varicose veins procedure preparation

Overview

Varicose veins are swollen, twisted veins that you can see just under the skin. They usually happen in the legs and look blue or purple. The veins have weak walls or valves that don't work well, causing blood to pool.

Yes, varicose veins are very common. About 23% of adults in the UK have them. They become more common as you get older.

Anyone can get varicose veins, but they are more common in women, people over 50, those who are pregnant, people who are overweight, and those with a family history. Standing or sitting for long periods at work also raises the risk.

Symptoms

Common symptoms

• Bulging, twisted veins that are blue or dark purple.
• Aching, heavy, or tired feeling in the legs.
• Swelling in the ankles or feet after standing for a while.
• Itching or a burning sensation around the vein.
• Mild pain that gets better when you walk or raise your legs.

Symptoms in children

• Varicose veins are very rare in children. If they appear, it may be due to a vein problem present from birth. Always see a doctor for evaluation.

Symptoms in older adults

• The same symptoms as in younger adults, but older adults may have more swelling, skin changes, or sores because the condition has been present longer.
• Older adults are also more likely to have other health issues that affect vein health, like high blood pressure or diabetes.

Causes

Main causes

• Weak or damaged valves inside the veins that let blood flow backward and pool.
• Weak vein walls that stretch out under pressure.

Risk factors

• Age (veins wear out over time).
• Being female (hormonal changes, pregnancy).
• Pregnancy (increased blood volume and pressure on leg veins).
• Being overweight or obese.
• Standing or sitting for long periods without moving.
• Family history of varicose veins.
• Previous blood clots in the legs.

When to see a doctor

See a doctor urgently if:

• If you have sudden swelling, pain, or redness in one leg, especially if it feels warm or looks different from the other leg.
• If a varicose vein bleeds or a sore on your leg is not healing.

Book a routine appointment if:

• If varicose veins are causing ongoing aching, heaviness, or swelling that bothers your daily life.
• If you are thinking about treatment and want to know your options.
• If skin around the veins becomes dry, itchy, or discolored.

Diagnosis

A doctor or nurse can often diagnose varicose veins by looking at your legs while you stand. They will ask about your symptoms and check for swelling, skin changes, or tenderness.

Tests that may be done

• Doppler ultrasound: a painless scan that uses sound waves to see how blood flows through your veins. It helps find which valves are weak and if there are any blood clots.

What to expect at your appointment

During a doppler ultrasound, you lie down and a gel is put on your leg. The doctor or technician moves a small wand over your skin. It is painless and takes about 30 minutes. The results help decide the best treatment for you.

Treatment

Treatment for varicose veins depends on how severe they are and how much they bother you. Mild cases may only need self-care. For more bothersome veins, there are several minimally invasive procedures that can close or remove the affected veins. These treatments are done in a clinic or hospital and usually have a quick recovery.

Self-care at home

• Wear graduated compression stockings (ask your doctor or pharmacist for the right strength and fit).
• Raise your legs above heart level for 15 to 30 minutes several times a day.
• Walk or exercise regularly to improve blood flow.
• Avoid standing or sitting for long periods—take breaks to move around.
• Maintain a healthy weight to reduce pressure on your veins.

Medical treatments

If self-care isn't enough, your doctor may recommend procedures such as sclerotherapy (injecting a solution to close the vein), endothermal ablation (using laser or radiofrequency energy to seal the vein), or phlebectomy (removing smaller veins through tiny cuts). These are done under local anaesthetic (you stay awake but the area is numb). Your doctor will explain which option is best for you and how to prepare.

When is surgery considered?

For very large varicose veins or if other treatments haven't worked, surgery like vein stripping (tying and removing the vein) may be an option. Surgery is less common now because newer treatments work well. Your doctor will discuss the risks and benefits.

Living with this condition

Living with varicose veins often means making small changes to manage symptoms. Wear comfortable shoes and avoid tight clothes around your waist or legs. When you rest, put your feet up. If you sit at a desk, stand up and walk every hour.

Lifestyle tips

• Stay active—walking, swimming, and cycling are great for circulation.
• Elevate your legs when possible, especially after a long day.
• Wear compression stockings as recommended by your healthcare provider.
• Avoid crossing your legs when sitting, as it can reduce blood flow.

Diet and exercise

Eating a healthy diet with plenty of fibre (like fruits, vegetables, and whole grains) can help prevent constipation, which puts pressure on your veins. Drinking enough water keeps your blood flowing well. Regular exercise strengthens your calf muscles, which act as a pump to push blood upward. Aim for at least 30 minutes of moderate activity most days.

Mental health and emotional wellbeing

Varicose veins can affect how you feel about your appearance, which may cause worry or low self-esteem. Talking to your doctor can help—they can explain your options and reassure you. If you feel very self-conscious or anxious, consider speaking with a counsellor or therapist. You are not alone, and help is available.

Prevention

You cannot always prevent varicose veins, especially if they run in your family. But you can lower your risk by staying at a healthy weight, exercising regularly, avoiding long periods of standing or sitting, and wearing comfortable clothing that doesn't restrict blood flow.

Complications

If left untreated

• Skin changes such as dryness, itching, or darkening (stasis dermatitis).
• Open sores (ulcers) near the ankle that can be slow to heal.
• Bleeding from a varicose vein if it is injured.
• Blood clots in a superficial vein (superficial thrombophlebitis), causing pain and redness.
• Rarely, deep vein thrombosis (DVT), a clot in a deeper vein that can be serious.

Long-term outlook

For most people, varicose veins are a manageable condition. With simple self-care and, if needed, a minor procedure, you can relieve symptoms, prevent complications, and improve the appearance of your legs. Treatment is usually very effective and has a low risk of problems. Always talk to your healthcare provider to get the care that is right for you.

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