Health Insights · Cardiology
Varicose veins: symptoms, self-care and treatment options
Varicose veins occur when the valves inside leg veins stop working, so blood pools instead of returning to the heart. Many cause nothing but appearance. But skin changes around the ankle mean the pressure is damaging tissue, and that is the stage at which treatment prevents an ulcer rather than treating one.
Seek urgent assessment if you have
- bleeding from a varicose vein — lie down, elevate the leg high and press firmly
- a hot, hard, red, tender vein — this may be superficial thrombophlebitis
- calf swelling, pain and warmth with breathlessness — a possible DVT
- a break in the skin or ulcer that is not healing
- sudden severe leg pain, or a leg that is pale, cold or numb
Bleeding from a varicose vein can be surprisingly heavy because the pressure is high. Lying flat with the leg raised above heart level stops it far more effectively than sitting and pressing. In an emergency call 999, or go to the Royal London Hospital Emergency Department, Whitechapel Road, London E1 1FR.
Symptoms
- visible bulging, twisted veins, usually on the calf or inner thigh
- aching, heaviness or throbbing, worse by the end of the day and after standing
- ankle swelling, itching over the veins, night cramps
- restless legs, and relief on elevating the leg
- symptoms often worse in hot weather and, in women, around periods
The signs that mean it is no longer cosmetic
Brown staining of the skin around the ankle, hardened or tight skin, eczema over the veins, or a small white scarred area all indicate long-standing venous pressure damaging the tissues. These are the stages immediately preceding a venous leg ulcer, and they are the point at which treating the veins prevents one. NHS criteria for treating varicose veins include exactly these features — so if you have them, this is a medical problem, not a cosmetic one.
What helps day to day
Helps
- Elevating the legs above heart level when resting
- Walking regularly — the calf muscle pumps blood upwards
- Compression stockings, correctly fitted and worn all day
- Losing excess weight, and moisturising the skin daily
- Ankle exercises and moving about on long journeys
Makes it worse
- Prolonged standing or sitting without moving
- Crossing the legs for long periods
- Very hot baths, saunas and sunbathing on the legs
- Tight clothing around the groin
- Scratching — venous eczema breaks the skin and starts ulcers
Compression stockings must be fitted, not guessed
Class and size both matter, and a stocking bought online at the wrong compression is either useless or harmful. Before compression is prescribed, the arterial circulation should be checked — usually with an ankle-brachial pressure measurement — because applying compression to a leg with poor arterial supply can cause serious damage. Put them on first thing before swelling develops, and replace them every three to six months as they lose elasticity.
Treatment
- Treatment begins with an ultrasound scan mapping which veins are refluxing. Nothing sensible can be decided without it.
- Endothermal ablation — radiofrequency or laser closing the vein from inside, under local anaesthetic. Now the first-line treatment.
- Ultrasound-guided foam sclerotherapy — foam injected to close the vein.
- Surgery — stripping and ligation, used less often than previously.
- Most treatments are day cases with a rapid return to normal activity, and compression is worn afterwards.
- Treating the underlying reflux is what prevents recurrence; treating only the visible veins does not.
Why come to us. The first step is a proper venous duplex ultrasound, and we perform ultrasound on site with the scan interpreted and explained to you in the same visit — rather than a scan at one place and a discussion weeks later somewhere else. We can assess whether your veins have crossed from cosmetic into the skin-damage stage, check the arterial circulation before any compression is prescribed, fit compression properly, and arrange treatment through our CQC-registered partners without a wait. 7 days a week, no referral needed, fees published.
Private assessment for varicose veins in London
Varicose veins are common and often harmless, but when they ache, swell, or cause skin changes or ulcers, assessment and treatment help. A private GP in East London can examine your legs and arrange a venous ultrasound to map the veins, and advise on compression, lifestyle and referral for treatment where appropriate. Varicose veins are assessed at our private vascular service in Whitechapel, East London, within reach of Canary Wharf and the City.
Varicose veins: assessment and treatment options
When should varicose veins be assessed?
If they ache or swell, bleed, or cause skin changes, eczema or ulcers around the ankle, they should be assessed.
What treatments are available?
Options range from compression stockings to minimally invasive procedures; a venous ultrasound guides the choice.
Do varicose veins come back?
They can, so treating the underlying vein and ongoing leg care both matter.
Do I need a referral?
No — you can start with a private GP who can arrange an ultrasound and onward care.
Where can I get varicose veins assessed near me in East London?
Our vein and vascular service at Whitechapel, near Canary Wharf, can assess varicose veins with an ultrasound scan in London and advise on treatment.
Do varicose veins need treating?
Often they are a cosmetic concern, but aching, skin changes or ulcers warrant treatment; our vascular team can advise on options.
Venous ultrasound and assessment in one visit
Scanned, explained and planned the same day. 7 days a week.