Page last reviewed: 07 May Next review due: 07 May Other symptoms include: aching, heavy and uncomfortable legs swollen feet and ankles burning or throbbing in your legs muscle cramp in your legs, particularly at night dry, itchy and thin skin over the affected vein The symptoms are usually worse during warm weather or if you've been standing up for long periods of time. When to see a GP If you have varicose veins and they do not cause you any discomfort, you may not need to visit a GP.
Varicose veins are rarely a serious condition and do not usually require treatment. But speak to a GP if: your varicose veins are causing you pain or discomfort the skin over your veins is sore and irritated the aching in your legs is causing irritation at night and disturbing your sleep The GP can diagnose varicose veins based on these symptoms, although further tests may be carried out.
Read about diagnosing varicose veins. Causes of varicose veins Varicose veins develop when the small valves inside the veins stop working properly. Certain things can increase your chances of developing varicose veins, such as: being female having a close family member with varicose veins being older being overweight having a job that involves long periods of standing being pregnant other conditions Read about the causes of varicose veins.
Treating varicose veins If treatment is necessary, your doctor may first recommend using compression stockings, taking regular exercise and elevating the affected area when resting. Varicose veins are rarely a serious condition and they don't usually require treatment. Varicose veins are diagnosed by their appearance. Your GP will examine your legs while you're standing to check for signs of swelling. You may also be asked to describe any pain you have and whether there are situations that make your varicose veins worse.
For example, some women find their menstrual cycle periods affects their varicose veins. Your GP will also want to know if you're at an increased risk of developing varicose veins, such as:. Your GP may refer you to a vascular specialist a doctor who specialises in veins if you have any of the following:. In most cases, a test called a duplex ultrasound scan will be carried out. This is a type of scan that uses high-frequency sound waves to produce a picture of the veins in your legs.
The picture shows the blood flow and helps the vascular specialist locate any damaged valves that might be causing your varicose veins. For most people, varicose veins don't present a serious health problem.
They may have an unpleasant appearance, but should not affect circulation or cause long-term health problems. Most varicose veins don't require any treatment, but if treatment is necessary, your doctor may first recommend up to six months of self care at home, including:. If you meet the criteria for referral to see a vascular specialist a doctor who specialises in veins , varicose veins can be treated in several ways, the most common being:. It's unlikely you'll receive varicose veins treatment on the NHS for cosmetic reasons - you'll have to pay for this privately.
Read more about treating varicose veins and complications of varicose veins. There is little evidence to suggest you can stop varicose veins getting worse, or completely prevent new ones developing. Compression stockings are specially designed to steadily squeeze your legs to improve circulation. They are often tightest at the ankle and get gradually looser as they go further up your leg.
This encourages blood to flow upwards towards your heart. Compression stockings may help relieve the pain, discomfort and swelling in your legs caused by your varicose veins. However, it's not known whether the stockings help prevent your varicose veins getting worse, or if they prevent new varicose veins appearing. The National Institute for Health and Care Excellence NICE only recommends using compression stockings as a long-term treatment for varicose veins if all other treatments are not suitable for you.
If you are pregnant and you have varicose veins, NICE says you may be offered compression stockings for the duration of your pregnancy. Compression stockings are available in a variety of different sizes and pressures. Most people with varicose veins will be prescribed a class 1 light compression or class 2 medium compression stocking.
They are also available in:. Compression tights are also available, but not on the NHS. They can be bought from pharmacies or directly from the manufacturers. You may need to wear compression stockings for the rest of your life if you have deep venous incompetence.
Deep venous incompetence is where you have problems with the valves, or blockages, in the deep veins in your legs. In these circumstances, you will need to wear compression stockings even if you have had surgery to treat some varicose veins. You usually need to put your compression stockings on as soon as you get up in the morning and take them off when you go to bed. They can be uncomfortable, particularly during hot weather, but it's important to wear your stockings correctly to get the most benefit from them.
Pull them all the way up so the correct level of compression is applied to each part of your leg. Don't let the stocking roll down, or it may dig into your skin in a tight band around your leg. Speak to your GP if the stockings are uncomfortable or don't seem to fit.
It may be possible to get custom-made stockings that will fit you exactly. If custom-made compression stockings are recommended, your legs will need to be measured in several places to ensure they are the correct size. If your legs are often swollen, they should be measured in the morning, when any swelling is likely to be minimal. If compression stockings are causing the skin on your legs to become dry, try applying a moisturising cream emollient before you go to bed to keep your skin moist.
You should also keep an eye out for sore marks on your legs, as well as blisters and discolouration. Compression stockings usually have to be replaced every three to six months. If your stockings become damaged, speak to your GP because they may no longer be effective.
You should be prescribed two stockings or two sets of stockings if you are wearing one on each leg so that one stocking can be worn while the other is being washed and dried. Compression stockings should be hand washed in warm water and dried away from direct heat. If your varicose veins meet the requirements for further treatment, the type of treatment will depend on:. A vascular specialist a doctor who specialises in veins will be able to advise you about the most suitable form of treatment for you.
One of the first treatments offered will usually be endothermal ablation. This involves using energy either from high-frequency radio waves radiofrequency ablation or lasers endovenous laser treatment to seal the affected veins. Radiofrequency ablation involves heating the wall of your varicose vein using radiofrequency energy.
The vein is accessed through a small cut made just above or below the knee. A narrow tube called a catheter is guided into the vein using an ultrasound scan. A probe is inserted into the catheter that sends out radiofrequency energy. This heats the vein until its walls collapse, closing it and sealing it shut.
Once the vein has been sealed shut, your blood will naturally be redirected to one of your healthy veins. Radiofrequency ablation can be carried out under either local anaesthetic you are awake or general anaesthetic you are asleep.
The procedure may cause some short-term side effects, such as pins and needles paraesthesia. You may need to wear compression stockings for up to a week after having radiofrequency ablation. As with radiofrequency ablation, endovenous laser treatment involves having a catheter inserted into your vein and using an ultrasound scan to guide it into the correct position.
A tiny laser is passed through the catheter and positioned at the top of your varicose vein. The laser delivers short bursts of energy that heat up the vein and seal it closed. The laser is slowly pulled along the vein using the ultrasound scan to guide it, allowing the entire length of the vein to be closed. Endovenous laser treatment can be carried out under local or general anaesthetic. After the procedure you may feel some tightness in your legs, and the affected areas may be bruised and painful.
Nerve injury is also possible, but it's usually only temporary. If endothermal ablation treatment is unsuitable for you, you'll usually be offered a treatment called sclerotherapy instead. This treatment involves injecting special foam into your veins. The foam scars the veins, which seals them closed.
This type of treatment may not be suitable if you have previously had deep vein thrombosis. The injection is guided to the vein using an ultrasound scan. It's possible to treat more than one vein in the same session. Both standard sclerotherapy and foam sclerotherapy are usually carried out under local anaesthetic, where a painkilling medication will be used to numb the area being treated.
After sclerotherapy, your varicose veins should begin to fade after a few weeks as stronger veins take over the role of the damaged vein, which is no longer filled with blood. You may require treatment more than once before the vein fades, and there is a chance the vein may reappear.
Although sclerotherapy has proven to be effective, it's not yet known how effective foam sclerotherapy is in the long term. NICE found, on average, the treatment was effective in 84 out of cases. Varicose veins may also develop as the womb uterus begins to grow. As the womb expands it puts pressure on veins in your pelvic area, which can sometimes cause them to become varicose. Although being pregnant can increase your risk of developing varicose veins, most women find their veins significantly improve after the baby is born.
Read more about varicose veins during pregnancy. Page last reviewed: 07 May Next review due: 07 May Varicose veins are usually caused by weak vein walls and valves. Increased risk A number of things can increase your likelihood of developing varicose veins, including: being female having a close family member with varicose veins older age being overweight having a job that involves long periods of standing being pregnant other conditions Gender Women are more likely to be affected by varicose veins than men.
Genetics Your risk of developing varicose veins is increased if a close family member has the condition. Age As you get older, your veins start to lose their elasticity and the valves inside them stop working as well. Being overweight Being overweight puts extra pressure on your veins, which means they have to work harder to send the blood back to your heart.
This can put increased pressure on the valves, making them more prone to leaking. Occupation Some research suggests jobs that require long periods of standing may increase your risk of getting varicose veins.
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