What varicose veins are

Varicose veins develop when the valves inside a vein become damaged, allowing blood to pool and the vein to become enlarged and swollen. They typically appear on the legs, coloured blue, purple or green, and can cause swelling, cramps, itchiness and heaviness in the legs.

Varicose veins are common - around a third of Australians are affected. They carry a small proportion of the body's blood flow, which is why closing or removing a varicose vein does not compromise circulation; the blood simply redirects through healthier veins.

Why varicose veins form

There are several contributing factors:

• Heredity - the most common factor. A family history of varicose veins substantially increases your likelihood of developing them.
• Age - vein valves weaken over time.
• Pregnancy - increased blood volume and hormonal change.
• Prolonged standing - occupations that involve long periods on your feet, such as teaching, hairdressing and retail work.

The first step: assessment

Treatment begins with a consultation, where your veins are assessed and your suitability for treatment established. Where the veins are larger, symptoms are significant, or the source vein is not obvious, duplex ultrasound is used to map which veins are refluxing.

This matters because treating what is visible at the surface without identifying an underlying refluxing vein tends to give a short-lived result.

Treatment options

Sclerotherapy

A sclerosant solution is injected into the vein through a tiny needle. The solution irritates the vein wall, the body initiates a natural healing process, and the vein shrinks and gradually disappears.

Sclerotherapy is commonly used for smaller accessory veins, where treating early can prevent them deteriorating into larger bulging varicose veins. It can also treat large veins, either alone or alongside less invasive outpatient surgery.

From $470 per session. See sclerotherapy.

Endovenous laser treatment (EVLT)

Used for larger veins such as the greater saphenous and small saphenous veins. A fibre-optic probe is inserted into the vein, and laser light heats the vein along its length, causing it to shrink through the effect of heat on the collagen in the vein wall. The treated vein develops new collagen during healing.

The main advantage over surgical stripping is the shorter recovery - patients are generally up and walking immediately. After EVLT, any remaining surface varicose and spider veins can be treated with sclerotherapy.

From $4,200. See endovenous laser ablation.

Other options

Ultrasound-guided sclerotherapy (from $740) targets veins hidden beneath the skin. VenaSeal vein glue closes a refluxing trunk vein without heat. Vein surgery is reserved as a last option.

What happens after treatment

• Bruising is expected, and veins may temporarily turn dark before returning to normal.
• Tenderness and redness along sections of the treated veins is normal and is not an infection.
• Walking is required after treatment - it reduces discomfort.
• Compression stockings or socks are required for up to seven days after treatment. The pressure helps reduce side effects and supports more effective healing.
• Normal activities can generally be resumed immediately, but excessive standing and vigorous activity are not advised for two to four days.

Individual results may vary, and more than one session is often required.

What happens if varicose veins are left untreated

Varicose veins are not always harmful, and some people never need treatment. However, longstanding untreated venous disease can progress. As blood pools within the vein, pressure increases and fluid can leak into the surrounding tissue, leading to skin changes - discolouration, hardening of the skin, and in more advanced cases venous ulceration around the ankles.

If your veins are symptomatic, changing in appearance, or causing skin changes, they are worth having examined.

Timing

Vein treatment can be performed year round. Some treatments require compression stockings for a period afterwards, which some people find easier to manage in cooler months - so treating before summer is a common preference rather than a clinical requirement. EVLT specifically can be performed in both summer and winter.

Costs and Medicare

As at September 2024 and including GST, a vein consultation with a doctor - which may include ultrasound - is $230. Treatment starts from $470. See varicose vein treatment costs.

You may be able to claim a Medicare rebate for vein treatment. Your physician will discuss any applicable rebates at your initial consultation, and a valid GP referral supports a claim.

Risks

All procedures carry some risk. Risks vary by treatment method and are discussed with you in detail at consultation, and you are given written information to take home. Please read our information on the risks and complications of cosmetic surgery before proceeding.

Any surgical or invasive procedure carries risks. Before proceeding you should seek a second opinion from an appropriately qualified health practitioner.

Booking

To arrange a consultation, call the clinic on 03 9569 3511 or enquire through the contact form. Me Clinic is at 4 Burke Road, Malvern East VIC 3145.

Related pages

See varicose veins, spider veins, or all vein treatments.