Varicose veins: will vascular consultant help?

[Charlock]

Hi,

I'm finally seeing a vascular surgeon this week about skin changes on my lower legs due to varicose veins. I saw two GPs who both wouldn't refer me, but I invoked NICE guidelines with the second so he referred me about a year ago. Anyway, I've got a big purplely/red patch made up of lots of what look like tiny, broken veins on each leg, and they are getting slowly bigger. I'm becoming extremely self conscious of them and worried about how all this is going to progress (I'm 47).

Because the GPs were so dismissive I'm worried that the consultant won't be bothered either. I know everyone says oh varicose veins are cosmetic, but these skin changes are progressing and the prospect of potential leg ulcers down the line is horrid. I've never had terrific legs, and I've had bulging varicose veins for years but the addition of these skin changes has really made me self conscious when swimming and wearing short trousers.

Does anyone have any experience of this and if so is there any treatment I could get that might help? Is there anything that could take these patches away? Thank you.

Yes you can have a laser ablation followed by a few sessions of foam sclerotherapy to sort the patches of tiny veins. It’s very easily resolved, but very difficult to access on the nhs unless you emphasise the discomfort element a lot . And the waiting lists are long long. I had mine done privately in the end , which was around £2000 and done in a few hours with some follow ups for foam sessions. Very effective .I did have another vein pop up a few years after , and this time it was less prominent , but I went down the nhs route that time armed with my previous consultation advice that I’d had privately which escalated the process. I’d had recurrent phlebitis requiring heparin injections though so it was becoming problematic in the eyes of the nhs.
The nhs offer was for the old style stripping , not laser , and the recovery and process was much longer, with lots of stipulations about how long I couldn’t fly for and so on.
It was a very frustrating process, eg i’d see a consultant and he’d refer me for an ultrasound six months later, when in a private consultation the doc has the ultrasound machine there and does it on the spot.
Even more frustrating given that one of the reasons it takes so long to see an nhs vascular consultant is that they often work between nhs and private, just that in the nhs the process is slow, and the diagnostic equipment not readily available at appointments.

Thanks @Cabbageandcoconut that's really helpful. I doubt I'll be a strong candidate for treatment as I'm not in a lot of pain. I feel them when I walk and the big, red/purple patches are quite itchy. How they look is really affecting me though and I'm not an excessively vain person normally. It's only going to get worse as well. I was having a look at Veincentre there, they look really good but I just don't have the money to pay private at the moment.

I’m an NHS vascular consultant. The sort of veins you describe are thread veins and may or may not be related to superficial venous incompetence.
They are a cosmetic issue and not going to cause ulcers or other venous complications in the future. I hope that is reassuring.
They can be treated either with sclerotherapy .
The NHS is a postcode lottery where venous treatments are concerned but pretty much no area commissions this kind of purely cosmetic work.
By the way, i don’t work between NHS and private sector and my clinics all have same visit ultrasound … 😀

Sorry I know that’s not what you wanted to hear….

Thanks @olympicsrock, I lucked out finding you here tonight! So the big purpley/red patches are growing in size. My understanding is that this is due to the varicose veins valve not working and the blood that should be getting pumped up the way pooling around the vein and this becoming visible through the skin (sorry not medical). I thought that this would continue to progress over time, possibly leading to eczema and risk of ulcer? I wanted to know if there was anything I could do to stop this process like wearing compression stocking at least part of the time.

Op @olympicsrock may disagree with me here but I had some amazing results pre surgery with a product called liotin gel which I bought abroad. Massively relieves discomfort and reduces the appearance of the patches .
I believe you can purchase it online.

Thank you. If the NHS aren't going to help I'll need to look at any other affordable options.

I had my appointment. I found the experience totally humiliating and degrading. I had to stand and wait behind a curtain in my pants for 5 minutes with the consulting room door open to the waiting area. The consultant finally arrived, I lay on the table and he looked at the front of my legs and said not seeing much here. I pointed out area round the back of my leg. He told me to walk more, lose weight, elevate my feet in evening. I said I do these things apart from the weight loss. He seemed to assume I did not exercise and then quizzed me on what exercise I did, and seemed surprised. I asked him about the bulging varicose veins on the rest of my legs, so he asked me to get up and he looked at my legs and said 'look, yes, you do have them' and pointed them out to me, as if I hadn't noticed before. And as I stood there in my underwear he proceeded to tell me about Michael Moseley's book he wrote with his wife containing low calorie recipes. I felt utterly humiliated standing there. I'm 5' 7' size 14, I do need to lose some weight but I am fit and healthy otherwise. He seemed to assume I did no exercise and didn't know how to eat healthily. He prescribed compression stockings and left as I was putting my jeans back on. I went to leave and the nurse who was there caught me at the door and asked if I was okay with the consultation, said something about how pregnancy can do these things (sort of implying the consultant being a man didn't understand), explained about the stockings and apologised that they couldn't offer anything more. I was in tears by this point and just wanted out of there. @olympicsrock I'm not sure if that describes a normal consultation, I wasn't sure what to expect but it definitely wasn't that. It was dehumanising.

I’m sorry you had an awful time.
unfortunately based on guidelines here, with the symptoms you describe, your gp was right and you shouldn’t have been referred in the first place.
Unfortunately that does waste an appt and I think you felt that frustration.
why was the door open? Was there anyone in with you keeping it open?

Varicose veins would need to be treated privately rather than NHS. Don’t feel embarrassed OP, the GP shouldn’t have referred you.

Sorry to hear it went so badly. I’ve
had all the treatments detailed via NHS and private operations… at 29,38 and 59.
i can’t lie, losing weight was the best treatment and I say that as someone whose BMI has always been under 25.

Should also have said my last op was sclerotherapy and cost £3k for both.( I think I have a referral code somewhere ) and while it has cleaned up my legs and made them normal colour again, the weight loss has been best thing by far…

What/why are the bulging veins? I’m 48 and on HRT and in literally a matter of a short couple of months - after Covid which affected me quite badly- I now have a series of bulging veins only on my inside calf of left leg, poking out like the backbone of some creepy monster. Some days if I am lucky the first original bulge to appear which is just by the back of my knee, becomes surrounded by a giant grey brusie. I don’t understand why it’s all happened so fast and don’t like how these veins can ache and puff up.

DH on the other hands has loads of tiny blue spider veins around his feet and ankles which he hates but have been there for years. Why are we all so different, and what vein behaviout should we be worried about? (leaving aside the aesthetics for now) the lumpy veins are becoming accompanied by blue veins like you see in marble across the back of my left leg only.

@UncharteredWaters I asked to be referred based on NICE guidelines i.e. skin changes, with itching and dryness. I'm not an overly vain person but I'm very self conscious of these red/purple patches which are about 5cm diameter on each leg, in addition to the large lumpy vein running the length of each leg. I don't really understand how they are just a cosmetic issue when there is a disease progression happening. The consultant didn't seem frustrated, more just that I was a piece of meat on a production line that hadn't ever had a sentient thought in its life. The door was left lying open.

@Mum5net that is good to know. Both my parents had them so it was inevitable I would get them. Though neither of them developed the skin changes I'm seeing. I developed them when I was a lot slimmer 18 years ago but weight gain I understand will be worsening them. I struggle with my weight since being on SSRIs and peri/hormone stuff. It isn't so easy to 'just lose weight' for me. But I am making a renewed effort now for my veins!

@Pottedflowers I think I'd probably get that checked out by GP, just because it seems to have come on so fast. Mine have been more of a slow development, I only saw GP about it last year for first time.

My legs were like that and I didn’t qualify for NHS treatment.

I asked my GP for a private referral.

@UncharteredWaters I think because these skin changes are so obvious and unsightly, I'm having a hard time with doctors just shrugging their shoulders about it. I'm not wishing to sound like a diva demanding a ton of attention over nothing. I just really would like to stop this getting worse.

Where to? Did you get it treated?

Anyone wear compression socks? Is it as horrible as it sounds?

Losing weight is good and all that, but my varicose veins appeared when I was 18 and a size six , and got worse and never better with subsequent pregnancies, despite losing lots of weight after each one.
sorry you had a horrible experience at your consultation op, sounds crap.
And yes I’ve had lots of compression socks over the years, in fact big thigh high stockings. They’re ugly, hot , restrictive, itchy, impractical …and sometimes they can be quite effective, if not simply for relieving fatigue in the legs .
The good ones are expensive and generally need to be fitted properly (you’d get this in most European pharmacies ,I can’t imagine they do it in the uk, I guess you’d just measure yourself with a tape measure) .
@Pottedflowers it can be amazing how sometimes it’s just one vein causing so many issues… one of the veins I had ablated was bulging everywhere, from bikini line to thigh ,then all over my calf too.

Thanks @Cabbageandcoconut I'm being prescribed compression socks, will get measured by GP. The GP seemed to need me to be seen by consultant for this, and told me not to just buy some while waiting the year or so to see consultant. I actually (somewhat foolishly) thought they would scan my legs to visualise before prescribing, I thought that was standard in NICE guidelines. He must have been able to see externally what he needed to know. Can I ask, I have a vein on each leg which bulges from the bikini line to ankle and the areas of red/purple seem to be at the base of these. If I were to have these treated in an ideal world (privately) would they potentially perform EVLA on the big veins then foam schlerotherapy on the areas of discolouration? I'm wondering if I lost some weight I could look to get this down the line.

Local vascular surgeon who did a laser ablation. Best £3000 I have ever spent and I wish I’d had it done years ago.

A friend had the foam treatment and had to have it done again a few years later. She also has brown lines where the veins were. I have no scars or marks at all where they were.

Mine was one and done. I was told I had a 50:50 chance of the bulging veins collapsing by themselves or could have them removed. I opted for removal

All done under local and I was home for lunch. The worst bit by far was the compression socks. They were so uncomfortable. Mine kept rolling on the thigh and cutting in. That was a long week.

Thanks @Elphame presumably you don't wear compression socks since you recovered. Interesting they didn't return, often read that they most likely do. Were they consequence of pregnancy/weight gain?

Where are you? If in south east London can refer a good private person. I had 2 bulging veins in my leg but my legs were really sore and the consultant was more worried about what he couldn't see and picked up and what he could see. Anyway they got treated and as it was private was much more helpful. If I had paid I think it was about £2k per leg. I would pay £250 for a private consult and see what he can offer you and if you would be happy to pay that.