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Everything You Need to Know about Varicose Veins

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Woman’s legs crossed at the ankle, leaning against a blue wall.

Having a good understanding of what varicose veins are, and the reasons they happen, is important if you are looking at varicose vein treatment options. Read on for a comprehensive look at the cause, symptoms and management of varicose veins.

What are varicose veins?

Varicose veins are enlarged and swollen veins, often appearing blue/green or dark purple. These veins contain faulty valves which result in backwards flow of blood towards the feet.

What are the symptoms of varicose veins?

The interesting thing about varicose veins is that symptoms don’t always correlate with the appearance, i.e. people with large varicose veins may not have any symptoms, and people with no or minimal visible varicose veins may have the symptoms and presence of venous dysfunction. Symptoms may include aching, pain or a feeling of heaviness or tiredness in the legs. This is often relieved by elevation of the legs or walking, and is exacerbated by standing or sitting still. People may also experience itchiness, cramps (especially at night), or restless legs.

What causes varicose veins?

It is unclear if the issue starts with weak vein walls or weak vein valves, but the end result is stretched dilated veins that have lost their elasticity and recoil, and valves that are floppy and incompetent causing inefficient venous drainage. Inflammation resulting from the turbulent backwards blood flow causes further damage to the venous system. 

How common are varicose veins?

25-30% of the population have varicose veins. Around 80% if you include reticular and spider veins.

Venous disease has a strong familial tendency. If one parent has varicose veins, you have a 50% chance of developing them. If both parents have varicose veins your chance of developing them is 90%! Women are more likely to develop varicose veins as oestrogen weakens vessel walls and valves. Being female, taking the oral contraceptive pill or hormone replacement therapy, and pregnancies all add to the likelihood of developing venous dysfunction over time.

Varicose veins tend to become more prevalent with age and with increasing weight. Occupations which involve long hours standing without moving around too much such as being a hairdresser, a chef or a nurse increase the risk of developing varicose veins.

What are management options of varicose veins?

Conservative options

·       Elevate the legs to allow your veins to drain during breaks and at the end of the day.

·       Walk regularly to develop the calf muscle pump which drives venous drainage in the legs.

·       Maintain a healthy weight to reduce excess pressure on the venous system.

·       Wear compression socks to improve venous drainage and reduce the chance of deep vein thrombosis.


Surgical stripping was the treatment of choice in the past. This involved surgically removing all, or part of the vein. It is no longer recommended, as there are now less invasive closure methods which have lower risks, less down-time and better long-term results.

The gold standard treatment for varicose veins, as recommended by the National Institute for Health and Care Excellence, is Radiofrequency Ablation or Endovenous Laser Ablation. Either technique involves cauterizing the inside of the vein to close it. Once the faulty vein is closed, the body resorbs it over a number of months. Any smaller veins can be treated with ultrasound-guided sclerotherapy.

What can happen if they are left untreated?

In most cases, symptoms and signs will progress if left untreated. The rate at which this happens can vary widely. The presence of varicose veins carries 5-6x the risk of experiencing deep vein thrombosis. The development of skin changes is usually a strong indication that it is time to proceed with treatment.

Explore your options at Palm Clinic

If you would like further advice or are considering varicose vein treatment, book in for a consultation with us today. We have an experienced team of professionals at our skin and vein clinic who are here to help you navigate your options.

Consulatation at Palm Clinic with Dr Sam Dunn

Why Palm Clinic?

Our highly skilled medical team treat you with care and understanding.

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