It's NOT just women who get varicose veins: Look at your other half's legs - you may be in for a shock

By John Mcentee for the Daily Mail

Published: 20:06 EDT, 7 January 2013 | Updated: 20:06 EDT, 7 January 2013

For years varicose veins have been the scourge of middle-aged women.

But now some experts say the problem is just as common in men — the only difference is that they are worse at seeking help.

‘Everyone used to think that more women got varicose veins than men,’ says consultant vascular surgeon Mark Whiteley.

Varicose veins are most common in the legs and feet because the veins there are under the greatest pressure from standing and walking

‘That’s because all the older text books say there is a one-in-seven or one-in-five men-to-women ratio. But the reality is different.’

Mr Whiteley speaks from professional and personal experience — he, too, suffers from varicose veins, but only realised after his then 15-year-old daughter Emily pointed at his right leg and asked: ‘Dad, what on earth is that?’ ‘That’ was the bulging blue trail of a varicose vein.

The discovery was more than ironic, as Mr Whiteley specialises in the condition at his clinic in Surrey — and performed the first keyhole surgery on varicose veins in the UK, in March 1999.

He says: ‘There I was on the beach, enjoying my summer holidays, and I discovered I had varicose veins. I’d never noticed them before. Like most men I hadn’t looked.

‘What is even worse is that in the five years since, I have yet to get them done. But I have promised to get them treated by a colleague in the next few weeks.’

While female celebrities including Emma Thompson, Ulrika Jonsson and Britney Spears have made no secret of their varicose veins, Mr Whiteley’s attitude sums up the reaction of many men who develop them.

‘Unfortunately, men generally do not tend to go to the doctor,’ he says.

‘If they have a problem, they tend to go and have a pint, whereas women will talk to friends, then go to the doctor.

'The reason we used to think that more women got varicose veins was simply because they went to see their doctor.’

While Mr Whiteley believes the problem is equally divided between men and women, a study published in the BMJ journal in 1999 suggests, in fact, more men are affected.

In a group of 699 men and 867 women aged 18-64, 40 per cent of men had varicose veins compared with 32 per cent of the women.

However, the men were more likely to have a mild form.

There is some dispute over the percentages involved, but most experts agree that a significant number of men get the condition.

Eddie Chaloner, a consultant vascular surgeon at The Blackheath Hospital, South-East London, says: ‘Generally speaking, around 40 per cent of women will get some sort of problem with their veins at some point in their life, whereas 25  per cent of men will. That’s one in four men, which is a lot.’

Men with varicose veins generally do not tend to go to the doctor

With women the trigger is often pregnancy, because of the extra weight and hormones.

The female hormone progesterone, for instance, relaxes vein walls to allow a greater blood flow, which can damage the valves that control that flow.

Mr Chaloner says: ‘There is no particular risk factor for varicose veins in men.

'What we do know is that there’s a gene involved in valve formation, so the condition is often simply hereditary.’

Whatever the cause, the weakened valves allow the blood to flow backwards down the leg, where it collects or ‘pools’ in the vein.

Initially this causes aching, swelling and itching but eventually the vein becomes enlarged.

These blue or purple-looking varicose veins can bleed or even lead to the formation of clots.

In some cases, the blood pools in the skin around the ankles, where it can cause swelling, itching, aching, red or brown ‘stains’ and eventually leg ulcers.

Varicose veins are most common in the legs and feet because the veins there are under the greatest pressure from standing and walking.

And the blood has to struggle against the effects of gravity to return to the heart.

Mr Whiteley says many of the men he treats have more severe problems than women.

‘This is because they’ve had them longer. They tend to wait until they are getting bleeding or clots.’

Mr Chaloner adds: ‘Women will come as soon as they see a problem. They tend to seek help when the problem is cosmetic, whereas men come along only when it hurts. They don’t worry so much if it’s unsightly.’

However, the longer the varicose veins are left, the more likely it is that complications will develop.

‘They get bigger and start causing skin damage,’ says Mr Whiteley.

‘If the veins get scratched, they bleed profusely as they are full of blood. This can be stopped by lying down and lifting up the leg in the short-term, and treating the vein to stop it happening again in the long-term.’

Mr Whiteley believes up to 40  per cent of the public have varicose veins, but many people are unaware of them.

He says: ‘It is easy to check for visible veins — you can usually see big lumpy veins on the leg.’

But there are also ‘hidden’ varicose veins, as he calls them.

‘The tell-tale signs are if your legs ache when you are standing but get better when you sit down.

‘When people think they have varicose veins or hidden varicose veins they need to have a venous duplex ultrasound scan that shows which valves have failed.’

However, these days it is hard to get treatment for unsightly varicose veins on the NHS.

‘Basically, the NHS sticks to what used to be called the Derbyshire Protocol, which means if you haven’t got clots, bleeding or a leg ulcer then you are unlikely to get an operation funded on the NHS,’ says Mr Whiteley.

‘Most medical insurers are starting to say the same thing. It means they don’t fix the varicose when they are easy to fix.

‘People have to have complications to be treated even privately on insurance.

‘The Government is always saying they want to prevent things, but this isn’t what’s happening in the case of varicose veins.

'The big story is that unless you pay to have them treated, you are probably not going to get them done.’