: trunk varicose veins (great and small saphenous veins—dilatations > 3 mm, visible and tortuous) — reticular varicose veins (1–3 mm — blue, subcutaneous) — telangiectasias or spider veins (< 1 mm — red or purplish “spider veins”)
• Risk factors: heredity (primary factor—risk × 3 if both parents are affected)—female gender (hormones that relax the vein walls) — pregnancy (iliofemoral compression + progesterone + hypervolemia) — prolonged standing — overweight (abdominal venous hypertension) — age — smoking (Tobacco Info Service: 3989)
• Distinguishing varicose veins from heavy legs: varicose veins are an objective anatomical finding (visible lesion) — heavy legs are a subjective symptom — the two often coexist but not always

What are the complications of varicose veins, and when should you seek emergency care?

• Superficial thrombophlebitis: inflammation and thrombosis of a varicose vein — a red, warm, painful cord along the course of the varicose vein — risk of spreading to the saphenofemoral junction → phlebitis (DVT) — seek urgent medical attention
• Venous ulcer (CEAP C6): chronic ankle wound resulting from severe and prolonged venous hypertension—preceded by ochre dermatitis, hyperpigmentation, and lipodermatosclerosis—specialized care (nurse + angiologist + physical therapy)
• Varicose vein rupture: external bleeding due to rupture of a superficial varicose vein—immediate direct pressure and elevation of the limb → call 15 if bleeding is uncontrolled
• Essential vascular evaluation: venous Doppler ultrasound (reflux mapping—saphenous junctions, incompetent segments)—performed by an angiologist—guides treatment selection

Medical treatments and natural supplements for varicose veins

• Compression stockings: Class 2 or 3 (20–36 mmHg) by prescription — standard of care — put on in the morning before getting out of bed — never wear if you have lower extremity arterial disease
• Sclerotherapy: injection of a sclerosing agent (chemical solution or foam) — chemical closure of the vein — effective for reticular varicose veins and telangiectasias — multiple sessions required — performed by a vascular specialist
• Endovenous thermal techniques: endovenous laser or radiofrequency — thermocoagulation of the great saphenous vein — performed on an outpatient basis — highly effective with minimal scarring
• Surgery (stripping): removal of the great saphenous vein — indicated for large saphenous varicose veins under general or regional anesthesia
• Escin (horse chestnut): veinotonic and anti-edematous—EMA, well-established use in chronic venous insufficiency—available as a topical gel or capsules—supports venous comfort as a complement to treatments—contraindicated with anticoagulants
• Red vine: vasoprotective OPCs — strengthens vein walls — EMA — see venous circulation
• Bioflavonoids (diosmin, hesperidin): reduce capillary permeability and venous hypertension — robust clinical data in chronic venous insufficiency