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NICE backs newer treatment alternatives for varicose veins


People with varicose veins should be offered less invasive treatments before doctors resort to surgery, health officials have said.

Historically surgery and compression stockings were the only option for people suffering from complications from the condition but in recent years new treatments have been developed.

“We are highlighting the right tools and treatments healthcare professionals should use to help improve symptoms for affected patients”

Gillian Leng

These alternatives can result in much faster recovery and shorter hospital stays, the National Institute for Health and Care Excellence, said.

In its new quality standard, NICE said that patients in England should first be offered laser treatment or heat therapy followed by injections of special foam into the affected veins before doctors consider surgery or compression stockings.

Up to a third of the adult population are affected by varicose veins. The condition normally occurs in the legs and develops when small valves inside the veins stop working properly, causing them to become enlarged and blood to flow in the wrong direction.

Many people with varicose veins have no symptoms, but for some the swollen veins can cause pain, aching, itching or bleeding and even leg ulcers.

In its new quality standard, NICE also said that patients should be referred to a vascular service if they have varicose veins that cause symptoms or complications.

Gillian Leng

When they are seen by the vascular service, patients should be assessed with a “duplex ultrasound” instead of handheld Doppler machines − which NICE says are “outdated and do not provide the detailed, accurate information produced by duplex ultrasound”.

NICE’s deputy chief executive Professor Gillian Leng said: “Our quality standards aim to help healthcare professionals in the NHS pinpoint the areas where improvements are most needed to provide the best care for patients.

“With our standard for varicose veins, we are highlighting the right tools and treatments healthcare professionals should use to help improve symptoms for affected patients.”


Readers' comments (4)

  • ..and has anybody invested in the equipment or workforce to scan all the additional varicose vein patients?

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  • 'Ive been to my GP for my varicose veins but they wont refer me for treatment ! Do they not have to follow NICE guidelines ?

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  • I have set up a laser vein clinic with a vascular surgeon here in Australia. We have to depend upon patient with private funds or pensions to be able to pay for their treatment. Our health system will only fund the ultrasound pre and post laser.
    The whole session takes 45mins per leg including sclero injections. We have had really good results in the healing of ulcers and happy patients. We would love to be able to offer this to patients in great need rather than waiting on never ending lists.

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  • It's all well and good NICE setting the guide lines, it's just a shame they are not available on the NHS and would cost a few thousand pounds to have done privately. I also had trouble getting a referral to a vascular surgeon.

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