Skin breakdown can be a complication of varicose veins


A small ulcer on his ankle originally alerted Doug Jones to a potentially serious problem.

man's legsAs a clinical fellow performing surgeries and procedures in Beth Israel Deaconess Medical Center’s Division of Vascular and Endovascular Surgery, Jones was spending eight to 12 hours a day on his feet when he began experiencing pain, swelling and itching in his legs. It was then that he realized that the skin ulcer he had experienced years before was probably related to venous disease.

“When I was growing up, my mother had varicose veins,” says Jones. “Then when I was in college, I began experiencing slight bulging in the veins in my legs and then noticed the skin breakdown on my ankle. The skin ulcer eventually healed, but it took a long time.”

When problems began recurring last year, Jones knew that varicose veins were the likely problem.

“I tried wearing compression stockings when I could, but my legs were still itching and aching at the end of the day,” he remembers.

Concerned that the situation was not going to improve with just conservative measures, Jones talked with his colleagues in the CardioVascular Institute at BIDMC and decided to undergo a radiofrequency ablation procedure to treat the varicose veins and try to avoid future problems.

How Venous Ulcers Develop

"Venous leg ulcers take a long time to develop,” explains 

Allen Hamdan, MD, Vascular Surgery  (right), Medical Director of the Vein Care Program in the Division of Vascular and Endovascular Surgery.

The problem begins when varicose veins — which have broken valves that don’t close properly — become enlarged and cause blood to pool. This pooling causes swelling in the ankles and can lead to changes in the skin characterized by a brown discoloration called hyperpigmentation.

A skin ulcer can develop when a tiny scratch or nick causes the affected skin to open. As the skin continues to break down, an ulcer or sore develops.

“These ulcers affect a small percentage of patients with varicose veins and they don’t typically resolve on their own,” adds Hamdan, also an Associate Professor of Surgery at Harvard Medical School. “As Dr. Jones recognized, treatment of his underlying varicose veins was necessary to prevent the ulcer from recurring.”

Jones’ experience highlights several important, but often overlooked facts about varicose veins:

  • Procedures to correct varicose veins are not just for cosmetic purposes — they can prevent potentially serious complications from developing.
  • Varicose veins affect both men and women of all ages.
  • More than half of all people with varicose veins have a family history of the condition.

Radiofrequency Ablation

Before making a final treatment decision, Jones underwent ultrasound imaging in the CVI’s Vascular Laboratory.

“Ultrasound enables us to carefully view both deep and superficial veins, to confirm the problem and determine treatment strategy,” says Hamdan.

The radiofrequency ablation procedure for treating varicose veins is completely percutaneous, requiring no surgical incisions and performed through the skin by way of a catheter.

“This procedure has really revolutionized the way we treat patients with varicose veins,” says Dr. Hamdan. “The recovery time is much shorter, making it an option for patients of all ages. Patients can be much more comfortable and be protected against infections and open wounds on the legs.”

Jones was back at work right away and, several weeks after the procedure, reported that the end-of-day swelling, aching and itchiness had subsided: “I’m glad I underwent the treatment.”

  • Learn more about venous leg ulcers, symptoms and treatments for varicose veins at bidmc.org/veins.
  • Make an appointment with a vein-care specialist: 617-632-9959

Above content provided by the CardioVascular Institute at Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.

July 2017