Frequently Asked Questions
Varicose Veins
What are varicose veins?
Varicose veins are enlarged veins that commonly appear on the legs. They can be associated with underlying vein valve dysfunction, known as venous reflux or chronic venous insufficiency.
Some people are mainly concerned about appearance, while others experience symptoms such as aching, heaviness, swelling, throbbing or itching.
What is chronic venous insufficiency?
Chronic venous insufficiency occurs when the leg veins are not efficiently returning blood back toward the heart, often due to vein valve dysfunction (venous reflux).
Symptoms may include heaviness, aching, swelling, visible veins, skin changes or leg ulcers. Varicose veins are commonly associated with chronic venous insufficiency.
What causes varicose veins?
Varicose veins are commonly caused by increased pressure within the leg veins and failure of the vein valves that normally help blood flow back toward the heart.
Factors that may contribute include:
- Genetics and family history
- Pregnancy
- Standing or sitting for long periods
- Ageing
- Previous blood clots
- Weight changes
Are varicose veins dangerous?
Many varicose veins are not dangerous, but some people can develop complications such as:
- Leg swelling
- Skin staining or eczema
- Bleeding veins
- Superficial thrombophlebitis
- Venous ulcers
- Lymphoedema
Assessment can help determine whether treatment may be appropriate.
Why do my legs feel heavy or ache at the end of the day?
Heavy, aching or tired legs can sometimes be related to underlying venous insufficiency, particularly if symptoms worsen after prolonged standing or improve with leg elevation.
Other causes are also possible, which is why proper assessment is important.
Can varicose veins cause leg swelling?
Yes. Chronic venous insufficiency can contribute to leg swelling, particularly around the ankles and lower legs.
Swelling may worsen throughout the day and can overlap with other conditions such as lymphoedema or lipoedema.
Do varicose veins always need treatment?
Not always.
Some people choose treatment because of discomfort or skin changes, while others are mainly concerned about appearance. In some cases, conservative management such as compression stockings, exercise and leg elevation may be appropriate.
Treatment recommendations depend on your symptoms, ultrasound findings and medical history.
When should I worry about a vein?
Medical assessment may be appropriate if you develop:
- Leg swelling
- Pain, heaviness or aching
- Skin changes around the ankles
- Bleeding veins
- Sudden tenderness, redness or hardness over a vein
- Ulcers or wounds near the ankles
Assessment can help determine whether underlying venous insufficiency or another vascular condition may be contributing to your symptoms.
What treatments are available for varicose veins?
Modern treatment options may include:
- Endovenous laser ablation or endovenous radiofrequency ablation
- Ultrasound-guided sclerotherapy
- Microsclerotherapy
- Compression therapy
The most suitable treatment depends on the underlying vein pattern and ultrasound assessment.
Is varicose vein treatment painful?
Modern minimally invasive vein treatments are generally much simpler than many people expect. Many patients describe the discomfort during treatment as mild, and local anaesthetic options are used to help improve comfort during procedures.
Most treatments are performed without open surgery and are designed to minimise downtime, although experiences vary between individuals.
How long is recovery after varicose vein treatment?
Recovery depends on the type of treatment performed.
Many patients are able to walk immediately after treatment and return to normal activities relatively quickly, although individual recovery times vary. Depending on the type of treatment and the nature of your work, some patients are able to return to work the following day.
Do I need an ultrasound for varicose veins?
In most cases, yes. Ultrasound assessment is an important part of evaluating varicose veins and symptoms of venous insufficiency.
Ultrasound helps identify underlying reflux within the leg veins and assists with diagnosis and treatment planning. It can also help determine which treatments may be most appropriate for your individual vein pattern.