What are varicose veins

Varicose veins are swollen, twisted veins caused by faulty valves that allow blood to collect instead of returning properly to the heart. The guide explains symptoms, risks, self-care, treatment options, recovery, effectiveness, costs, and access to NHS services.

What are varicose veins?

Varicose veins are widened veins that appear swollen and twisted and bulge out under the skin. They are very common and are usually found in the legs but can be found anywhere in the body.

Are varicose veins the same as thread veins?

No. Thread veins are abnormal veins inside the skin while varicose veins are abnormal veins below the skin.

What causes varicose veins?

Varicose veins occur when the people develop faulty valves in their veins. This stops blood in the veins flowing properly. It causes the blood to build up on the vein instead of returning to your heart.

Anyone can get varicose veins. They often occur in working-age people but they are more common in older people and those who are overweight, or spend a lot of time standing. They are also common following pregnancy although they can start while you are pregnant.

They are more likely to happen if you have had deep vein thrombosis.

Are varicose veins harmful?

Varicose veins are not usually harmful but they may get worse over several years and need treating.

A large proportion of people have symptoms such as pain which can have a large impact on their quality of life and the ability to perform routine daily tasks, including work, caring activities and leisure.

They tend to progress over time, causing irreversible skin and soft tissue damage, which can lead to ulceration. This is a very severe condition involving the development of wounds which are very hard to heal and often cause severe symptoms including pain and disability.

They are also associated with social isolation and a need for ongoing regular healthcare for months or even years. Varicose veins can be associated with acute complications including bleeding in rare cases and blood clots which on rare occasions can be severe.

Treatment has been shown to improve quality of life and is likely to reduce the development of complications in the future.

When should you see a doctor about varicose veins?

Visit your GP if your varicose veins are getting worse or if they’re painful, itching or causing your legs to swell or your skin to discolour or thicken. You should also see a doctor if you have eczema over the varicose veins, or if you experience bleeding or develop sores or ulcers.

Your GP may refer you for specialist treatment at a vascular service for example.

Who treats varicose veins?

Varicose veins are typically treated by vascular surgeons.

How can I improve the symptoms of varicose veins?

There are a few things you can do to help prevent your symptoms from worsening. These include maintaining a healthy weight and staying active by walking, for example, to improve your blood flow.

Avoid standing or sitting for too long unless your legs are raised. If you have dry or itchy skin use a moisturiser.

If you smoke, then stopping can help. Also try to avoid injuring your legs and causing bleeding.

You can also wear compression socks. These should ideally be medical grade ones provided by a doctor or nurse.

You can also ask your doctor or pharmacist about taking herbal remedies such as horse chestnut extract or MPFF (daflon) or ruscus extract.

How are varicose veins treated?

Before having treatment, you should have a scan to check your blood flow. This is known as a duplex ultrasound.

You may then be referred for treatment. Almost all treatments are routinely performed under local anaesthetic. You can usually go home on the same day and return to normal activities soon after.

Treatments include:

Endothermal ablation - This is usually the most effective treatment. It works by sealing the vein closed permanently using heat. It involves inserting a thin tube called a catheter into the vein which is then removed at the end of the procedure.
Foam sclerotherapy – This may be offered if endothermal ablation isn’t suitable for you. It involves injecting a foam-based medication in the vein. However, you may experience some pain and bruising afterwards.
Surgical stripping – This procedure has largely been replaced by more modern and effective techniques. Stripping is done under general anaesthetic and involves tying up and removing the problematic vein.

Your doctor will be able to talk you through which treatment is suitable for you and any potential complications.

What aftercare is involved in varicose vein removal?

Most people’s legs are sore after surgery.

Your leg will be tightly bandaged afterwards and you will typically need compression socks for a week or two. You may also have some pain and bruising which could make moving uncomfortable.

It is best to move as much as possible afterwards to help prevent deep vein thrombosis (DVT) but can make the legs feel more uncomfortable.

How often is treatment effective?

Success varies between patients and the outcomes they are after. Research shows a significant improvement in the overall quality of life for many patients for 10 years or longer.

Endothermal ablation successfully blocks veins in around 95% of cases while foam works in around 50% of cases.

Will I have a scar afterwards?

After surgery the leg will appear bruised for three to four weeks.

Everyone responds differently to surgery but scars tend to be small and not very noticeable.

Are there any risks or potential complications?

There is a small risk of deep vein thrombosis occurring after surgery but this can be reduced by wearing compression socks and moving around after the operation.

Although uncommon, nerve injuries can happen in 1 in 20 cases. This can lead to reduced sensation in the leg but this normally gets better and doesn’t cause long term problems.

Changes in sensations in the affected area tends to happen in around 30% of cases although it rarely causes complaints.

What costs and fees are typically involved in having varicose veins removed privately?

Costs vary but can be around £3,000 to £5,000. Speak to the clinic you want to use about costs, including possible treatment plans.

If you have private health insurance, speak to your provider about whether they will help cover the costs.

Are varicose vein treatments available on the NHS?

Varicose veins can be treated on the NHS unless they are being treated for cosmetic reasons.

However, access to treatment is a 'postcode lottery' so it depends on where you live.

Where can I get varicose veins removal near me?

Our website has a database you can search for hospitals and consultants offering vascular surgery you can see privately near you.

Please note: This link takes you to an example search result. You will need to 'Edit the search' to enter your postcode and add 'vascular surgery' to the Specialty box or 'varicose vein surgery' to the Procedure box to find results near you.

Treatment: Varicose veins