Should I Have My Varicose Veins Treated?

posted in: Varicose Veins

Varicose veins are more than just a cosmetic concern. These twisted, enlarged veins, most commonly appearing in the legs and feet, signal an underlying vascular condition that, for many, can lead to discomfort and potential health complications. In the UK, a significant portion of the adult population grapples with varicose veins, prompting questions about the necessity and benefits of treatment.

Varicose veins occur when veins become overfilled with blood, causing them to enlarge. Usually, one-way valves in veins keep blood flowing towards the heart, but when these valves fail or become weak, blood can accumulate in the veins, leading to varicosities. Symptoms often extend beyond the visible signs, including aching pain, feelings of heaviness, itching, and swelling in the affected limbs. For some, these symptoms can be merely a nuisance, but for others, they signify a considerable decline in quality of life.

The importance of treatment for varicose veins lies in alleviating these symptoms and preventing more severe complications, such as leg ulcers, bleeding, and deep vein thrombosis. In the context of the UK’s healthcare system, the National Health Service (NHS) provides guidelines and treatment pathways for those suffering from varicose veins.

Deciding whether to undergo treatment for varicose veins involves carefully considering various factors, including the severity of symptoms, the potential for complications, and the impact on an individual’s daily life and well-being. The NHS offers a range of treatment options, from conservative measures like compression stockings and lifestyle changes to more invasive procedures such as sclerotherapy, laser treatments, and surgery.

Should I Have My Varicose Veins Treated? - Vein Solutions

Varicose Veins

Varicose veins are enlarged, twisted veins commonly appearing beneath the skin’s surface, especially in the legs. Unlike arteries, which transport blood from the heart to the rest of the body, veins carry blood back to the heart. Varicose veins develop when the valves in the veins that regulate blood flow weaken, causing blood to pool and veins to enlarge. This condition differs from spider veins, smaller, thread-like veins visible under the skin’s surface, often red or blue. While spider veins are primarily a cosmetic concern, varicose veins can lead to discomfort and more severe health issues.

Common symptoms associated with varicose veins include aching pain, a sensation of heaviness in the legs, swelling, and skin discolouration around the affected veins. These symptoms can worsen over time, particularly after prolonged standing or sitting, leading to increased discomfort and impacting daily activities.

Causes and Risk Factors

The development of varicose veins is influenced by several factors, with genetics playing a significant role. If family members have varicose veins, the likelihood of developing them increases. Other risk factors include:

The risk increases with age due to wear and tear on the valves in the veins.

Women are more likely to develop varicose veins, partly due to hormonal changes during pregnancy, premenstrual, or menopause, which can relax vein walls.

The increased volume of blood in the body during pregnancy can cause veins to enlarge. The expanding uterus also puts pressure on the veins.

Excess weight puts additional pressure on veins, contributing to varicose veins.

Standing or sitting for prolonged periods can force veins to work harder to pump blood to the heart, leading to varicose veins.


Varicose veins are a common condition in the UK, affecting an estimated 30% of the adult population at some point in their lives. This prevalence puts a significant demand on healthcare resources, with thousands of treatments performed annually under the NHS. The condition impacts individual health and quality of life. It represents a considerable workload for healthcare providers, necessitating efficient management and treatment strategies to mitigate its effects on patients and the NHS.

Managing varicose veins represents a notable challenge for the NHS, given their high prevalence and the potential for complications. Treatment strategies range from conservative measures, such as compression therapy and lifestyle changes, to more advanced procedures like endothermal ablation, sclerotherapy, and surgery. The NHS prioritises treatments based on clinical need, symptom severity, and potential complications, striving to allocate resources efficiently while ensuring patients receive appropriate care.


Diagnosis and When to Seek Treatment

Identifying when to seek medical advice for varicose veins is crucial for effective management and treatment. Symptoms that should prompt a visit to a General Practitioner (GP) or a vascular specialist include:

  • Persistent pain, swelling, or heavy feelings in the legs, especially after standing or sitting for long periods.
  • Skin changes include discolouration or thickening around the veins.
  • The formation of ulcers or open sores on the skin near varicose veins, indicating severe vascular problems.
  • Bleeding from or near varicose veins.
  • A sudden swelling or severe pain in the leg, which could suggest a blood clot.

The NHS recommends that anyone experiencing discomfort or concern about the appearance of their veins consult with a healthcare professional to assess the need for further investigation or treatment.

The NHS provides clear guidelines for the referral and treatment of varicose veins. Referrals for specialist assessment are typically based on symptom severity, complications, and the impact on quality of life. The NHS prioritises therapy for individuals experiencing symptoms that significantly affect their daily activities or those at risk of complications, such as skin changes or ulcers.

Diagnostic Tests

The next step is often diagnostic testing to confirm the presence and severity of varicose veins. The primary diagnostic tool is a Doppler Ultrasound scan, a non-invasive test that uses high-frequency sound waves to create images of the veins in the legs. This scan helps assess the blood flow and identifies any malfunctioning valves contributing to varicose veins. Other tests might include a Color Duplex Ultrasound scan, which provides detailed images of the vein structure and blood flow, helping to plan effective treatment.

Assessment Criteria

To be eligible for treatment on the NHS, patients must meet specific criteria, which include:

  • Experiencing symptoms such as pain, swelling, or skin changes due to varicose veins.
  • Having complications from varicose veins, such as bleeding, venous ulcers, or thrombophlebitis (vein inflammation).
  • Having previously tried conservative measures, such as wearing compression stockings, without sufficient improvement.

These criteria ensure that NHS resources are allocated to those most in need of treatment, focusing on alleviating symptoms and preventing complications.

Private Care

Individuals not meeting the NHS criteria for treatment still have options. Many turn to private healthcare for cosmetic treatments or for interventions that might not be covered under NHS guidelines. Private treatment allows access to the same range of procedures, from laser therapy and sclerotherapy to surgery, albeit at a personal cost. Additionally, those not eligible for NHS treatment are encouraged to continue with conservative management strategies, such as exercise, weight management, and compression stockings, which can significantly alleviate symptoms and improve quality of life.


Treatment Options

Non-surgical Treatments

Lifestyle Changes:
Critical non-surgical interventions include regular exercise to improve blood circulation in the legs, weight management to reduce pressure on leg veins, and elevating the legs when resting to aid venous return. These changes can alleviate symptoms and prevent further deterioration of varicose veins.

Compression Stockings:
Wearing compression stockings is a common first-line treatment. They apply gentle pressure to the legs, helping veins and leg muscles move blood more efficiently. The benefits include reduced swelling, discomfort, and risk of ulcers. However, limitations exist; they may not prevent varicose veins from worsening over time and can be uncomfortable, especially in warm weather.

Surgical and Minimally Invasive Treatments

Endothermal Ablation:
This involves using heat from radiofrequency or lasers to seal affected veins. It’s a minimally invasive procedure preferred by the NHS for its high success rates, minimal recovery time, and reduced risk of complications compared to traditional surgery.

This treatment involves injecting a special foam into small to medium-sized varicose veins, causing them to scar and close. This method is effective for treating surface veins but may require multiple sessions.

Laser Treatments:
For smaller varicose veins and spider veins, laser treatments can be effective. They involve sending intense bursts of light into the vein, which makes the vein slowly fade and disappear. No incisions or needles are used.

Conventional Surgery:
Also known as ligation and stripping, this is usually reserved for the most prominent varicose veins. The procedure involves tying off the vein before removing it through small incisions. This treatment is less commonly performed due to the availability of less invasive options but is still an option for severe cases.

Latest Advances in Treatment

The UK’s NHS continuously adopts new technologies and methods for treating varicose veins, focusing on improving patient outcomes and recovery times. Innovations such as cyanoacrylate glue embolisation (a type of medical adhesive used to close off varicose veins) and mechanochemical ablation (a combination of mechanical and chemical methods to close veins) represent the forefront of varicose vein treatment, offering alternatives to traditional procedures with the potential for fewer side effects and quicker recovery periods.

Comparing Costs

Treatment costs can vary significantly between the NHS and private healthcare providers. The NHS provides varicose vein treatments free at the point of use for eligible patients, focusing on those with significant symptoms or complications. In contrast, private treatment costs depend on the specific procedure and provider, with prices ranging widely. Private healthcare may offer faster access to treatment and options for procedures unavailable on the NHS, such as cosmetic treatments for spider veins.


Risks and Considerations

Treating varicose veins, like any medical procedure, carries potential risks alongside its benefits. Short-term risks may include bruising, swelling, changes in skin colouration around the treatment area, and mild discomfort. Although rare, more severe complications can occur, such as deep vein thrombosis (DVT), infection at the injection or incision sites, and nerve damage.

Long-term outcomes of varicose vein treatments are generally positive, with many patients experiencing significant relief from symptoms and improvement in the appearance of their veins. However, it’s important to note that treatment does not prevent new varicose veins from developing in the future, particularly in individuals with strong predisposing factors.

Within the UK healthcare system, complications are managed through careful patient monitoring, follow-up appointments, and, if necessary, additional treatments. The NHS provides guidelines for post-treatment care and whom to contact during complications, ensuring patients have access to the required support and interventions.

To Treat or Not to Treat

Deciding whether to undergo treatment for varicose veins is a personal decision that should be made based on several factors:

Severity of Symptoms:
Treatment may provide significant relief if varicose veins cause pain, swelling, or other discomforts that affect daily life.

Lifestyle Impact:
Consider how varicose veins affect activities, such as standing for long periods, exercising, or even choosing clothing. Treatment can improve the quality of life for those significantly impacted.

Medical Advice:
Consultation with a healthcare professional is crucial. They can assess the severity of the condition, discuss potential risks and benefits of treatment, and recommend the most appropriate options based on individual health needs.

We strongly encourage anyone considering varicose vein treatment to consult their GP or a vascular specialist. These professionals can offer expert insights, answer questions, and help navigate decision-making with informed, evidence-based advice. Additionally, the NHS and other reputable health resources provide a wealth of information on varicose veins, treatment options, and patient care guidelines, serving as valuable tools for those seeking to learn more about their condition and treatment possibilities.

While treating varicose veins may seem daunting, understanding the condition, recognising the importance of professional medical advice, and accessing reliable resources can empower individuals to make informed decisions that enhance their health and quality of life.


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