varicose veins treatment options overview

Overview

Varicose veins are swollen, twisted veins that you can see just under the surface of your skin. They usually happen in your legs. Inside your veins there are tiny one-way valves that help blood flow back up to your heart. When these valves become weak, blood can pool in the vein, causing it to stretch and bulge.

Yes. Varicose veins affect up to 3 in 10 adults in the UK, and they become more common as you get older.

Anyone can get varicose veins, but they are more common in women, in people who stand or sit for long periods, and in people who are overweight, pregnant, or have a family history of varicose veins.

Symptoms

Common symptoms

• Bulging, blue or dark purple veins on the legs
• Aching, heavy, or tired feeling in the legs
• Swelling in the ankles and feet
• Itching or burning sensation over the vein
• Muscle cramps at night

Symptoms in children

• Varicose veins are rare in children. If you notice a swollen or twisted vein in a child, it may be related to a birth condition or injury. Always seek advice from a doctor.

Symptoms in older adults

• Older adults may have the same symptoms as younger people, but they are more likely to also have skin changes such as thinning skin, eczema, or sores near the ankle.
• Leg swelling and a feeling of heaviness may become more noticeable with age.

Causes

Main causes

• Veins have one-way valves that help blood flow upward toward your heart.
• When these valves weaken or become damaged, blood can flow backward and pool in the vein.
• The pooling blood stretches and twists the vein, making it bulge and appear varicose.

Risk factors

• Getting older
• Being female
• Pregnancy
• Having a family history of varicose veins
• Standing or sitting for long periods
• Being overweight or obese
• Having had a previous blood clot in the leg

When to see a doctor

See a doctor urgently if:

• You have an open sore or ulcer on your leg that is not healing.
• Your leg is red, swollen, warm, or very painful — these could be signs of a blood clot or infection.

Book a routine appointment if:

• Your legs ache, feel heavy, or swell after standing or sitting.
• You are bothered by the appearance of your veins and want to know about treatment options.
• You have varicose veins and a family history of vein problems, and you want a check-up.

Diagnosis

A doctor can usually tell if you have varicose veins by looking at your legs and asking about your symptoms. Often, they will also recommend a simple painless ultrasound scan to see how blood is flowing through your veins.

Tests that may be done

• Physical examination of your legs, usually while you are standing
• Duplex ultrasound scan — a painless scan that uses sound waves to check blood flow and look for blood clots

What to expect at your appointment

Your doctor will ask about your symptoms and medical history, then examine your legs. If they think you need further tests, they may refer you to a vascular specialist or a vein clinic. The scan is usually quick and painless, with no needles or injections.

Treatment

Treatment for varicose veins depends on your symptoms, the size of the veins, and your overall health. Many people only need self-care measures and regular check-ups. If your symptoms are more bothersome or complications develop, there are several effective medical treatments available. A qualified healthcare provider can explain your options and help you choose what is best for you.

Self-care at home

• Wear compression stockings or bandages during the day, as recommended by a doctor or pharmacist.
• Keep your legs raised (elevated) whenever you are resting.
• Avoid standing or sitting for long periods — take regular breaks to walk around.
• Exercise regularly, such as walking, to help keep blood moving.
• Aim to keep a healthy weight to reduce pressure on your legs.

Medical treatments

Medical treatments for varicose veins are usually done as outpatient procedures, so you do not need to stay in hospital overnight. They include endothermal ablation, which uses heat to close the vein; sclerotherapy, which involves injecting a solution that makes the vein fade; foam sclerotherapy; and laser treatment. If these are not suitable, surgery such as vein stripping or phlebectomy may be recommended to remove or tie off the affected veins. Your specialist will talk through the most appropriate approach based on your situation and what is available locally.

When is surgery considered?

Surgery is now used less often than in the past, but it is still an option for very large varicose veins or if other treatments have not worked. Ask your doctor about the benefits, risks, and recovery time.

Living with this condition

Most people with varicose veins live comfortably by following simple self-care measures. Stay active, take short walks, and put your feet up whenever you can. If your symptoms bother you or change, speak to your doctor.

Lifestyle tips

• Walk or do gentle exercise most days, like swimming or cycling.
• Avoid long periods of standing or sitting. If you must sit, wiggle your toes and flex your ankles regularly.
• Wear compression stockings if your doctor recommends them.
• If you are overweight, losing even a small amount of weight can help reduce pressure on your veins.

Diet and exercise

Eating a balanced diet with plenty of fibre and staying well hydrated can help prevent constipation, which can put extra pressure on your veins. Regular exercise improves circulation in your legs without straining them.

Mental health and emotional wellbeing

Varicose veins can affect how you feel about your legs, especially if they are visible. It is normal to feel self-conscious or frustrated. Speaking to your doctor about treatment options, including cosmetic options, can improve your confidence. If you feel anxious or distressed, consider talking to a trusted friend, your GP, or a mental health professional.

Prevention

There is no guaranteed way to prevent varicose veins, but you can lower your risk by staying active, keeping a healthy weight, and taking breaks from sitting or standing for long periods.

Vaccines

There is no vaccine that prevents varicose veins.

Screening programmes

There is no national screening programme for varicose veins. However, if you have symptoms or concerns, you can ask your doctor for an assessment at any time.

Complications

If left untreated

• Chronic venous insufficiency — long-term swelling, aching, and skin changes in the legs.
• Skin ulcers — open sores that most often form near the ankle.
• Superficial thrombophlebitis — a blood clot in a vein near the skin, which can feel like a hard, tender cord.
• Bleeding from a varicose vein if it is injured or knocked.

Long-term outlook

For most people, varicose veins do not cause serious health problems. With modern treatments and simple self-care, symptoms can be greatly improved. Even if complications do develop, most can be treated successfully. The key is to speak to your doctor early and follow the advice you are given. Most people continue to lead a full and active life.

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