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April 2017
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In the summer, when the temperature starts to go up, many problems related to poor circulation arise. The first to be affected are the legs, the favourite place for annoying imperfections to appear, such as varicose veins or spider veins, that is when capillaries break and cause reddy-blue reticular marks to appear. These problems are often genetic but they can get worse with high temperatures, as well as after pregnancy, weight gain and bulging of the veins due to aging.

The causes
The circulatory system of the legs, the job of which is to take blood towards the heart, can be divided into 3 subsystems:
• the superficial network, which consists of capillaries and the small and great saphenous veins (the latter is the longest vein in the body);
• the network of perforating blood vessels, which is made up of the blood vessels that connect deep veins to those in the superficial blood vessel network;
• the deep network, made up of all the veins that are located within muscles.

Blood vessel circulation in the legs depends on good functioning of the valves, which are found inside the veins, and their job is to stop blood from going back down the vein. When veins are not working properly, especially superficial ones, they tend to dilate and the opening of the valves becomes further apart and this causes a reflux and stagnation of the blood, which, in turn, causes varicose veins to develop along the lower limbs, as well as edema and localised swelling. Other factors can aggravate these symptoms, such as the heat, which can make circulation problems worse and cause pains that feel similar to cramp, a feeling of heaviness and itching. Furthermore, poor functioning of the lymphatic system, which is made up of veins, capillaries and the thoracic duct, that is the big vessel that the lymphatic veins flow into, the job of which is to bring lymph back to the blood after it has been ‘cleaned’, can make swelling and fluid stagnation worse, contributing to the formation of cellulite, as well as other things. Posture also plays an important role in good functioning of the circulatory system: staying seated for too long or, vice versa, standing up for long periods of time can encourage fluid stagnation in the limbs. One’s diet is also important: eating lots of salty food and not consuming enough fluid does not help vascularisation of tissues at all and it inhibits the removal of waste products and toxins and causes edema.

When blood vessel circulation is not working as it should, uncomfortable symptoms may occur in the legs and many superficial imperfections may appear; for instance, swelling, a feeling of heaviness, cellulite, tingling and visible capillaries are all problems that can end up affecting a person’s everyday life. However, these signs could also be signs of more complex problems in the hormonal, lymphatic and cardiovascular systems. This may be the case, for example, when varicose veins are present and are caused by dilatation and a loss of the tone in the leg veins: signs of this include heaviness in the lower limbs together with overall pain, superficial veins getting larger and swollen ankles. In more serious cases, there is a risk of developing deep vein thrombosis, haemorrhages, phlebitis, thrombosis and ulcers. 

Treatments and cures
In order to prevent or ease symptoms, the first thing to do is adopt a healthy lifestyle which involves doing regular physical activity and following a food regime that is low in salt and rich in fluids, fruit and vegetables. The consumption of red fruits should be increased in particular, such as blue berries because they help to strengthen the walls of blood vessels. Some special attention should be paid to our clothing too: it is a good idea to avoid wearing very tight clothing, clothes made of synthetic fibres and very high heels or completely flat shoes.
During work hours, when we have to stay seated for long periods of time, it is important to change position often and stretch out the legs regularly: taking a few steps every hour is enough to limit the problem. If, on the other hand, you spend most of the day standing up, it is a good idea to go on to your tiptoes every now and then to encourage the blood in the legs to go back up towards the heart. Furthermore, whenever possible, place your legs horizontally, preferably slightly raised with the help of a pillow, for example when lying in bed or sitting on the sofa.
When you have to travel for a long time in the car, it is best to take regular 'leg-saving' breaks: taking a quick walk at a service station can prevent blood from stagnating. Furthermore, when travelling long distances by plane, get up and walk up and down the aisle when possible and, when seated, do not keep the legs bent for too long periods of time.
However, given that the legs suffer more in the summer, it is precisely during this period that we have to take further precautions. In fact, those who already have circulation problems should avoid too much exposure to the sun and should take regular walks in fresh water and stay under a sun umbrella during the hottest hours of the day. It is also a good idea to apply a refreshing cream in the evenings by massaging it into the legs from the bottom upwards and concentrating on the calf and ankles zones in particular.
In more serious cases, when the symptoms are quite severe and continue even after the summer, just changing lifestyle will not be enough. At this point, the sufferer must turn to a specialist who, after carrying out tests, which may require the help of equipment such as an ecodoppler, will decide upon the best course of treatment. Fortunately, there are ever more sophisticated instruments available today that are used to treat diseases of the blood vessels in the lower limbs, and using these together with various techniques, such as medical treatments, sclerotherapy, elastocompression, skin lasering, mesotherapy and mini-invasive surgery, great results are guaranteed.
When a person suffers from actual varicose veins though, the worsening of which is usually slow but inescapable, surgery is necessary both for healing purposes and aesthetic reasons. The modern philosophy of surgical treatment involves a very sophisticated, mini invasive and personalised approach and this means that, whatever the type of surgery, recovery is quick, local anaesthetic, and conscious sedation too if required, foam sclerosis and thermal ablation procedures are used (radiotherapy, laser therapy and, very soon, vapour therapy) and treatment is selective and therefore only the affected veins are treated with microincisions, which protects the saphenous veins (this is possible in approximately 70% of surgeries using the so called 'Asval' method). This less aggressive approach significantly reduces post-surgical pain and bruising and allows surgeons to operate earlier, reducing the need to sacrifice the saphenous vein, reducing the likelihood of relapses and speeding up recovery time so that the patient can go back to doing normal day to day activities straight away.


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