Varicose veins: causes, treatments and removal

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What causes varicose veins?

It’s a misconception that varicose veins are a problem confined to the baby boomer generation. In fact today, doctors are regularly treating young, fit, healthy people in their 40s, 30s and even 20s with the condition.

And contrary to popular opinion, the veins aren’t caused by sitting with your legs crossed for too long, or standing up for hours on end.

“There is one main fundamental cause for varicose veins,” says The Private Clinic’s Consultant Vascular and Endovascular Surgeon, Mr Constantinos Kyriakides. “And that’s genetics. In more than 80 per cent of cases, varicose veins occur in people because they are already genetically predisposed to them.”

Varicose veins are formed when the walls of the veins become stretched and lose their elasticity, causing the valves to weaken.

If the valves don’t function properly, this can cause the blood to leak and flow backwards. If this happens, the blood will collect in the veins, which will become swollen and enlarged. Pregnancy can act as a trigger, as hormonal changes in the body can cause the vein walls to relax, making them prone to leaking.

“Pregnancy can cause these veins to appear sooner than they otherwise might have done,” says Mr Kyriakides. “As can obesity, though to a much lesser extent.”

I ticked all three of these boxes: genetics, pregnancy and weight gain. Varicose veins run in my family and in each of my pregnancies I managed to put on over four stone in weight. After my babies were born the weight came off, but these horrid, lumpy veins remained in my legs.

I felt so self-conscious about them I no longer wanted to wear the clothes I loved. I felt that I had the legs of an 80-year-old woman 40 ears too early. My son’s friends would unashamedly ask what was wrong with them. I began to look into treatment options.

Can varicose veins be removed by the NHS?

There is a postcode lottery at play if you wish to get your varicose veins treated on the NHS. In many areas, the criteria is extremely strict and treatment will only be given if your health is seriously at risk.

Mr Kyriakides, who also works as a Consultant Vascular Surgeon for the NHS at Barts, explains: “For varicose veins there’s a huge discrepancy between how Clinical.

Commissioning Groups [doctors’ surgeries] view this condition across the country. Some will only fund treatment for varicose veins if they meet three strict criteria:

“1: The patient has an active leg ulcer caused by varicose veins.

2: The patient has experienced internal bleeding from the varicose veins that was severe enough for them to attend hospital (a potentially life threatening condition).

3: The patient has experienced three or more episodes of thrombosis – a painful condition that runs the risk of becoming deep vein thrombosis.”

Other CCGs will allow a patient to be treated if the veins are painful or causing the patient discomfort.

I just wanted mine removed because I felt self-conscious.

My experience:

I went to visit Mr Kyriakides at The Private Clinic on London’s Harley Street for a consultation, where my legs were scanned using an ultrasound machine to see how the veins were behaving.

I had two large varicose veins running from my pelvis down to my knees (caused by pressure from the babies during pregnancy) and further varicose veins in my calves.

He explained that the larger veins could be treated using the Endovenous Laser Ablation technique – or EVLA, which is recommended by the National Institute of Health.

EVLA involves the surgeon using ultrasound, so that he can access the vein along the whole of its course and treat it in its entirety. The vein is effectively cauterised, drying out the cells that make the vein wall and ‘killing’ them so they are absorbed by the body over three to 12 months.

EVLA offers fewer complications than actual vein removal, patients recover more quickly (in three days, rather than 14) and there is a 0.3 per cent chance of the varicose veins reoccurring following treatment.

The smaller, tributary veins in the calves needed to be removed using a process called micro phlebectomy, where the vein is taken out. This can be done once the main vein is cauterised and gives a good cosmetic result.

The surgery took one hour and was straightforward. Numbing cream was applied to my legs before the operation, which was performed under local anaesthetic.

I was given support stockings to wear for the next two weeks and advised to take ibuprofen if I felt uncomfortable. I only needed to do this on the first night.

The results

After a few weeks the bruising faded and I couldn’t believe the results. My pre-pregnancy legs were back! I felt like myself again, rather than a 40-year-old woman with a much older body. Shorts are now no longer off limits – along with the knee-length skirts and dresses I love to wear. For me, it’s no exaggeration to say this surgery has been life-changing.


I asked Dr Kyriakides if he sees lots of women my age in a similar position.

“It is a misconception that this is a problem for the elderly,” he said. “I see a lot of people in their 20s and 30s. Some of my female patients, who’ve had varicose veins for most of their lives, tell me that they’ve been able to completely change their wardrobes and buy the things they’ve always wanted to wear.

“But I also see a lot of men in their 40s and 50s who have very heavy, tired legs. They see the varicose veins – but they don’t realise this is what’s causing their legs to feel this way.

“Once the veins are treated, they are able to exercise as much as they want to. They thought that their age was causing them to feel tired – but it was actually just the veins.”


*All images, videos and testimonials are based on the personal experiences of our patients and represent individual body shapes and results. Results may vary from person to person. All testimonials are provided voluntarily by our patients and clients and all photos and videos have been consented to and have not been altered in any way.

A FAMILY man who was too ashamed to show his bare legs because of severe varicose veins has undergone a procedure to remove them.
Rob Crowley, 35, suffered with varicose veins so badly they covered his legs from top to bottom and left him in agonising pain.
Despite being an avid swimmer, he was too self conscious to swim at his local pool.
The Wolverhampton resident, who is a butcher by profession, is often required to stand for long periods of time each day – something which made each and every working day incredibly painful for him.
Speaking about the condition, Rob said: “Whenever I was standing up for a prolonged period of time, my legs would throb which was extremely painful and as you can imagine.
“Being a butcher, I was on my feet for the majority of the day so this was a huge problem for me.”
But it wasn’t just physical pain getting to Rob, he was also suffering from mean taunting and teasing.
On the rare occasion he did show his legs, children would point at them and make comments.
He revealed: “The veins on my legs would make me really self-conscious, especially in the summer. When I was on holiday with my family I would buy really long shorts in order to cover them up. If children did see them, they would point.”
Several years ago, Rob opted to undergo a surgical procedure on the NHS in an effort to remove his veins.
But it wasn’t successful and Rob’s varicose veins returned – more prominent and painful than ever before.
“The pain afterwards was horrendous. But I was then told that the NHS would not fund any further treatment so I looked into private alternatives.
“All the reviews and information I found online pointed me in the direction of The Private Clinic.”
Rob took charge of his health and organised a meeting with Mr Rajiv Kumar Vohra, a Consultant Vascular Surgeon at The Private Clinic in Birmingham.
Mr Vohra advised Rob that a minimally invasive method of varicose veins removal, known as Endovenous Laser Ablation Therapy (EVLA), would be the best option for him.
The treatment works by inserting a very fine probe into the patient’s leg and delivering laser energy to seal faulty veins, preventing blood from flowing through them. The procedure not only removes the appearance of varicose veins but it also removes the discomfort caused by their presence.
After a couple of weeks of wearing compression garments, Rob was able to appreciate the full results of the treatment. His veins had disappeared and his self confidence had been restored.
He explained: “I couldn’t be happier with the results. Before I would avoid going swimming, which is something I love to do; now I go three times a week!”

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