Varicose veins

A varicose vein occurs when the one-way valves in a vein become weak or damaged, allowing blood to flow backwards. The blood forms pools in your vein, which becomes swollen and enlarged (varicose).

Varicose veins are a very common chronic (long-term) condition that usually occurs in the legs or feet. However, varicose veins can happen anywhere, including around your anus (bottom), when they’re called haemorrhoids.

About three in 10 adults are affected by varicose veins. They're more likely to develop as you get older, with women at a higher risk of varicose veins.

You’re also at a higher risk of developing varicose veins if you:

• Are pregnant
• Are obese
• Have a family history of varicose veins
• Have an occupation involving a lot of standing

Lifestyle changes such as losing weight or taking more exercise can sometimes prevent varicose veins symptoms worsening.

If your varicose veins are causing problems, they can be removed through surgical and non-surgical techniques.

The main symptom of a varicose vein is a swollen, twisted, purple vein that may have bulges or lumps. Other varicose veins symptoms include:

• Aching, heavy, painful legs, which are often worse after long periods of standing
• Swollen feet and ankles
• Dry, flaky, itchy and discoloured skin around your varicose veins (varicose eczema)
• Muscle cramps, burning or throbbing in your legs
• Leg ulcers - chronic sores which can cause pain, itching and swelling
• Legs which bleed or bruise easily

If varicose veins are causing you discomfort or you’re unhappy about their appearance, see your GP. They'll recommend how to get rid of varicose veins or suggest ways of relieving your varicose veins symptoms.

Your GP will ask about your general health and how your varicose veins symptoms are affecting you. They may discuss what causes varicose veins and provide lifestyle advice about ways to relieve your symptoms, including:

• Losing weight
• Exercising more
• Wearing compression stockings to improve your circulation
• Avoiding standing for long periods
• Raising your feet when relaxing
• Using a varicose veins cream to relieve discomfort and swelling

If your varicose veins symptoms are troublesome, your GP may recommend varicose veins removal and refer you to a vascular surgeon.

A vascular surgeon will examine your affected veins and may send you for an ultrasound scan to locate the damaged valves in your varicose veins.

Varicose veins treatment involves closing off and destroying the affected veins. There are several surgical techniques and innovations that can be used to remove varicose veins, including:

• Endovenous laser ablation (EVLA) – a tiny laser inside a catheter is inserted into the affected vein which emits bursts of energy to heat and seal the vein
• Radiofrequency ablation (Venefit/VNUS closure) – a probe inside a catheter is inserted into the affected vein and uses radiofrequency energy to heat and seal the vein
• Ligation and stripping - open surgery which involves tying off and stripping out your varicose veins

Other treatments include:

• Ultrasound-guided foam sclerotherapy (USGFS) – a special foam is injected into the affected vein which blocks it
• ClariVein® – a catheter is inserted into your vein and the end rotates and releases a chemical which seals the vein
• VenaSeal™ closure system – a catheter is inserted into the affected vein and a special glue is released at regular intervals down the vein to seal it closed
• Hook phlebectomy or microphlebectomy – small incisions are made close to the vein and a hook-shaped instrument is used to remove the affected veins through the incisions
• Transilluminated powered phlebectomy – a special light is used under your skin to see the affected veins which are then cut and removed by suction

Your doctor will discuss which surgical treatment is best for you. This will depend on your general health and the size, shape and severity of your varicose veins.