Treatment for Varicose Veins on the NHS

If you are considering getting treatment for your varicose veins you may be wondering if you can get treatment from the National Health Service (NHS). In most cases, the answer is no. It must be clinically necessary for the NHS to consider treating an individual’s varicose veins, and there are strict guidelines in place. In the majority of cases, the only way to get treatment for varicose veins is to pay for it at a private clinic or hospital.

This guide explains:

  • Who may be able to access treatment for varicose veins on the NHS
  • How to get assessed for NHS treatment
  • What to expect if you are considered eligible
  • Alternative options.

Who can get treatment for varicose veins on the NHS?

The NHS will only consider treating varicose veins if there is a strong clinical reason to do so. In most cases, this means that you would have to be experiencing severe complications as a result of your varicose veins to be eligible for assessment. The NHS will not treat varicose veins for cosmetic reasons or if symptoms can be managed with self-care measures at home.

Getting assessed for NHS treatment of varicose veins

Arriving at a diagnosis of varicose veins and any associated complications can be a lengthy process. It begins with a GP assessment at your local medical centre followed by a specialist assessment if your GP thinks you may need treatment.

Stage one GP assessment

If you think you may be suitable for NHS treatment, arrange to see your GP. You can prepare for your appointment by keeping a record of:

  • When your leg veins cause you discomfort
  • Any other symptoms
  • Activities that ease and worsen your symptoms
  • The level of discomfort you experience from 0 (none) – 10 (extreme)
  • The impact your symptoms have on your ability to carry out day-to-day activities.

At the appointment, your GP will:

  • Ask you questions about your medical history and your symptoms
  • Perform a physical examination of your leg veins.

Your GP will assess if you may need further assessment and treatment based on guidelines, and will refer you to a specialist vascular consultant if indicated.

Stage two assessment by a vascular consultant

The second stage assessment will be similar to the GP assessment. It usually involves:

  • A consultation to discuss your medical history and symptoms
  • A physical examination of your leg veins
  • An ultrasound to assess the blood flow through your veins.

At the end of the appointment, your consultant will provide you with a diagnosis and tell you whether you meet the criteria for treatment on the NHS.

Varicose veins treatment on the NHS

Patients who meet the criteria for varicose vein treatment on the NHS will usually be given moderate at-home interventions before being offered hospital-based procedures.

First-line interventions

First-line interventions typically include:

  • Compressions stockings
  • Advice on lifestyle changes that support vein health
  • A prescription for medication that provides symptomatic relief.

Compression stockings

If your ultrasound revealed that you have poor vein circulation, you may be asked to try compression stockings to help improve your circulation. They work by gently squeezing your legs to encourage blood to flow upwards to your heart.

Compression stockings help to relieve discomfort, swelling and pain. However, there is no evidence to suggest that stockings can prevent varicose veins from getting worse or prevent new varicose veins from developing.

Are compression stockings a long-term solution?

The National Institute for Health and Care Excellence (NICE) only recommends using compression stockings as a long-term treatment for varicose veins in two situations:

  • When other treatments are deemed unsuitable
  • When the patient has deep venous incompetence (blockages or problems with the valves deep in their legs).
Pregnant women

If you have developed varicose veins during pregnancy, you may be offered compression stockings for the duration of your pregnancy.

Lifestyle changes

Depending on your situation, your consultant may recommend one or more lifestyle changes, including:

  • Elevating your legs when resting
  • Avoiding standing or sitting for long periods
  • Taking regular gentle exercise, such as walking, yoga, swimming or pilates
  • Losing weight if you are overweight
  • Making changes to your diet

Medications

In addition to recommending lifestyle changes and/or issuing compression stockings, you may be prescribed painkillers to help manage pain and discomfort, and topical ointment for any skin conditions associated with your varicose veins.

Second-line interventions

If first-line treatment fails, you may be offered further treatment, which usually takes the form of endothermal ablation, sclerotherapy or surgery. The type of treatment offered depends on the size, severity and location of your veins, and your general health.

Endothermal ablation – the use of heat, in the form of radiofrequency or laser, to seal off the affected veins.

Ultrasound-guided sclerotherapy/foam sclerotherapy – a liquid or foam (for larger veins) is injected into the affected veins to close them off.

Surgery – the affected veins are removed (ligation) and the saphenous vein is stripped to prevent recurrences. This is a very invasive procedure with a long and often uncomfortable recovery time.

Alternative options to seeking NHS treatment for varicose veins

If you have the means to pay for private varicose vein treatment (self-funded or through insurance), it is possible for you to have a diagnosis and treatment almost immediately and in a comfortable environment. A private clinic or hospital will treat you whether you want to get rid of your varicose for clinical reasons, aesthetic reasons or both. In most cases, private providers offer walk-in-walk-out treatments with fast recovery times.

Always use a specialist

Unfortunately, there are a number of beauty clinics and generalist surgeons offering private varicose vein treatment. It is important to avoid these and choose a specialist venous consultant who has the qualifications, training, skills and experience to:

  • Provide an accurate diagnosis of varicose veins and any associated conditions
  • Propose a safe treatment plan that will provide the best possible results
  • Carry out the specialist treatment successfully
  • Provide suitable aftercare and any necessary follow-up procedures.

Click on the links below to learn more about the best varicose vein treatments available and treatment prices.

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