Varicose Veins:
What Are Varicose Veins?
Varicose veins are enlarged, twisted veins that most commonly appear in the legs. They develop when the valves inside the veins become weak or damaged, causing blood to flow backward and pool instead of moving efficiently toward the heart. Over time, this increased pressure makes the veins stretch, bulge, and become visible under the skin.
Varicose veins are more than a cosmetic concern. While some people notice only their appearance, others experience symptoms that affect comfort and quality of life.
Why Do VaricoseVeins Occur?
Several factors can increase the risk of developing varicose veins, including:
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Family history (genetics)
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Prolonged standing or sitting
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Pregnancy
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Aging
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Obesity
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Hormonal changes
Who Can Get Affected?
Varicose veins can affect anyone, but certain factors increase the risk.
Age plays a significant role in who might develop varicose veins. Around 40% of people who develop varicose veins are over 60, but younger people can also be affected.
Other than age, genetics can also be a risk for varicose veins. If a parent has varicose veins you are at increased risk. If both parents have varicose veins your risk of developing them is around 90%
Women are more likely to be affected than men, due to hormonal changes weakening the vein wall
Common Symptoms of Varicose Veins
Common symptoms of varicose veins range from cosmetic changes to significant leg discomfort. They often worsen with prolonged standing and improve with leg elevation.
Visible signs
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Enlarged, twisted, bulging veins (blue or purple)
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Veins most often seen in the calves or thighs
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Spider veins may coexist
Sensations and discomfort
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Aching, throbbing, or heaviness in the legs
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Leg fatigue, especially at the end of the day
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Burning or tingling sensations
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Cramping, particularly at night
Swelling and skin changes
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Ankle or lower leg swelling
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Itching over the veins
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Dry or irritated skin
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Skin discoloration (brownish staining near the ankles)
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Hardening or tightening of the skin (lipodermatosclerosis)
Complications of Varicose Veins
Leg Ulcers
Venous leg ulcers develop as a long-term complication of chronic venous insufficiency, when the veins in the legs can’t effectively return blood back to the heart.
Here’s the process step by step:
1. Venous valve failure:
Leg veins contain one-way valves that prevent blood from flowing backward. If these valves become damaged (from aging, prior blood clots, obesity, pregnancy, or prolonged standing), blood pools in the lower legs instead of moving upward.
2. Increased venous pressure (venous hypertension):
Pooling blood raises pressure inside the veins, especially around the ankles. This sustained high pressure stresses the vein walls and nearby tissues.
3. Fluid and protein leakage:
High pressure causes fluid, red blood cells, and proteins to leak out of capillaries into surrounding tissues.
This leads to:
- Edema (swelling)
- Inflammation
- Skin discoloration (hemosiderin staining)
4. Skin and tissue damage:
Chronic inflammation reduces oxygen and nutrient delivery to the skin. The skin becomes:
Thin and fragile
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Dry or itchy
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Hardened (lipodermatosclerosis)
5. Breakdown of skin:
Even minor trauma (scratching, tight shoes, small cuts) can cause the damaged skin to break down. Because circulation is poor, healing is slow, and an open sore develops.
6. Ulcer formation:
The wound typically forms
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Around the medial (inner) ankle
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With irregular edges
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Often shallow but slow to heal
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Accompanied by swelling and aching that improves with leg elevation
Key risk factors for ulceration
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Varicose veins
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Previous deep vein thrombosis
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Older age
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Obesity
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Prolonged standing or immobility
Superficial Thrombophlebitis
Superficial thrombophlebitis is inflammation of a superficial vein (a vein close to the skin) caused by a blood clot forming inside it.
What happens:
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A clot develops in a superficial vein, most commonly in the legs
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The vein becomes inflamed and irritated
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It often occurs in varicose veins, but can also follow IV cannulation, injury, or prolonged immobility
Common symptoms:
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Localized pain or tenderness along the vein
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Redness and warmth of the overlying skin
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A firm, cord-like vein you can feel under the skin
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Mild swelling around the area
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Symptoms usually develop over hours to days.
How it differs from deep vein thrombosis (DVT):
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Superficial thrombophlebitis affects surface veins, not deep veins
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It is usually less dangerous than DVT
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However, if the clot is close to where superficial veins connect to deep veins, it can extend into the deep system
Causes and risk factors
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Varicose veins
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Trauma or irritation (e.g. IV lines)
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Pregnancy and postpartum period
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Recent surgery or immobility
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Smoking, obesity, clotting disorders
Treatment for Varicose Veins
Radiofrequency Ablation (RFA)
RFA is a minimally invasive treatment for varicose veins. Instead of removing the vein surgically, a thin catheter (tube) is inserted into the affected vein.
Radiofrequency (heat) energy is delivered through the catheter to heat the vein wall, causing it to collapse and seal shut.
Over time, the treated vein is absorbed by the body, and blood is naturally rerouted to healthy veins.
Benefits of RFA
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Minimally invasive (no large cuts or stitches)
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Done under local anaesthetic (no general anaesthetic risk)
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Short recovery time — people walk immediately after the procedure
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Less pain and bruising than traditional surgery
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Improved cosmetic appearance (avoiding unsightly scarring)
Ultrasound Guided Foam Sclerotherapy (UGFS)
Ultrasound foam-guided sclerotherapy (UGFS) is a minimally invasive treatment for varicose veins. It involves injecting a foam solution, comprising a mixture of Fibrovein and air, into the affected vein under ultrasound guidance. This foam causes the vein walls to stick together and close.
Over time, the treated vein is absorbed by the body and blood is naturally redirected to healthier veins.
Why am I having this treatment?
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To improve symptoms including aching, heaviness, itching, swelling, or cramps
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To reduce the visual appearance of varicose veins
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To help prevent complications such as future skin damage and ulceration
Varicose Vein Treatment Pathway.
1.
Consultation .
At the initial consultation you will be asked questions about your symptoms and any previous treatment for varicose veins.
You will also be asked if you have any history of deep venous thrombosis and about your medical history in general.
It is also important to know if you are on any medications particularly blood thinners and if you have any allergies.
2.
Examination & Ultrasound.
Your legs will then be examined to look at the distribution of your veins and if you have any skin changes or ulcers.
It is a good idea to wear loose fitting clothing and even bring a pair of shorts with you.
You will then have a duplex ultrasound which is a very simple painless procedure where we can look in detail at the veins in your legs and determine how best to treat them.
3.
Treatment Discussion.
We will then discuss in detail with you the various treatment options outlining the advantages and disadvantages of all.
You will be provided with an information leaflet for the treatments suitable for you.
At this stage we can either book you in for a suitable date for your treatment or you can contact us again via phone or email if you would like treatment to be arranged.
Have a question?
Have a question or ready to take the next step? Contact us to discuss your concerns or arrange a consultation.