Preparing for varicose vein surgery

Overview

Varicose veins are swollen, twisted veins that often appear blue or dark purple just under the skin, usually on the legs. They happen when the valves inside the veins weaken and blood pools instead of flowing upward toward the heart.

Yes, varicose veins are very common, especially as people get older.

They are more common in women than men and often run in families. People who stand or sit for long periods, are overweight, or have had multiple pregnancies are also at higher risk.

Symptoms

Common symptoms

• Bulging, twisted veins visible under the skin
• Aching, heavy, or tired feeling in the legs
• Swelling in the ankles or lower legs
• Itching or burning around the veins
• Muscle cramps, especially at night

Symptoms in children

• Varicose veins are rare in children, but if they occur, they may appear as small spider veins or be linked to an underlying condition. A child with swollen legs or visible veins should see a doctor.

Symptoms in older adults

• In older adults, varicose veins are more common and may cause more discomfort, swelling, and skin changes like eczema or ulcers. They can also increase the risk of blood clots.

Causes

Main causes

• Weak or damaged valves inside the veins that allow blood to flow backward and pool
• Weakness in the vein walls, which makes them stretch and bulge

Risk factors

• Age (over 50)
• Being female (hormonal changes during pregnancy, menopause)
• Family history of varicose veins
• Being overweight or obese
• Pregnancy (especially multiple pregnancies)
• Standing or sitting for long periods
• Lack of regular exercise

When to see a doctor

See a doctor urgently if:

• Sudden, severe leg pain or swelling
• Red, hot, or tender leg – could be a blood clot
• Bleeding from a varicose vein that does not stop with pressure

Book a routine appointment if:

• Legs ache, feel heavy, or swell often
• Skin around the veins becomes itchy, dry, or discolored
• You want to explore treatment options for cosmetic or comfort reasons

Diagnosis

A doctor can usually diagnose varicose veins by looking at your legs while you stand. They may also feel your veins and ask about your symptoms and family history.

Tests that may be done

• Duplex ultrasound – a painless test that uses sound waves to check blood flow in the veins and identify valve problems

What to expect at your appointment

You will lie on an examination table while a gel is spread on your leg and a small handheld device is moved over the skin. There is no pain, and the test usually takes about 20 to 30 minutes. The ultrasound helps the doctor decide if treatment is needed and which type might work best.

Treatment

Treatment for varicose veins ranges from simple self-care to medical procedures. The goal is to relieve symptoms, improve appearance, and prevent complications. Your doctor will suggest options based on your symptoms and vein size.

Self-care at home

• Elevate your legs above heart level for 15 to 20 minutes several times a day
• Wear compression stockings (ask your doctor about the right fit and strength)
• Exercise regularly – walking, swimming, and cycling help improve blood flow
• Avoid standing or sitting for long stretches – take breaks to move around
• Maintain a healthy weight

Medical treatments

If self-care is not enough, doctors may recommend procedures such as sclerotherapy (injecting a solution into the vein to close it), laser or radiofrequency treatment (using heat to seal the vein), or vein stripping (surgically removing the vein). These are generally done as outpatient procedures with local or general anesthesia. Your doctor will explain the risks and benefits of each option.

When is surgery considered?

Surgery for varicose veins may be considered if symptoms are severe, self-care and other procedures haven't worked, or if complications like skin ulcers or bleeding develop. Preparing for surgery usually involves stopping certain medications (as advised by your doctor), arranging for time off work, and having someone drive you home. Your healthcare team will give you specific instructions.

Living with this condition

Wear compression stockings if recommended. Elevate your legs whenever you can, especially after long periods of standing or sitting. Check your legs regularly for any changes, like new swelling or skin breakdown.

Lifestyle tips

• Avoid prolonged standing or sitting – take short walks every hour
• Sleep with your legs slightly raised (use a pillow under your feet)
• Avoid tight clothing that restricts blood flow in your waist or legs
• Wear comfortable shoes and avoid high heels for long periods

Diet and exercise

Stay physically active with low-impact exercises like walking, swimming, or cycling. A diet rich in fiber (fruits, vegetables, whole grains) helps prevent constipation, which can worsen vein pressure. Drinking plenty of water also helps keep blood moving.

Mental health and emotional wellbeing

Varicose veins can sometimes make people feel self-conscious about their legs or worry about pain and complications. It’s normal to have these feelings. Talking to a doctor or a counselor can help, and knowing there are effective treatments can bring relief.

Prevention

You cannot always prevent varicose veins, especially if they run in your family. However, you can lower your risk by staying active, maintaining a healthy weight, avoiding long periods of standing or sitting, and elevating your legs when possible.

Screening programmes

If you have a strong family history of varicose veins or related conditions, you may want to ask your doctor if screening (like an ultrasound) is right for you. There are no routine screening recommendations for the general public.

Complications

If left untreated

• Skin changes like thickening, discoloration, or eczema
• Leg ulcers (open sores) that are slow to heal
• Bleeding from a weakened vein
• Superficial thrombophlebitis (inflammation and blood clot in a vein just under the skin)
• Deep vein thrombosis (a more serious clot in a deeper vein)

Long-term outlook

For most people, varicose veins are a manageable condition and not a serious health threat. With proper self-care and treatment when needed, symptoms can be greatly improved, and complications are rare. The outlook is very good, and many people return to normal activities quickly after treatment.

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