I chose a private clinic in London and in October 2021, I had my initial consultation. The doctor, standing on my wings, performed a “double ultrasound”, scanning my leg from the groin to my feet.
By January 2022, I had saved enough money to get going: just under £3,000. I had the treatment done in the winter because you are left with very little scarring and bruising and I had to wear compression stockings constantly for a week afterwards. So it was much more practical in cold January.
The two-hour appointment included two procedures. The first was intravenous laser ablation (EVLA), which addressed the underlying cause of my varicose veins. Under local anesthesia, my doctor used an ultrasound to guide a laser into my large saphenous vein – one of the main culprits for varicose veins. The laser heated the vein and destroyed it. My body has gradually absorbed this dead vein and healthy blood flow is resuming in my leg.
While EVLA investigates the root cause, it does not get rid of visible veins. For this, I needed extractions (also called phlebectomies), for the second procedure. The doctor made tiny incisions (less than 2mm) above my visible veins and physically “hooked” them.
This is different to the old-fashioned method of surgically removing varicose veins, which is no longer used in the UK. In contrast, abortions are minimally invasive and can be performed under local anesthesia. I felt no pain, just a pulling sensation.
Within hours, I was catching the train home. Once the anesthetic wore off, my leg was more sore than I expected, so I took pain meds for a day. I removed the steri-strips, bandages and compression stocking, my leg was not pretty. But beneath the bruises and tiny scars, I could see a significant difference: no knocks, no scaly veins. Ask!
I still had some remaining, smaller veins in my lower leg, so a few weeks later, I returned for one final treatment – foam sclerotherapy. My doctor inserted a small needle into the vein to be treated, injecting it with a foam solution that displaces the blood in the vein and attacks the vein wall. The result? The vein shrank and was absorbed by my body.
As the winter of 2022 faded, so did my scars and bruises. For the first time in years, I proudly had two smooth legs and my heart didn’t sink when I looked down into the shower. I wore jean shorts to my son’s sports day and bought dresses with high hemlines. I even went out for cocktails on my 43rd birthday in November wearing a mini dress with no pantyhose.
This summer, I can’t wait to enjoy our holidays without being embarrassed by my veins. Finally, my legs feel like mine again.
Varicose veins: what you need to know
Tahir Hussain is a leading vascular surgeon with 25 years of experience. He consults at London North West University Healthcare NHS Trust and the Private Clinic of Harley Street.
What are varicose veins?
“They’re swollen, bulging veins that can appear in your legs or feet and happen when there’s a valve problem in your veins,” says Hussain.
When a vein is healthy, your valves open and close to allow blood to pass through and pump blood to your heart.
“But when the valves stop working properly, when you stand up, the blood flows away from your heart to your legs. Your vein fills with blood, causing those classic bulging, enlarged varicose veins,” he says.
Are varicose veins dangerous?
Although they are not life-threatening, Hussain argues that they should not be dismissed as cosmetic problems. “It’s a big health issue, but with the financial constraints on the NHS, especially post-Covid, we’re not treating varicose veins as much as we should,” he says. “If your varicose veins are long-standing and you’ve had them for 40 or 50 years, you’ll get leg ulcers. You’re also at greater risk for blood clots, so we definitely need to treat them.”
What are the symptoms?
Varicose veins are usually purple or blue in color and may appear bulky, bulging or twisted. “You may also feel pain, aching or heaviness in your leg from blood pooling in your vein. The skin over your affected veins may also feel dry and itchy,” says Hussain.
Who gets varicose veins?
Certain factors mean you’re more likely to get them. “Although I see far more women than men in my clinic, a landmark study, the Edinburgh Vein Study, found that more men have varicose veins than women. There is also a genetic factor. Being overweight, getting older or pregnant also increases the chance,” says Hussain.
That said, some women find that their veins improve or disappear after giving birth. “If a woman comes to see me with varicose veins during pregnancy, I tell her to leave it for a year or two after giving birth and then see about it. Many women do not return because their veins have improved,” says Hussain.
Can Crossing Your Legs Make Varicose Veins Worse?
“There is no evidence of that. Factors that can make varicose veins worse are hot weather – it makes your veins dilate – and standing a lot,” says Hussain. “If you’re a hairdresser or a royal guard who stands outside Buckingham Palace all day, you’ll develop complications from varicose veins much sooner than someone who works in an office.” This is because your blood does not flow as easily when you stand for long periods of time.
Are spider veins the same thing?
“No, spider veins are not varicose veins. These are broken veins, in part due to the aging process once collagen is reduced. Spider veins do not cause pain or other symptoms,” says Hussain.
What can you do to relieve varicose veins?
“Compression socks (around £25 from drugstores) are the key. I had varicose veins after years of standing, had surgery and used them. They’re not particularly comfortable in the summer, but they relieve the symptoms – they bring the walls of your vein together, the valve starts working and the blood flows properly again,” says Hussain.
What treatment is out there?
“You may remember the surgical removal of varicose veins decades ago. You would be put to sleep under general anesthesia and your veins would be stripped. It was cheap but painful and the recovery was long and the chance of the varicose veins returning high. Now there are better, less invasive methods,” says Hussain.
As well as the remedies mentioned above [see Christina’s story] there are two other new treatments. First up, the VenaSeal, AKA adhesive therapy. “This involves one injection, whereas with other treatments like EVLA, you need multiple injections, which is not good if you’re needle-phobic,” says Hussain. “With VenaSeal, it’s the glue that closes the vein, not the thermal damage. Think of it like pressing two pieces of wood together with glue.”
Hussain is the principal investigator of a VenaSeal study involving over 1000 people. “The results will come out next year and I think they’ll show it’s as good as ablation and laser treatment,” he says.
There is also intravenous microwave ablation (EMWA). It’s similar to laser treatments in that it destroys the vein using heat – but has the advantage of not emitting light so you don’t need to take precautions like you do with a laser – for example, wearing laser eye PROTECTION.
Can varicose veins come back after treatment?
They can. “About 5 percent of people experience some form of relapse, and that can happen even in the best hands. We have studied this and we believe that people form new varicose veins – the blood finds a new path to travel. But normally, the veins come back very little and tend not to be as bad and you can deal with them again.”
