When Should You See a Vascular Specialist About Varicose Veins?
Many people live with varicose veins for years without requiring treatment. However, if your symptoms are affecting your quality of life or you are developing complications of chronic venous disease, it is advisable to seek assessment by a vascular specialist. A consultation allows your symptoms to be evaluated, alternative causes of leg discomfort to be excluded, and the underlying venous problem to be identified with a duplex ultrasound scan.
Persistent Symptoms
Arrange an assessment if you experience: aching or throbbing leg pain; a feeling of heaviness or tiredness in the legs; ankle swelling that worsens during the day; itching or burning around the veins; night discomfort or recurrent leg cramps; or symptoms that interfere with work, exercise or daily activities. These symptoms often indicate significant venous reflux and may improve with appropriate treatment.
Skin Changes
Seek medical advice if you notice: brown skin pigmentation around the ankles; venous eczema (dry, itchy or inflamed skin); thickened or hardened skin (lipodermatosclerosis); or white scar-like patches (atrophie blanche). These changes suggest more advanced chronic venous disease and increase the risk of developing a venous leg ulcer if left untreated.
Bleeding or Blood Clots
You should also be assessed if you have: bleeding from a varicose vein; a painful, red, tender or cord-like vein (possible superficial vein thrombosis); or recurrent episodes of superficial thrombophlebitis. These conditions may require further investigation and treatment to prevent recurrence or progression.
A Slow-Healing Wound
A wound around the ankle or lower leg that has not healed within two weeks should be assessed promptly. Venous leg ulcers are often associated with underlying venous reflux, and early treatment improves healing and reduces the risk of recurrence.
What If My Veins Don't Hurt?
Not all varicose veins require treatment. If your veins are purely cosmetic and are not causing symptoms or complications, treatment is usually optional. However, if you are unsure whether your veins are associated with underlying venous disease, a consultation and duplex ultrasound scan can provide reassurance and help you make an informed decision.
Why Is Early Assessment Important?
Many patients wait until symptoms become severe before seeking help. However, chronic venous disease is often progressive. Early assessment allows the underlying problem to be identified before complications such as skin changes, bleeding or venous leg ulcers develop.
A duplex ultrasound scan is the gold standard investigation for assessing varicose veins. It identifies the source of venous reflux, evaluates the deep and superficial venous systems, and helps determine whether treatment is likely to improve symptoms or prevent future complications.
If treatment is appropriate, your vascular specialist will discuss the most suitable options based on your ultrasound findings, symptoms and overall health. Modern minimally invasive procedures — including endovenous laser ablation (EVLA), radiofrequency ablation (RFA), mechanochemical ablation (MOCA) and cyanoacrylate closure (VenaSeal™) — are performed as day procedures and enable most patients to return to normal activities within a few days.