Varicose veins
Varicose veins, assessed beyond appearance.
Varicose veins are swollen, twisted, bulging veins that appear most commonly in the legs, caused by faulty valves that allow blood to pool rather than flow efficiently back to the heart. Beyond their appearance, they can cause aching, heaviness and swelling — and warrant a proper assessment rather than a purely cosmetic fix.
Understanding varicose veins
More than a cosmetic concern.
Veins carry blood back to the heart using one-way valves that stop it flowing backward. When these valves weaken or fail — often due to genetics, prolonged standing, pregnancy, or age — blood pools in the vein, causing it to stretch, twist and bulge under the skin.
Varicose veins range from small, cosmetically bothersome spider veins to larger, rope-like veins associated with aching, heaviness, throbbing, swelling and night cramps. Left unaddressed, more significant varicose disease can lead to skin changes, persistent swelling and, in some cases, venous ulcers.
Because vein problems and appearance don't always correlate — some large varicose veins cause little discomfort, while some smaller ones are quite symptomatic — assessment focuses on both the visible veins and the underlying venous function.
What we assess and manage
- Varicose veins (legs)
- Spider veins (telangiectasia)
- Venous insufficiency symptoms — aching, heaviness, swelling
- Skin changes associated with chronic venous disease
- Superficial thrombophlebitis
- Cosmetic vein treatment
What we assess
Vein concerns, properly evaluated.
From cosmetic spider veins to symptomatic varicose disease — each is assessed on its own merits.
01
Spider veins
Fine, thread-like red or blue veins close to the skin's surface — primarily a cosmetic concern, treatable with targeted in-practice options.
02
Varicose veins
Larger, bulging veins that may cause aching, heaviness or swelling, particularly after standing for long periods. Assessment determines the best management path.
03
Symptomatic venous disease
Persistent swelling, skin changes or discomfort associated with vein problems, sometimes warranting referral for vascular investigation or intervention.
04
Cosmetic vein concerns
Where the primary concern is appearance rather than symptoms, treatment is planned around your goals and skin type.
Your assessment plan
Assess first. Then decide the right path.
Not every vein concern needs the same treatment — the right first step is an accurate assessment.
History and examination
A review of your symptoms, family history, occupation and lifestyle factors, alongside a physical examination of the affected veins.
Assess severity
Distinguishing cosmetic spider veins from more significant varicose disease, and identifying any skin changes that need attention.
Referral where indicated
Where venous insufficiency or larger varicose veins require vascular investigation (such as venous duplex ultrasound) or intervention, appropriate referral is arranged.
In-practice options
For appropriate cases, cosmetic or minor vein treatments are available in practice, alongside practical guidance on compression and lifestyle measures.
Ongoing management
Varicose veins are a chronic tendency — a management plan helps control symptoms and slow progression over time.
Varicose vein questions
Vein concerns, answered.
Have a question that isn't covered here? Contact the practice directly.
Are varicose veins just a cosmetic issue?
Not always. While some varicose veins are primarily a cosmetic concern, others cause aching, heaviness, swelling or skin changes, and can progress over time if the underlying venous insufficiency isn't addressed. A proper assessment distinguishes between the two.
Do I need a scan before treatment?
For larger or symptomatic varicose veins, a venous duplex ultrasound is often recommended to assess valve function before deciding on treatment. Smaller cosmetic spider veins don't always require this. Your assessment will clarify what's appropriate for your specific veins.
Can varicose veins be treated without surgery?
Many cases can. Options range from compression stockings and lifestyle measures for milder cases, to minimally invasive procedures for more significant veins. Surgical stripping is now reserved for select cases. The right option depends on the size, location and severity of your veins.
Will varicose veins get worse if I don't treat them?
They can progress over time, particularly with risk factors like prolonged standing, pregnancy or a strong family history. Not every case worsens significantly, but monitoring — and treating symptomatic or advancing disease — helps prevent complications like skin changes or venous ulcers.