Varicose Veins can be either large, lumpy, bulging veins beneath the surface of the skin, usually in the legs or they can be fine, networks of veins within the skin, so called spider veins or telangiectases.

Symptoms of Varicose Veins

The common symptoms can be the presence of lumps, pain, throbbing, discolouration or symptoms from complications of the varicose veins, such as swelling, ulceration, bleeding, skin rashes, discolouration or inflammation over the veins.

Why do we have Varicose Veins?

Arteries supply blood to the body for oxygenation and nutrition of all tissues.  Veins return the blood to the heart.  Venous return to heart is aided by a calf muscle pump and the presence of valves within the leg and arm veins.  Valves are one way valves, which diminish the pressure in the dependent legs and when standing or sitting and if the valves are dysfunctional and work inefficiently, then, there is a higher pressure venous system, which results in varicose veins and all the complications of varicose veins.  Over many years varicose veins develop as a consequence of this high pressure.

Varicose Veins are usually result from a strong family history, but can be a consequence of injury or thrombosis

Risk factors for Varicose Veins

  1. Family history.
  2. Advancing age.
  3. Female status.
  4. Childbirth.
  5. Prolonged standing.
  6. Obesity.

Assessment of Veins

  1. Clinical assessment.
  2. Ultrasound.
  3. Venogram (occasionally)

Modalities of treatment for Varicose Veins

  1. Support stockings.
  2. Injections.
  3. Ultrasound guided sclerotherapy.
  4. Endovenous laser ablation.
  5. Radiofrequency ablation.
  6. Surgery.


Sclerotherapy (injection of varicose veins)

Reason for procedure

  1. Spider veins.
  2. Small diameter.
  3. Discoloured (blue, purple).

Varicose veins within the skin can be treated by injection of sclerosant.  Sclerosant is a chemical agent, which irritates the lining of the vein and causes obliteration of varicose veins.

Fine needle (30 gauge) is used to inject directly into the skin veins and the resultant inflammation will cause some redness, itching and some discolouration, as well as  occasional pain.  The resultant inflammation will be noticeable in the weeks after the injection, but after four weeks the improvement is noticeable, but it may be several months before it is completely resolved.