Got varicose veins? Here's everything you need to know.

Image: iStock.

They’re the big, protruding blue veins that stick out on your legs. Yep, we’re talking about varicose veins. If yours are a source of pain or discomfort, there are ways you can get some relief. And if you’d darn well like them gone altogether, it’s not as difficult (or expensive) as you might imagine.

What are varicose veins?

Varicose veins are enlarged leg veins caused by leaky valves.

Like all veins in your body, leg veins carry blood towards your heart. (Arteries are the blood vessels that carry blood away from your heart to the rest of your body.) But because your leg veins are fighting gravity, blood-flow up to your heart is controlled one-way valves that open and shut.

When the valves are working properly, they stop the blood from flowing back down– particularly when you stand-up. When someone has leaky valves, the blood isn’t draining from their leg properly and a build-up of pressure damages their veins. This when they become dilated, lumpy and knotty – aka varicose veins.

Who gets varicose veins?

“They’re generally born with a predisposition, but over time and the effects of gravity and being upright and various physical activity, pregnancy – that all causes the build up of venous pressure,” says vein specialist Dr Peter Chu, who sees five to 10 patients a week at Melbourne Vein Centre who are seeking varicose vein treatment.

He says being born with the predisposition doesn’t necessarily mean you are going to develop varicose veins, but you’re more likely to get them as you get older.

“You may have the faulty valves, but things that encourage the veins to grow is if you’re more physical active on your feet a lot – that puts more pressure on the veins with the affects of gravity and also with the hormonal changes of pregnancy.” (Meanwhile, these are some not-so-sound treatments celebrities have tried. Post continues after gallery.)

How can I get rid of them?

There is no cure for varicose veins because of their underlying cause, but there are a number of treatments available. Dr Chu says varicose veins may reoccur, with reoccurrence rates between 10 and 30 percent depending on the type of treatment.

Compression therapy.

Compression stockings are worn every day to relieve the symptoms of pain and discomfort by controlling the build-up of blood in the legs. The stockings must be replaced about every six months.

Pros: This option is completely non-invasive, painless, and requires no recovery time. If you’re diligent with wearing stockings every day, you can prevent future complications.

Cons: The stockings can be uncomfortable and difficult to put on. Dr Chu says, for these reasons, compliance is very low and this treatment is “not very effective” in the long term. This method doesn’t address the cause of the symptoms, just relieves them.

Cost: $120 - $150 per pair, replaced once or twice a year.

Surgery.

This involves going under general anaesthetic, while a surgeon removes the damaged veins as well the faulty valves that cause them.

Pros: There’s a lower reoccurrence rate of between 10 and 20 per cent.

Cons: It requires a hospital stay and about two to three weeks of recovery. You're left with small, but permanent scarring. There's also a very low risk of numbness around the ankle from nerve injury.

Cost: $1500 - $3000 out-of-pocket for most procedures, but free if you qualify for treatment in the public system.

Sclerotherapy.

This method involves injecting an irritant into the vein – sometimes a strong saline solution – which causes the vein to collapse and, essentially, die. It’s then absorbed into the body. The area will be a bit inflamed immediately afterward and tender to touch – similar to a bruise.

Pros: You can receive treatment in a clinic, rather than a hospital, and be back on your feet straight afterwards.

Cons: The reoccurrence rate is about 30 percent. One in 10,000 people are allergic to the medication, while 1 in 1000 may experience ulceration or deep vein thrombosis. Some people will see a brown "stain" on the skin over the treated veins for a few months and up to two years.

Cost: $500 - $2000 (after Medicare rebate).

Endovenous radiofrequency or laser ablation.

A special radio-frequency catheter or a laser fibre is inserted into the vein and burns it shut. This method often combined with sclerotherapy or surgery. The area will have minor inflammation and be tender to touch immediately afterward.

Pros: It’s a walk-in-walk-out treatment with no down-time. There’s a lower reoccurrence rate of about 10 percent.

Cons: It requires a reasonably straight vein to be able to put the fibre or catheter through. There is a less than 1 per cent risk of burn injury to the surrounding tissue. If combined with sclerotherapy it carries similar, but slightly-reduced, risks.

Cost: $1500- $3000 (after Medicare rebate).

VenaSeal vein glue.

A glue is injected into the varicose vein, which seals it shut. The vein dies and is absorbed into the body.

Pros: This is the least invasive option after compression therapy and there’s no need to take time off work to recover.

Cons: Dr Chu warns that VenaSeal is a new treatment, so success rates aren’t known beyond 18 months post-treatment. It’s equal to the most expensive option.

Cost: $3000 - $5000.

But it’s a vein, don’t I need it?

Your legs have two sets of veins, deep veins – which are inside the muscle - and surface veins. The surface veins link to the deep veins and aren’t as important.

The surface veins are more likely to become varicose and the only type that are treatable. Dr Chu said when a varicose vein is removed, the blood will always have another path to return to the heart.

As with any treatment, book an appointment with your doctor to get a professional opinion on which option will suit your situation best.

Do you have varicose veins?