Varicose Veins
This article is general health information for the selected condition. It is not a diagnosis and does not replace clinical judgement. If you have questions or need treatment advice, please consult a qualified healthcare professional.
What is varicose veins?
Varicose veins are enlarged, twisted superficial veins, usually in the legs, caused by failure of the one way valves that keep blood moving upward. Many people have only cosmetic concerns, but persistent venous hypertension can cause skin changes and ulceration, which is why symptomatic disease deserves proper assessment.
Causes
- Incompetent venous valves allowing backflow
- Weakness of the vein wall
- Raised venous pressure from prolonged standing
- Previous deep vein thrombosis damaging valves
- Pregnancy increasing pelvic venous pressure
Symptoms
- Visible bulging twisted veins
- Aching or heaviness in the legs
- Symptoms worse after prolonged standing
- Ankle swelling by the end of the day
- Itching over the veins
- Night cramps
- Skin discolouration or hardening near the ankle
- Venous ulceration in advanced disease
Risk factors
- Family history
- Female sex
- Increasing age
- Pregnancy, particularly multiple pregnancies
- Obesity
- Occupations involving prolonged standing
- Previous deep vein thrombosis
Diagnosis
- Clinical examination standing and lying
- Duplex ultrasound to map reflux
- Assessment for skin changes and ulceration
- Exclusion of deep venous obstruction
- Ankle brachial pressure index before compression therapy
Treatment
- Graduated compression stockings
- Regular walking and leg elevation
- Weight management
- Endothermal ablation with radiofrequency or laser
- Ultrasound guided foam sclerotherapy
- Surgical stripping in selected cases
- Prompt referral if skin changes or ulceration develop
Self care
- Wear graduated compression stockings as advised
- Elevate the legs above hip level when resting
- Walk regularly, which drives the calf muscle pump
- Avoid prolonged standing or sitting without moving
- Keep skin moisturised to prevent breakdown
- Lose weight if overweight
- Avoid crossing legs for long periods
When to see a doctor
Book an appointment if:
- Aching, heaviness or swelling affecting daily life
- Skin changes such as darkening or hardening near the ankle
- Itchy eczema over the veins
- A vein that has bled
- Recurrent superficial thrombophlebitis
- Any ulcer developing around the ankle
Some symptoms need emergency care rather than an appointment. See the warning signs listed above.
Prevention
- Stay physically active and walk regularly
- Avoid prolonged standing without moving
- Maintain a healthy weight
- Elevate legs when resting
- Wear compression during long journeys or pregnancy if advised
Outlook
Varicose veins do not usually cause serious harm, but they tend to progress slowly. Compression relieves symptoms without correcting the underlying valve failure. Endothermal ablation and foam sclerotherapy are effective day case treatments with good long term results. Treating them prevents progression to skin damage and venous ulceration.
Common questions
Are varicose veins only a cosmetic problem?
Not always. When they cause aching, swelling, skin discolouration, eczema or ulceration, they represent chronic venous insufficiency and warrant assessment and treatment rather than reassurance.
Do compression stockings cure them?
No. They relieve symptoms and slow progression but do not remove the underlying valve failure. Definitive treatment requires ablation or surgery of the affected veins.
Can varicose veins cause blood clots?
They can cause superficial thrombophlebitis, a painful hard red vein. Extensive superficial clots near the groin can extend into the deep system, so assessment is advised.
References
Important: Dard AI is not a medical device and does not diagnose, treat, or replace clinician judgement. This article is general information only. Always consult a qualified healthcare professional about diagnosis and treatment, and seek emergency care for severe or rapidly worsening symptoms.