Advances In Varicose Vein Treatment

Overview

Varicose veins are swollen, twisted veins that appear just under the skin, usually on the legs. They happen when the valves inside the veins weaken and blood flows backward, causing the veins to pool with blood and bulge.

Yes. Varicose veins are a very common condition, especially as people get older.

Anyone can develop varicose veins, but they are more common in women, people who are overweight, those who stand for long periods, and people with a family history. Pregnancy also increases the risk.

Symptoms

Common symptoms

• Aching or heavy feeling in the legs
• Burning, throbbing, or muscle cramping in the legs
• Swelling in the feet and ankles
• Itching or a rash around the veins
• Changes in the color of the skin around the vein

Symptoms in children

• Varicose veins are rare in children. If they appear, they may be linked to a more unusual vein problem, and it is best to get a medical check.

Symptoms in older adults

• In older adults, varicose veins may cause more noticeable swelling, skin dryness or thinning, and sometimes open sores (ulcers) near the ankle. The veins may also be more fragile and bleed more easily.

Causes

Main causes

• Weak or damaged valves in the leg veins
• Increased pressure in the leg veins from standing for long periods, pregnancy, or excess weight

Risk factors

• Age (being older)
• Being female
• Pregnancy
• Obesity
• Family history of varicose veins
• Jobs that involve standing for long hours

When to see a doctor

See a doctor urgently if:

• If you have bleeding from a varicose vein that doesn't stop
• If you have sudden leg swelling, pain, or redness (possible blood clot)
• If you have an open sore that is not healing

Book a routine appointment if:

• If you have aching, heavy, or swollen legs that bother you
• If you are worried about the look of your veins
• If your symptoms interfere with daily activities

Diagnosis

A doctor usually diagnoses varicose veins by looking at your legs while you are standing and asking about your symptoms. They may also feel the veins and check for swelling or skin changes.

Tests that may be done

• An ultrasound scan of the leg veins (called a duplex scan) to see how blood is flowing and whether the valves are working
• A physical exam that may include lying and standing positions to check how the veins fill

What to expect at your appointment

Ultrasound is painless and uses sound waves to look at the vein structure. There is no need for needles or dye. You may be asked to stand during the scan. The whole check usually takes about 15–30 minutes.

Treatment

There are now several effective, minimally invasive treatments for varicose veins. The best approach depends on your symptoms, the size and position of the veins, and your overall health. Many people go home the same day.

Self-care at home

• Elevate your legs when resting to help blood drain
• Take regular walks and move your legs to keep blood flowing
• Wear medical compression stockings as advised by a clinician to help support veins and reduce swelling
• Avoid long periods of standing or sitting without breaks

Medical treatments

Common procedures include endothermal ablation (using laser or radiofrequency heat to seal the vein from inside), foam sclerotherapy (injecting a special foam into the vein to close it), and medical-grade glue (which closes the vein without heat). A doctor may also recommend removing the vein through small cuts (ambulatory phlebectomy) or, in some cases, a traditional operation called ligation and stripping. Compression stockings are often used alongside treatment. The choice of treatment is tailored to each person's clinical need.

When is surgery considered?

Surgery (ligation and stripping) is less common now, but may still be recommended for very large veins or if other techniques are not possible. This is usually done under general anaesthetic.

Living with this condition

Most people with varicose veins can live a full, active life. Wearing compression stockings and moving regularly can greatly reduce discomfort. Simple changes like elevating your legs at the end of the day make a big difference.

Lifestyle tips

• Keep a healthy weight to reduce pressure on your veins
• Exercise regularly, especially walking, swimming, or cycling
• Take breaks from sitting or standing by moving around every 30 minutes
• Elevate your legs whenever you get the chance

Diet and exercise

A balanced diet rich in fibre and low in salt can help prevent constipation and fluid retention. Regular exercise, especially walking, helps pump blood back toward the heart and strengthens the calf muscles.

Mental health and emotional wellbeing

Living with visible or painful varicose veins can affect confidence and body image. It is normal to feel self-conscious. Talking to a doctor about treatment can help, and many people feel much better after treatment.

Prevention

Varicose veins cannot always be prevented, especially if you have a family history. However, staying active, maintaining a healthy weight, elevating the legs, and avoiding long periods of standing or sitting can lower your risk.

Complications

If left untreated

• Skin changes, such as hardening, thinning, or darkening of the skin over the affected vein
• Open sores (venous ulcers) near the ankle
• Superficial thrombophlebitis (a painful, inflamed blood clot just under the skin)
• Bleeding from a varicose vein
• Deep vein thrombosis (a blood clot in a deeper vein, which is a serious condition)

Long-term outlook

For most people, varicose veins do not cause serious health problems. Modern treatments are highly effective and can relieve symptoms, improve the look of the legs, and reduce the risk of ulcers. Getting a proper assessment from a healthcare provider is the first step to feeling better.

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