Varicose veins are elongated, bulged and twisted veins below the skin on your legs that are darkish blue colour. Spider veins look like spider webs. Spider veins are much smaller and closer to skin and can be dark red colour.

Symptoms such as heaviness, cramp, burning sensations and aching of the leg that gets worse towards the end of the day. In advanced vein disease, swelling and skin colour change of legs are more noticeable.

Healthy veins have small valves that help blood flow towards the heart. If these small valves stop working, the pressure inside the vein increases and causes veins to get longer and swollen. There are some factors that increase the risk of developing varicose veins such as pregnancy, obesity, family history, history of DVT, old age and lengthy periods in the standing position.

Regular exercise, weight loss, avoiding long standing/sitting positions and using compression stockings can help to prevent or slow the progression of varicose veins.

Untreated varicose veins can cause leg cramps, heaviness and burning sensations at the end of the day or overnight. It also can cause serious medical and surgical issues such as blood clots in varicose veins, permanent skin changes and leg ulcers.

It is wise to manage varicose vein as soon as you notice vein disease symptoms. You will benefit from consulting your GP or Vein specialist to ask for a management plan sooner rather than later. It is much easier, and cost-effective, to treat your varicose veins in the early stages before you face a varicose veins complication such as blood clots or leg ulcers.

If varicose vein disease is left untreated, it can cause further leg swelling, leg pain and cramp, venous dermatitis, blood clots and leg venous ulcers.

There are several minimally invasive treatments for varicose veins such as Laser treatment, Radiofrequency (RF), medical super glue, foam and liquid sclerotherapy. High ligation and vein stripping, plus ambulatory phlebectomy are the available surgical techniques for varicose vein management. Spider veins are treated with foam or liquid sclerotherapy.

The best management and treatment options will determined thorough examination and assessment of the deep and superficial venous system. This will take into account the patient's past medical and surgical history. The pros and cons of various treatment option will then be discussed during the first consultation and best the treatment plan will then be recommended.

Correctly treated varicose veins and spider veins will not cause any further problems, however there is a risk of developing new varicose veins and spider veins in future. Risk factors for developing varicose veins/ Spider veins include the pill, pregnancy, lack of exercise and long periods in the 'standing-up' position.

Sclerotheray is an effective minimally invasive procedure, which has been used for several decades to treat spider veins and small varicose veins tributaries. Sclerotherapy involves injecting a solution into the varicose vein under direct vision or ultrasound guidance. The solution irritates the inner layer of vein and cause immediate collapse of the vein. These veins will disappear over time. The published success rate of sclerotherapy for spider vein and small varicose veins is around 70% after the first year of treatment.

There are several rare short term and long-term complications to Sclerotherapy. Immediate adverse reactions are redness, itchiness and minimal inflammation at injection area. These usually last for a few minutes to an hour. Bruising and dark discolouration are the other side effects which are self-resolvable within a few weeks. Rare complications include small blood clots inside the injected vein and tiny skin ulcers that all are manageable in an outpatient setting.

Endovenous laser ablation (EVLA) is an ultrasound guided minimally invasive procedure that uses controlled heat from a laser to cause collapse and sclerosis on the varicose vein wall. The skin incision is 2-3 mm and the procedure happens under local anaesthetic. Published success rate of EVLA in 5 years follow up is above 95%.

Endovanous laser varicose vein surgery have some uncommon (less than 5%) risks such as infection, pain, minimal bleeding. There are some rare (less than 1%) complications as well such as skin burn, painful lumps, blood clots (deep or superficial) and nerve damage during procedure.

The number of required treatment sessions will depend on the extent of your venous disease. Treatment of large varicose veins will usually requires one treatment session. If there are several small varicose vein tributaries and spider veins, you may need two or three short treatment sessions.

It is important your vein specialist knows about all of your medications, because you may be asked to stop taking some of your medications on the day or day before your operation. Sometimes your doctor can prescribe anxiety medication on the day of surgery if you are suffering from anxiety or needle phobia. Your specialist will also ask you to wear comfortable cloths and have your compression stocking on for the day of your operation. It is advisable to have someone pick you up from the practice on the day of procedure.

All the procedures for varicose veins and spider veins are day surgery and you should be able to resume normal activities after the procedure.

You will be able to drive after EVLA or sclerotherapy as long as you have not taken any anti-anxiety medication on the day of surgery.

You will be able to go home almost immediately after your procedure. You will be advised to wear your compression stocking and to walk for 30 minutes after surgery.

It is recommended to avoid long flight or traveling in a car (over 4 hours) for 3 to 4 weeks before surgery and for 2 weeks after surgery. Although in a special circumstances, some preventive measures can be considered by your vein specialist to accomodate travel requirements.

After your procedure, it is strongly recommended to walk a minimum of 30 minutes once or twice a day. Light and gentle exercise such as jogging can commence after the first week. High impact activities such as heavy lifting, Pilates or competitive contact sports can be commenced after the second week.

It is recommended to wear compression stocking immediately after the operation and keep it on for the first 72 hrs at all times. From day 4 you can take your compression stocking off at night for sleep, then put it on first thing in the morning. At a minimum, it is strongly recommended to wear the compression stocking for at least one week.

Your next visit will be 2 weeks after the procedure for post-surgery ultrasound to review your veins and the success of the operation. We will also check for possible complications such as deep or superficial clots. The next appointment is usually 3 months after the procedure for review. You can contact the practice at any time to address any questions or concerns you may have.

Treatment costs are variable and based on the extent of your vein disease. After a full assessment of your venous disease, you will receive written information detailing the cost of treatment. Part of the cost of varicose vein treatment is claimable through Medicare.