Varicose veins range from a cosmetic nuisance to the cause of an ulcer that will not heal. Which treatment is right depends on what an ultrasound scan of the leg shows, not on how the veins look from across a consulting room. Every leg is mapped before anything is offered.
Both legs are scanned standing before any treatment is discussed. The scan, not the appearance of the leg, decides what is offered.
Open surgery, endovenous laser and foam sclerotherapy. The recommendation is not limited by what the clinic can do.
Most vein treatment is done as a day case, much of it awake under local anaesthetic, and you walk immediately afterwards.
A venous ulcer needs compression, arterial assessment and treatment of the underlying reflux. All of that is handled here.
A faulty vein can be removed, sealed shut with heat, or closed chemically. All three end with a vein that no longer carries blood the wrong way, and each suits a different leg.
The sequence matters. Treating the surface before the source is the commonest reason vein treatment disappoints.
History, examination standing, and a duplex ultrasound of both legs. Arterial circulation is checked at the same visit if there is any skin damage.
What is actually wrong, whether it needs treating, and what each option would and would not achieve. Some legs need nothing more than compression.
Once the scan has shown the extent of the work, you get a written estimate and, where relevant, the documentation your insurer needs.
Surgery, laser or foam as planned. Veins are marked while you stand, which is what makes the cosmetic result predictable. You walk the same day.
Compression as prescribed, regular walking, and a review to check healing and, after laser, a scan to confirm the vein has stayed closed.
If a clinic only offers one treatment, that is the treatment you will be recommended.
Open surgery, endovenous laser and ultrasound guided foam are all done here. That matters because the honest recommendation for a very large, very twisted vein is often stripping, while most straightforward trunks do better with laser, and recurrent veins in scar tissue are usually best handled with foam.
Assessment always starts with duplex ultrasound of both legs, standing. Arterial supply is checked before any compression is prescribed, because compression on a leg with poor arterial flow is dangerous. Where the scan shows nothing treatable, you will be told that rather than sold a procedure.
Treatment for symptomatic varicose veins, and particularly where there are skin changes or an ulcer, is commonly covered by health insurance and by government schemes. Treatment of thread veins for appearance alone is not, and that is made clear before anything is booked. Every estimate is written and follows the scan, because only then is the extent of the work known.
Ask for an estimate →The questions asked in almost every vein consultation.
Ask your question →No. Many people live with them for years without difficulty. The reasons to treat are symptoms that affect daily life, and skin change at the ankle. If the skin is already darkening or hardening, leaving it carries a real risk of ulceration, which is far harder to heal than to prevent.
The scan decides. Most straightforward saphenous trunks do well with laser, which means less bruising and a faster return to work. Very large, very twisted or very superficial veins are often better stripped. Recurrent veins and veins around an ulcer are usually best treated with foam.
No. Thread veins come from separate tiny vessels in the skin. Treating the trunk stops them being made worse, but existing ones need separate treatment. That treatment is cosmetic and is not covered by insurance.
Treatment for symptomatic varicose veins is commonly covered by health insurance and by government schemes, particularly where there are skin changes or an ulcer. Treatment of thread veins for appearance alone is not.
The vein that is removed or sealed cannot come back. New veins can become varicose over the following years, especially with a strong family history or a standing occupation, and a minority of patients need further treatment. Compression when standing for long periods helps.
After laser, often within two to four days for desk work. After stripping, usually one to two weeks. Work involving long standing, heavy lifting or a lot of driving takes longer, and you will be given a realistic date for your actual job.
