Varicose Vein Symptoms: When to Seek Treatment & Options | Nottingham

In this guide, we'll cover the most common symptoms, the warning signs that mean you should seek advice sooner, and the modern walk-in, walk-out treatment options available.

What are varicose veins?

Varicose veins develop when the one-way valves inside the leg veins stop working properly. Blood leaks backwards (venous reflux), pressure builds up, and the vein stretches and becomes visible.

Diagram comparing a healthy vein with functioning valves versus a varicose vein with failed valves and blood reflux — Healthy valves prevent backflow. Failed valves allow reflux and pooling, which can lead to varicose veins.

Common varicose vein symptoms

Symptoms often build gradually. Many people notice they're worse after prolonged standing or towards the end of the day.

Aching, heaviness, or tired legs
Swelling around the ankles
Itching, burning, or irritated skin
Night cramps
Visible bulging veins that are getting larger over time

When should you seek treatment?

It's worth arranging an assessment if symptoms are persistent, affecting sleep, work, or daily comfort — or if you're noticing skin changes.

Seek advice sooner if you notice:

Skin discolouration around the ankle (brown/red staining)
Venous eczema (itchy, inflamed, flaky skin)
A hard, tender vein (possible superficial thrombophlebitis)
Bleeding from a varicose vein
A slow-healing wound near the ankle (possible venous ulcer)

The role of duplex ultrasound

A duplex ultrasound scan is the key investigation for varicose veins. It maps the vein anatomy and blood flow, identifies where valves are failing, and guides a targeted treatment plan.

Your treatment options

Modern varicose vein treatments are minimally invasive and usually performed under local anaesthetic as day cases.

1) Radiofrequency ablation (RFA)

RFA uses controlled heat delivered via a thin catheter to seal the faulty vein from the inside. Blood is rerouted through healthy veins.

Cross-section diagram showing a catheter delivering radiofrequency energy inside a varicose vein to seal the vein wall — Radiofrequency ablation seals the refluxing vein from the inside using controlled heat.

Infographic showing the four stages of radiofrequency ablation: ultrasound mapping, local anaesthetic, catheter treatment, and recovery — Typical RFA pathway: scan — local anaesthetic — treatment — walk out the same day.

2) Foam sclerotherapy

Foam sclerotherapy involves injecting a medical foam into the affected vein (often under ultrasound guidance). The foam causes the vein to close and be absorbed over time.

Diagram showing foam sclerotherapy: foam injected into a varicose vein via a fine needle, displacing blood and sealing the vein — Foam sclerotherapy is an injection treatment that closes the vein without incisions.

3) Avulsions (phlebectomy)

Avulsions remove visible surface varicose veins through tiny micro-incisions (usually 2–3 mm). They're often combined with RFA or foam to treat both the underlying reflux and the visible branches.

Four-step infographic showing avulsion (phlebectomy): marking veins, local anaesthetic, removing the vein through tiny incisions, and closure with adhesive strips — Avulsions remove bulging surface veins through micro-incisions, typically under local anaesthetic.

What results can you expect?

Most patients are back on their feet immediately after treatment. Discomfort usually settles within around two weeks, and many patients experience significant symptom improvement within weeks.

Book an assessment and duplex ultrasound

If you're experiencing varicose vein symptoms — or you're unsure what's causing your leg discomfort — a consultation with duplex ultrasound can give you clear answers and a personalised plan.

Book an assessment Call 07928 516261

If you have urgent symptoms (e.g. sudden leg swelling or significant bleeding), please seek urgent NHS assessment via 111 or A&E.

Varicose Vein Symptoms: When to Seek Treatment and Your Options