Varicose veins

What are varicose veins?

Varicose veins happen when tiny valves are damaged and when blood flows backwards and collects in the vein.

They mostly occur in the legs and can cause pain. Varicose veins can be dark purple in colour and look lumpy, bulging or twisted. The patient’s feet and ankles may be swollen. Varicose veins can look large and swollen and can feel like muscle cramp in the legs, particularly at night time.

There may be dry, itchy and thin skin over the vein and the patient may feel a burning or throbbing in the legs. The patient’s legs may be aching, feel heavy and uncomfortable.

Patient eligibility criteria:

Treatment for varicose veins will only be offered in cases where there has been no response to all other suggested treatments and therapies after an appropriate trial:

  • Varicose veins that have bled and might bleed again
  • The patient has a history of varicose ulcers (when underlying flesh is visible)
  • There has been a change in appearance such as swelling or skin discolouration
  • The patient has a loss of movement, reduced sensitivity or cramping.

The clinician in charge of the care of the patient’s specific condition, usually a hospital doctor, can assist the application, if there is exceptional clinical need for the treatment to be funded. The patient’s clinician must evidence clinical exceptionality and must be supported by the patient’s local NHS commissioning organisation. See separate leaflet for more information on Individual Funding Requests (IFRs)

Advice and further guidance:

A doctor who specialises in veins (a vascular specialist) will be able to advise the patient about the most suitable form of treatment. One of the first treatments offered will usually involve ultrasound or laser treatment to seal the affected veins and this is carried out under local anaesthetic, so the patient won’t feel any pain and the patient will normally go home the same day. The patient will need to wear compression stockings for up to a week after having treatment.

  • For more information search for ‘varicose veins’ at
  • Choosing Wisely UK is part of a global initiative aimed at improving conversations between patients and their doctors and nurses.

Treatment policy for patients covered by NHS Birmingham and Solihull CCG

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