Varicose veins

Lots of people have swollen or ‘varicose’ veins. Varicose veins can make our legs painful, heavy, itchy and swollen. This is because of how blood is pumped around our legs.

What are varicose veins?

Blood is pumped from our heart to the rest of our body through our arteries. It returns to your heart through your veins. Your blood is then propelled back to our heart by our heart pumping and by it being pushed by our leg and foot muscles as  we walk and move our ankles.

Our veins contain one-way valves to stop the blood falling back towards your toes. These valves can become weak or damaged. When this happens, our veins become so swollen (varicose veins) that blood is forced into the tissue of our skin. The pressure in our veins becomes higher than the pressure in our arteries and the blood flows backwards and collects in the vein. This makes the vein swollen and enlarged. We might also notice that our ankles are swollen and brown staining appears on our legs.

What do varicose veins look like?

Getting your varicose veins diagnosed

If your varicose veins  are causing pain, heaviness or itching, make an appointment at your GP practice.

It might be useful to keep a diary of symptoms that include the things that improve or worsen the symptoms and the time of day that they happen.

Remember to remove any nail polish from your toenails before your appointment.

When you see the nurse or doctor, they should:

• Ask about your symptoms and how long you have had problems
• Examine your lower legs

You might also be offered some tests to check for other health problems that can affect your legs, such as diabetes and anaemia.

If your varicose veins are bleeding your GP practice should refer you to a vascular service immediately. Your GP should also refer you to a vascular service if your varicose veins  are hard and painful, or causing skin discoloration or itchiness and eczema. This might be sign of problems with the blood flow in the leg so need to be checked out .

If you are referred to a specialist vascular clinic you will probably be offered a duplex ultrasound scan to diagnose your varicose veins. This scan uses high-frequency sound waves to produce a picture of the veins and blood flow in your legs.

Treatment – what treatment will I be offered for varicose veins?

There are lots of different options for treating varicose veins. These could include the following:

Surgery for varicose veins

Varicose vein surgery is minimally invasive and works by sealing shut or removing the damaged vein so that blood is redirected to heathy veins instead. This can be done by traditional operation or by newer endovenous techniques.

Types of operations / endovenous techniques include:

Endothermal ablation

This works by applying heat to the inside of the vein to seal it shut.

Ultrasound-guided foam sclerotherapy

A chemical – called a sclerosant –  is mixed with air or another gas to produce a foam. The foam is injected into the vein and ultrasound is used to check that the foam is going to the right places. The sclerosant in the foam creates scarring inside the vein, which closes it.

Ligation and stripping

Where the varicose vein is tied off and physically removed

Compression therapy (support bandages or socks) for varicose veins

If you have no problems with the blood supply to your legs, compression therapy can be a good way of reducing your symptoms of varicose veins and swelling.

Compression therapy works by applying pressure to the leg to improve the blood supply. The simplest way of doing this is by wearing compression socks, stockings or tights.

Compression therapy isn’t a permanent way of treating your varicose veins but can be helpful if none of the other treatments are suitable for you.

Pregnancy and compression therapy

If you’re pregnant and have varicose veins, your healthcare professional should explain how your pregnancy affects varicose veins. They may give you compression stockings to wear. Other treatment for varicose veins are not recommended during your pregnancy.

Lifestyle advice for people experiencing varicose veins

Making healthy changes to your lifestyle can help ease the symptoms of varicose veins:

• Maintain a healthy weight
• Take light to moderate exercise, such as swimming or walking for about 30 minutes, at least three times a week
• Avoid standing for a long time
• Avoid hot baths

You can read more about varicose veins on NHS Choices.

Dowload this page as a pdf to print