Varicose veins, or veins which reflux venous blood the wrong way, represent a health issue which is usually slowly progressive. There is no cure for being predisposed to varicose vein formation. However treatment selection involves having a very good understanding of why your varicose veins have formed, where they are, what size they are, and how much they trouble you. With this information we can choose a treatment plan that will ideally give you the longest period of time possible before more varicose veins may form.

Varicose vein intervention is rarely urgent.

Varicose veins can contribute to an increase in venous pressure, usually impacting most the lower parts of our legs. Over time, this increased pressure can cause changes in the skin and soft tissue of the lower leg, including pigmentation, eczema, capillaritis, lipodermatosclerosis, atrophied Blanche, oedema (swelling) and even ulcers. Treating varicose veins is very much about preventing these changes from developing. The development of these pressure changes develop over many years.

Varicose veins can also develop complications, such as superficial thrombophlebitis (blood clots within the varicose veins), spontaneous bleeding (which can be life-threatening). The latter complication is very rare. These complications make treatment of varicose veins much more urgent.

More commonly, varicose veins can cause any degree of ache, heaviness, throbbing, itching, leg cramps, restless legs, warmth in the areas of the body they occur. Some people have no symptoms. They can cause unsightly lumpy appearances or can be completely unseen by the naked eye.

Old advice used to suggest “waiting” until all child-bearing has been completed. We now know this is unnecessary and not recommended. Varicose veins disease will progress with each subsequent pregnancy, so we now advise treat when you can. The recurrence rates associated with certain varicose vein treatments now make recurrence (in a subsequent pregnancy) extremely unlikely in that treated vein. 

We do not actively treat varicose veins during known pregnancy (other than with compression garments) and prefer not to treat during breastfeeding. However, if you and baby are comfortable to wean for 48 hours, then necessary sclerotherapy treatments can be done in nursing mothers. However the recurrence rates associated with certain varicose vein treatments now make recurrence (in a subsequent pregnancy) extremely unlikely in that treated vein. 

In line with current international recommendations, we offer non-surgical treatment of varicose veins. Endothermal ablation (eg with laser) does not require hospital admission or a general anaesthetic. As such, we perform our treatments in rooms, no sedation required. Our patients can drive themselves to and from their treatments. Moreover, choosing the right non-surgical treatment for your varicose veins is likely to offer you a significantly reduced rate of recurrence than conventional surgical stripping. 

Yes. Wearing the correct type of compression on a leg treated for varicose veins or surface veins is part of our philosophy. Wearing Compression of the correct degree (25-30mmHg)  improves treatment success because it assists in helping the superficial veins to stay closed more effectively. Good quality compression also reduces post-treatment swelling, improves post treatment comfort, improves lymphatic and venous flow out of the leg,  helps improve comfort and reduces inflammation and pigmentation. Correct compression also assists in reducing your risk of complications such as thrombosis in superficial and deep veins following treatment.

Following treatment of varicose veins with either endovenous laser or ultrasound-guided foam sclerotherapy we require you to wear a class II level of compression , in the form of an open-toed stocking, for 2 weeks. Following direct vision sclerotherapy for surface veins, we require you to wear a class II stocking for at least 1 week. Certainly, the longer you choose to wear your stocking, the better your result is likely to be. 

We advise not to fly on a flight more than 4 hours within the first 4 weeks following any treatment on your veins, so as to reduce your chance of developing a deep vein thrombosis. If you must fly for urgent reasons, please talk to us and we will make appropriate arrangements including considering short courses of blood thinning medication to make your travel safer.

You can, but we do not recommend this. Recommendations from the Australasian College of Phlebology advise treating the largest superficial vein identified first, proceeding to smaller resulting veins after. Ensuring this approach is likely to give you a much more successful result, and more satisfying cosmetic result, and longer lasting results. Treating spider veins in the presence of untreated varicose veins is often frankly unsuccessful, or at best very brief. Complications such as matting (new small pink vessel formation) often develops. 

Duplex ultrasonography, or mapping, gives us an excellent understanding of the veins in your leg, or your pelvis. This style of ultrasound shows us direction of blood flow, which is intrinsic in diagnosing your varicose veins. It tells us details of where your varicose veins are, where they start from, where they drain to. It tells us the size and nature (straight or tortuous) of your varicose veins. It tells us exactly how deep they are (just under the skin, or under the superficial fascia, or connective tissue). It tells us if and where your varicose veins may involve perforator veins, which are the veins connecting your superficial system of veins to your deep system of veins. 

Duplex ultrasonography also allows us to assess your deep leg veins, which are often anomalous and unique. 

All of these pieces of information are essential to know for us to be able to recommend a treatment pathway specifically suited to you and your veins. No two treatments are the same because every person’s map is different. 

Within the first 2 weeks of treatment of varicose veins with either endothermal ablation (laser) or sclerotherapy under ultrasound guidance, we recommend abstaining from vigorous exercise which is of a high impact or forceful nature. This includes riding a bike, or resistance training. 

Daily walking, however, of 30 minutes minimum but can be more, is essential. Walking regularly reduces your chance of developing deep vein thrombosis and swelling post treatment.