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.

@Charlock

I had laser and foam treatment at a Veincentre 3 weeks ago.
Bloody brilliant!
Happy to answer any questions here or by PM.

@Charlock there are different types of skin changes. The worrying types are severe venous eczema, brown discolouration and a hardening of the skin and fat called lipodermatosclerosis. Thread veins and clusters of veins forming purple patches are just veins under the surface . They don’t increase the risk of ulcers and so are not treated on the NHS in most areas.

Maintaining a healthy weight really can help varicose veins ( the bulgy ones) be less prominent and if treated , a healthy weight reduces the risk of recurrence.

I’m sorry that you weren’t treated with kindness . I usually have my patients fully dressed when I enter the room, say hello and shake their hand and have a chat before trousers come off.

The options for venous treatment depends on the anatomy of the veins. Not all veins are suitable for the same treatment. I generally offer thermal ablation ( EVLA/ EVLT / laser/ radio frequency ablation) if veins are deeper and straight. If not I offer foam sclerotherapy but there is a lower success rate and it often causes ‘phlebitis’ which is pain and lumpiness and brown skin staining. Sometimes large torturous veins need pulling out ( often with GA) but we only do that when no other treatment is suitable.

Compression stockings are fine ( usually below the knee ones much better) can be with or without toes and different strengths.
The reason your GP asked for cons opinion was for us to check arteries by feeling pulse in foot or measuring pressure. A full scan is not necessary to wear stockings . Sadly , your GP should probably explained to you @Charlock that you were very unlikely to be offered any treatment. The consultant’s hands were tied by the commissioning criteria . We do actually like offering treatment!

anticoagulant gels only really help phlebitis not thread veins / patches or purple skin…

Thanks @olympicsrock you've done a better job explaining this than the clinicians I've seen. I think I said in an earlier comment, I could have left with the exact same result and felt okay with it, it was the consultant's manner and tone and the way it was performed that was the upsetting thing.

So the thread vein clusters aren't a precursor to the other changes you describe then. I guess it's all in a day's work for you guys but for me it's quite upsetting to be stuck with purple ankles. I'm experimenting with leg make up.

Re weight loss I'm feeling determined to try and succeed this time. The thought that it may improve the veins is a good motivator. If I lose weight and get private treatment do I still need to wear the stockings? I hope not. Shame I couldn't get Sweaty Betty Power leggings on prescription - my legs definitely feel better going hiking, doing classes with them on.

@Glitterbiscuits I may take you up on that!

@Charlock if you had treatment you wouldn’t need to keep wearing stockings. There are different t colours by the way.
the medical stockings are graduated compression stockings which means that the tightness is calculated to work with the different size of your calf and ankle. It’s really important that they include the foot to to prevent a swollen foot.

Really sorry about your experience at the gp
OP sounds horrible
can I ask how your appointment went? Your symptoms seem so close to mine and I’m really thinking it’s time to act this has ben a great thread and your candidness is very inspirational thank you sharing, It’s made me realise that I think I need to sort my legs out I’m tired of holidays hiding in leggings and trousers all the time it’s so depressing

@Pomollo sorry I'm just seeing this message now. I got measured for below the knee open toe compression and picked up my prescription last week. Have to say was dreading it. However, I'm finding the socks super comfy and although I wasn't really aware of this before, my legs feel much better at the end of the day, less achy and heavy. My gripe is that I mainly wear ankle grazing length jeans and trousers with Birkenstocks/flip flops/trainers all of the warmer months so it feels like half my wardrobe doesn't work anymore. I tend to wear trainer boots in winter so it won't matter so much then I guess. I'm still not really happy with this as a solution for the rest of my life. I've changed my diet in an attempt to get to a healthier weight for my height and would like to get my veins properly treated in future. But for now it's stockings. I'd say definitely go talk to your GP about your legs although don't expect much. Although I found the vascular consultant to be an arrogant and ignorant man I'm still glad I was referred otherwise I wouldn't have got the socks as my GP didn't seem to be able to do this without specialist input.

Not sure if anyone will get notifications from here but wanted to ask your thoughts on buying compression socks/tights not on prescription. I have two pairs to last me 6 months which is standard. But I was thinking in the colder months it would be good to have footless compression full tights to wear and wonder if this is something people do - obviously I would need to check the compression range and sizing was right. Do these have to be exactly the same do you know? Or is similar ballpark okay. Thanks

I had good results for years from an American brand called L'eggs that I found on Amazon - black footless tights that I used to wear with longline tops or tunics.

I had amazing results with sigvaris compression stockings , they’re really the bees knees, pricey but so good

@Cabbageandcoconut @Phineyj thanks for replying. Were you able to match your prescribed compression pretty well with those brands you mention?

I didn't have a prescribed compression. However, they looked "normal" which is what I was after.

I'm not sure how important it is to exactly match the prescribed compression. @olympicsrock if you're around maybe you could advise?