V is for varicose veins, a common disorder afflicting some 15 per cent of adults, about two thirds of them women. Varicose veins can cause aching legs, swollen feet and ankles, dry, scaly skin, ulcers in severe cases - and they definitely do not look good on the beach.

There are two principal systems of veins in the legs - the deep veins that carry about 90 per cent of the blood and the superficial veins that lie just below the skin. It is the latter that cause the problems. Swelling develops, usually on the calves and insides of the legs, when the valves that normally prevent blood from draining back down the legs become defective, causing the blood to pool. The veins become swollen, twisted and tortuous.

The condition is often hereditary, although standing around a lot doesn't help. Women tend to develop them while pregnant, because of hormonal changes as well as the extra weight they have to carry.

Varicose veins are one of the non-acute disorders for which treatment is being restricted to cut costs. Yet if left untreated, they can result in leg ulcers, may cause severe bleeding and can also be associated with deep vein thrombosis. This last may be be fatal if it causes a clot in the pulmonary artery, although the most recent research questions this.

While varicose veins in the legs are the best known type, they can occur elsewhere, notably the anus, the oesophagus, the scrotum and, during pregnancy, the vulva.

Severe varicose veins can be "stripped" from the leg by surgery: better techniques mean fewer scars from incisions and fewer stitches. Since the legs have a plentiful supply of veins, the blood is easily diverted. In less severe cases, an irritant solution is injected into the vein and the legs bandaged tightly, causing the blood to be diverted into healthier veins. Smaller veins can also be treated using laser and high-intensity light (known as photoderm) which "cook" the vein.

Varicose veins, if the tendency is hereditary, can probably not be prevented altogether, although support stockings and plenty of walking will help.

W is for wart, a contagious, harmless growth on the skin or mucous membranes. Warts are caused by a virus, human papillomavirus HPV, of which there exist at least 30 different types. These cause different types of warts at various sites, such as the hands, wrist, armpits, eyelids, feet (verrucas) or genitals: the virus that causes genital warts, HPV16, is associated with cervical cancer. The common wart often grows on sites subject to injury, such as the hands and knees, particularly in young children.

About 50 per cent of warts disappear within a year without treatment, although some can be removed, either by cryosurgery, (in which liquid nitrogen is used to freeze the wart), by special paint or plaster, or laser treatment. Genital warts may be removed by surgery or the application of the drug podophyllin, although they do tend to recur.

X is for X-linked inherited disorders in which the abnormal gene is located on the X chromosome and in which almost all those affected are males, although women may act as carriers of the genetic defect. Fragile X syndrome, the most common cause of mental retardation after Down's syndrome, is one such disorder: it affects one in 1,500 men, with one in 1,000 women being a carrier. Haemophilia, the bleeding disorder, is another.

In families affected by X-linked disorders, women can be offered DNA testing to see if they carry the faulty gene. Female carriers have a one in four chance of having an affected child. DNA testing can also determine if a male foetus is affected.

CHERRILL HICKS

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