Prof. Ramon Varcoe

If scars are left untreated, they may result in significant long-term complications. From a biological perspective, hypertrophic scars and keloids can continue to thicken and extend beyond the original wound site, leading to persistent pain, itching, and skin tightness (Bayat et al., 2003; Tziotzios et al., 2012). In functionally critical areas, such as around joints, scar contracture may occur, restricting mobility and impairing normal movement (Shih & Bayat, 2010).
From a psychological and social perspective, visible scars are strongly associated with emotional distress, lowered self-esteem, and social anxiety. Research indicates that more than one-quarter of individuals with prominent scars report a significant reduction in quality of life, with higher risks of anxiety and depression (Brown et al., 2008; Muller et al., 2022).
Over time, the biological behavior of scars tends to stabilize, making them increasingly resistant to natural remodeling. This progression may intensify both the physical burden—such as stiffness and discomfort—and the psychosocial burden, resulting in long-lasting impacts on daily life and overall well-being (Gauglitz et al., 2011).

How Varicose Veins Form: Pathophysiology Overview
Varicose veins develop as a result of chronic venous insufficiency, a condition in which the valves within the superficial veins of the lower extremities fail to function properly. Under normal conditions, these one-way valves help direct blood flow back toward the heart, working against gravity. When the valves become weakened or damaged—due to factors such as aging, genetics, hormonal changes, prolonged standing, or pregnancy—blood begins to pool in the veins.
This pooling increases venous pressure, leading to venous dilation, wall weakening, and further valve incompetence. Over time, the affected veins become visibly enlarged, twisted, and raised under the skin—typically in the legs. This condition is not only cosmetic but also pathological, as it can lead to symptoms like leg heaviness, fatigue, pain, itching, swelling, skin discoloration, and, in advanced cases, venous ulcers.