General information

Q. What are varicose veins?

A. They are lumpy, swollen , tortuous veins beneath the skin

Q. What causes varicose veins?

A. they are due to a weakness of the vein wall which causes them to dilate. They are often run in the family but can be aggravated by prolonged standing or pregnancy

Q.  If I leave my varicose veins will they get worse?

A. Yes generally speaking they get worse with time if left untreated. However there is some evidence that appropriate compression hosiery can slow this down, but cannot get rid of the varicose veins.

Q. What changes can I make to my diet and lifestyle to reduce my risk of developing varicose veins?

A. You can't always prevent varicose veins from developing, but there are steps that you can take that makes developing them less likely. You can help prevent varicose veins by improving your circulation and muscle tone, for example by taking regular exercise, losing excess weight and stopping smoking. Don't wear tight-fitting clothes that can restrict your circulation and don't sit or stand still for long periods of time, particularly if you're pregnant.

Q. I have varicose veins. Does this mean I'm more likely to develop a deep vein thrombosis (DVT)?

A. The veins in your legs that can become varicose are different to the ones deep within your legs where a blood clot or deep vein thrombosis (DVT) can occur. If you have varicose veins, you do not have an increased risk of DVT in normal daily life, but this risk may increase if you have had to undergo surgery on your stomach, bones, joints, muscles or ligaments.

Symptoms

Q. What are the symptoms of varicose veins?

A. They may cause, aching, throbbing, tenderness, cramps, leg heaviness, itching, swelling and can be unsightly. Sometimes they can lead to complications.

Q. I have quite a lot of varicose veins but they do not cause me any symptoms do I have to have them treated?

A. No, if you are not bothered by what they look like and they do not cause symptoms, it is perfectly safe not to treat them surgically.

Q.  I am worried about my varicose veins causing ulcers is that true?

A. Ulcers can be caused by varicose veins but not all varicose veins cause ulcers. Ulcers are caused by “venous hypertension” which is increased pressure in the veins caused by blood pooling in the leg veins due to faulty valves. Often before ulcers break out the skin can be affected by a brown discolouration and thickening “lipodermatosclerosis.”

Q. Are varicose veins harmful?

A. No, but they can cause complications such as superficial thrombophlebitis (tenderness and redness along the vein), eczema (itchy rash), swelling around the ankle, bleeding, discolouration and thickening of the skin (lipodermatosclerosis) and sometimes even ulceration.

Treatment

Q. Can I have my varicose veins treated on the NHS?

A. Not all varicose veins qualify for treatment on the NHS . NHS treatment is often restricted to those patients in whom varicose veins have caused complications e.g. skin changes, ulcers, thrombophlebitis and bleeding.  Often, patients with unsightly varicose veins with little in the way of symptoms will not be legible for treatment on the NHS. Patients in this category can have them treated privately or can use compression stockings to control their symptoms. If you are not sure about whether you are legible ask you local doctor for advice.

Q. Can taking medicines treat varicose veins?

A. No, medications cannot treat varicose veins but can relieve some of the symptoms such aching or throbbing.

Q.  I have problems with my circulation; can I still wear compression stockings for my varicose veins?

A. It is not advisable to wear compression stockings if you have peripheral arterial disease (narrowing of your arteries in your leg). Wearing tight compression stockings in these circumstances can constrict the circulation further and cause worsening of symptoms. You need to consult a doctor before wearing stockings who will measure your ABPI (ankle brachial pressure index) to check if you have peripheral arterial disease and assess how severe it is.

Q. How do I see a specialist for my varicose veins? Under the NHS and privately?

A. A good starting point is visiting your GP. Under the NHS 'choose and book' scheme, you can choose the hospital, or clinic, where you wish to receive treatment but you are not given a choice of which surgeon. If you wish to see a private specialist you will be able to choose your surgeon. It is still advisable to get a letter of referral from your GP for private consultations.

Q. There are so many treatments available for varicose veins, how do I choose the right one for me?

A. Your specialist will be able to help you make an informed choice. The choice of treatment depends on a number of factors and depends on your individual case.

Q. Are the newer minimally invasive techniques such as laser treatment and radiofrequency ablation as effective as surgery?

A. Yes they are as effective in treating varicose veins as surgery. However since they have not been around as long as surgery we do not have as much information about long term results.

Q. Is any additional treatment necessary for patients undergoing minimally invasive treatment?

A. Usually only the main leaky vein trunk is treated which blocks off the blood flow to the lumpy veins that you can see, causing them to disappear or at least reduce in size. In most cases this is sufficient to control symptoms. However in some cases additional treatment of any remaining varicosities is necessary. This can be done by injection sclerotherapy or phlebectomies (removal of the lumpy surgically by tiny incisions over them).

Q. Can varicose veins come back after treatment?

A. Yes it not uncommon for varicose veins to return even if the treatment has been perfectly successful. This may be because other superficial veins other than the ones treated can get become swollen and enlarged. Recurrence rate following successful varicose vein treatment can be up to 30%.