Day of varicose vein surgery

Overview

Varicose veins are swollen, twisted veins that you can see just under the surface of the skin, most often in the legs. They happen when the valves inside the veins stop working properly and blood pools instead of flowing back to the heart.

Yes, varicose veins are very common. About 1 in 4 adults in the UK have them.

Anyone can develop varicose veins, but they are more common in women, people over 40, and those who stand or sit for long periods.

Symptoms

Common symptoms

• Aching, heavy, or tired legs, especially after standing or sitting for a long time
• Swollen ankles and feet
• Itching or burning around the veins
• Discomfort that improves when you walk or elevate your legs

Symptoms in children

• Varicose veins are rare in children. If a child has them, a doctor should check for an underlying cause.

Symptoms in older adults

• Symptoms may be more noticeable because of thinner skin and longer time with the condition.
• Older adults are also more likely to have swelling and skin changes like ulcers (sores) near the ankle.

Causes

Main causes

• Weak or damaged valves inside the veins that allow blood to flow backward and pool
• Increased pressure in the veins from prolonged standing, pregnancy, or being overweight

Risk factors

• Family history of varicose veins
• Age (over 40)
• Being female (hormones can relax vein walls)
• Pregnancy
• Obesity
• Jobs that involve long periods of standing or sitting

When to see a doctor

See a doctor urgently if:

• If you have sudden severe leg pain, swelling, or skin changes (see emergency symptoms)
• If you have bleeding from a varicose vein that won't stop

Book a routine appointment if:

• If varicose veins are painful, itchy, or affecting your daily activities
• If you have skin sores or colour changes near the ankle
• Before considering surgery, to discuss all treatment options

Diagnosis

A doctor or specialist will examine your legs while you stand and may use an ultrasound scan to see how blood flows in the veins.

Tests that may be done

• Physical exam: looking and feeling for swollen veins
• Duplex ultrasound: a painless scan that shows blood flow and valve function

What to expect at your appointment

The diagnosis is usually straightforward. The ultrasound helps the doctor decide which treatment is best, including if surgery is appropriate.

Treatment

Treatment for varicose veins ranges from self-care to medical procedures. Surgery is one option, often done when veins are large and causing symptoms. On the day of varicose vein surgery, you will have a procedure to remove or close off the affected veins. This is usually a day case, meaning you go home the same day.

Self-care at home

• Regular walking and leg exercises to improve blood flow
• Elevate your legs when resting to reduce swelling
• Avoid long periods of standing or sitting still
• Wear compression stockings if recommended by your doctor

Medical treatments

Medical treatments include procedures done in a clinic, like using heat to close veins (thermal ablation), injecting a foam to seal them (sclerotherapy), or using special glue. These are less invasive than surgery.

When is surgery considered?

Surgery (called ligation and stripping or phlebectomy) is used for very large or twisted veins that don't respond to other treatments. On the day of surgery, the area is numbed or you may have a general anaesthetic. The surgeon makes small cuts and removes or ties off the problem veins. After surgery, you can usually walk immediately but will need to wear compression stockings and avoid heavy activity for a few weeks.

Living with this condition

After varicose vein surgery, you can usually return to light activities within a few days. Your leg may be bruised and sore, but walking is encouraged. Follow your surgeon's advice on when to return to work and exercise.

Lifestyle tips

• Walk regularly every day after surgery to help blood flow and prevent clots
• Wear compression stockings as prescribed for the recommended time
• Keep your legs elevated when sitting or lying down
• Avoid heavy lifting or strenuous exercise for the first few weeks

Diet and exercise

A balanced diet high in fibre (fruits, vegetables, whole grains) can help avoid constipation, which reduces pressure on leg veins. Staying active with walking is excellent. Swimming can be gentle on the legs.

Mental health and emotional wellbeing

Varicose veins and their treatment can affect how you feel about your legs. It's normal to feel embarrassed or worried. Surgery often improves both symptoms and appearance, which can boost confidence.

Prevention

You cannot always prevent varicose veins, but you can reduce your risk by staying active, maintaining a healthy weight, not crossing your legs for long periods, and taking breaks from sitting or standing.

Vaccines

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Screening programmes

Routine screening is not needed. If you have a family history or symptoms, see your doctor for evaluation.

Complications

If left untreated

• Chronic (long-lasting) swelling and skin changes
• Skin ulcers (sores) near the ankle that are slow to heal
• Superficial thrombophlebitis (inflammation and clotting in a surface vein)
• Deep vein thrombosis (a blood clot in a deeper vein, which can be serious)

Long-term outlook

With treatment, most people get significant relief from symptoms and improvement in leg appearance. Surgery and other treatments are generally safe and effective. Recovery is straightforward for most, and the risk of complications is low. By following your healthcare team's advice, you can expect a good outcome.

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