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Varicose Veins Leg Groin Distressingly Obvious

Unfortunately varicose veins leg groin area tend to be so in your face.  When you are sitting or looking in a mirror they stand out so prominently. What can be done?

They may not be causing many symptoms.  Largely because at their level there is not the same head of pressure behind them as those further down your legs. 

Varicose veins leg groin this in anterolateral vein distributionAnterolateral region varicosity

Like all forms though they will continue to extend over time.  Right down the full length of the leg.  Just following the natural tendency for progressive deterioration.

Most commonly they will track from about the middle of the front of your leg then head towards the outside as they extend to your knee. 

From there they can head to the front or back of your lower leg.  Or both.

In spite of the relative lack of pressure in them, they are often large.

From one aspect their position is fortunate. 

They can be covered with regular day to day clothes.  On the other hand more intimate clothing and situations will reveal them.

Where do varicose veins leg groin arise from?

Anterolateral Vein Distribution

The most common are those related to the anterolateral vein (otherwise known as the anterior accessory vein the thigh).

This is really a tributary to your long saphenous vein.  Often it connects with this vessel just before the saphenous vein empties into the deep vein at the groin crease.

The surface branches that show can arise very close to this area.  Or at times up to halfway down the thigh.

Sometimes the surface branch heads more to the inner thigh joining with a damaged segment of the long saphenous vein about the mid thigh.

Varicose veins leg groin with anatomic diagram of draining veinsConnections draining skin veins near top of thigh

The valves that control the topmost section at the groin connection with the deep vein can become involved.  Then the surface veins tend to become much bigger.

Small Connections Varicose Veins Leg Groin

Similar to the anterolateral vein there are a few other vessels connecting with the long saphenous vein at the top of your thigh.  They drain local sections of skin circulation of the groin region.

One I have mentioned already, the superficial external pudendal vein, is associated with labial veins.  These can extend into the skin of the groin as well.

Two others, the superficial epigastric and the superior circumflex iliac vein, tend to both drain the skin in your groin right at the front.

The superficial epigastric vein drains the area just below the groin crease while the other drains the region above.

As well as this there can be other smaller variant individual vessels associated with varicose veins leg groin presentations.

Determining Causes

Due to the variability of your possible underlying problems it is essential to use ultrasound imaging to determine the best way to manage your particular problem.

Treatment Aims

Only the damaged or malfunctioning segments need treating. 

But these underlying sections, as with other varicose vein treatments, need to be secured or closed first to ensure the best long-term improvement.

All healthy sections can be left untouched to continue the work they have been doing to maintain your circulation up until then.

A Common Problem

More often than in other areas varicose veins arising from the groin can involve trapped blood becoming lodged as they close down.

As your body naturally breaks down and remodels the trapped blood areas it can leave a brown staining where the vein was. 

This has been shown to be haemosiderin - basically iron left from when your red blood cells are broken down.  The body leaves it there to be available for making new red cells and in other functions requiring iron.

Once the blood has cleared two thirds of people will see the ongoing brown pigment disappear by one year.  The remaining third will go before the end of the second year.

I usually offer to release any trapped blood to minimise this nuisance and to speed up the improvement.

A Surgical Approach

For this reason operators with a surgical bent will often recommend treating these surface varicose veins leg groin with what is known as local avulsions. 

This involves nicking the skin above each vein and pulling out as much of each one as possible.  Then a further stab incision is made to access the next portion.

Their reasoning is that they wish to avoid trapped blood in the otherwise intact veins.


However each avulsion involves a small stab incision.  That can leave a small scar.  There is a risk of infection.  Bruising does occur. 

Any surgical incision causes the body to manufacture new vessels about the wound to repair the interrupted local circulation.  Such repair vessels can result in secondary visible veins which continue to concern people. 

Such skin wounds can also interrupt the underlying lymphatic circulation. 

Although usually rare for simple avulsions the body responds to this with weeping, fluid collections and, at its worst, swelling further down the leg.  Such consequnces can be difficult to settle and may result in long term problems.

Because varicose veins leg groin are so “in your face” it is best to achieve a long term outcome that gives you no ongoing adverse visual changes.

I will be covering more on these considerations in sections on your options for varicose vein treatments.

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