Treatment for Varicose Veins

What are varicose veins?

Varicose Veins are veins which are have become swollen, enlarged, lumpy, bulging and twisted. They usually appear on the legs and feet, but can occur elsewhere in the body. Varicose veins are either blue or deep purple. 

How do veins become varicose veins?

Veins transport oxygen-and nutrient poor blood back to the heart. Veins have pairs of leaflet valves on the inside, which prevent the blood from flowing backwards (retrograde flow or venous reflux), when it is transported against gravity. In healthy veins the skeletal-muscle pump helps to transport the blood upwards. In varicose veins the inner valves have become weak and the leaflets don't meet properly (vascular incompetence). Hence blood flows backwards, which pools and then enlarges the veins leading to a lumpy, bulging and twisted appearence of the veins. 


What are the sign and symptoms of varicose veins? 

Stage 0: no visible or palpable signs of venous disease

Stage 1: spiderveins or reticular veins; light swelling (ankles), itchiness, tightness, heaviness, cramps (calves), pains; no complications

Stage 2: varicose veins; symptoms as at stage 1 (but more pronounced), complications: skin changes including dermatitis, eczema, atrophy, induration, pigmentation; phlebitis (painful inflammation of the veins)

Stage 3: varicose veins: symptoms as in stage 2 (but even more pronounced), complications: as in stage 2 (but more pronounced), ulcus cruris (venous ulcer/open leg), bleeding

What are the causes?

Primary varicosis-

Secondary varicosis - due to deep vein thrombosis or tumor

Should varicose veins be treated and if yes, how?

Varicose veins are often seen as a "cosmetic problem", but are essentially a progressive disease whereby long-term venous backflow and increased peripheral-venous pressure is leading to severe damages of the lower legs including severe skin changes (see above later stages of the disease). 

(I) Conservative treatments

Earlier stages of varicose veins can be treated with regular manual lymphatic drainage (Dr Vodder method), decongestive therapy and wearing compression garments. Often spider-and reticular veins do leak and lymphatic fluids collect in the tissues leading to inflammation and oedema. By using the before mentioned treatment methods, lymphatic-and venous flow can be increased and tissues decongested, which in turn reduces the progression of the disease. Manual lymphatic drainage, in particular, will help to reduce any inflammation, swellings, pain, tightness and heaviness of the legs. 

Supplements and herbal remedies can further help in strengthening leaky blood capillaries (spider veins) and reticular veins. Effective supplements and tailor-made herbal remedies can be purchased at our clinic. Hydrotherapy, e.g. Kneipp water therapies, can help to improve the strength of veins and blood capillaries as well.

Fashionable, graduated compression garments (over the counter and made to measure) from major German companies may be ordered at our clinic, too. 

(II) Surgical treatments

Later stage varicose veins may need surgical treatment. This can include sclerotherapy (foam), endovenous thermal ablation (laser, radiofrequency, steam) and stripping (removal of veins). Often surgeons use a combination of the before mentioned techniques to treat advanced varicose veins. Which veins need to be treated with what technique depends on the test results of the Doppler Ultrasound, which in all cases precedes surgery.

After surgery the patient needs to wear compression garments for at least 6 weeks.  

Where to go for surgery? 

The National Institute for Health and Clinical Excellence (NICE) produced clinical guidelines in July 2013 recommending that all people with symptomatic varicose veins (Stage 2) and worse should be referred to a vascular service for treatment. 

However, unfortunately, the NHS only treats very advanced cases and waiting times are long. So, not surprisingly, a lot of private treatment centres and clinics offer surgical treatment for varicose veins. In London, fees for surgery starts at a minimum of £3050, but are often much higher!

German surgeons charge a minimum of 300 Euros only!! (yes, you read this correctly - this would include the consulation, Doppler Ultrasound and treatment with sclerotherapy). The patient can leave the clinic/hospital the same day. Even with the additional travel- and accommodation costs (if an extended stay is wished) it compares very favourably with private fees in the UK. If the surgeon decides that stripping needs to be done, this would incur higher costs and a hospital stay (a minimum of at least 1000 Euros, but prices can be higher depending on what needs to be done and the length of the surgery).

You may question, why fees are that low and if this would mean that you would receive a lesser good service. In Germany fees are regulated by law and fees for private and non-private patients are the same! German surgeons are highly trained and usually speak English very well.

If you wish to obtain further information for the conservative and surgical treatment, please do not hesitate to contact the clinic at 0790 22 33 747. 

The Lymphoedema Clinic London

Practices in Central and South London

For appointments please call 0790 22 33 747