Q. I’m worried about shedding my thick tights and showing my varicose veins at a summer wedding. I know it takes time to recover and wonder if I’ve left it too late? Also how do I find a good clinic as I gather it can’t be done on the NHS?

A. Consultant vascular surgeon Mr. John Scurr (jscurr.com) says recovery time is usually 12 weeks.  ‘The main problem is bruising and this varies from patient to patient,’ he says. So if you want to bare your legs, or sheath them in sheer tights, for May/June, you do have time if you organise it now.

These dilated blue veins, which are usually found on your legs, vary from tiny dilated veins through to bunch of grape-like structures behind the knee. ‘They can cause discolouration of the skin and ulceration around the ankle, with aching or tingling legs, pain while standing and cramps,’ says Mr. Scurr.

It is always worth consulting your GP, especially if you have any of the symptoms above. But if your concern is primarily cosmetic, there is, as you suspect, little likelihood of getting this treatment on the NHS (although you may be able to claim it on medical insurance). 

Even if you did fulfill the criteria for NHS treatment, you would probably be on a long waiting list. According to NHS UK, if treatment is necessary, your doctor may first recommend up to six months of self care at home, eg compression stockings (see below), regular exercise, avoiding standing up for long periods and elevating the affected area when resting.

Your GP may know of a good private clinic but very often they don’t. A practical route is to ask for recommendations from people who have had it done in your area. Be cautious and choosy. It is essential to have a proper assessment to assess the state of your veins both on the surface and deeper; Mr. Scurr advises checking the clinic will offer a non-invasive ultrasound imaging assessment. He also warns that some private clinics are charging very high fees so do shop around. 

There are various different techniques for removing varicose veins. Mr. Scurr advises that early varicose veins can be managed successfully with sclerotherapy, where a sclerosant chemical is injected into the vein, damaging the internal lining and causing the blood to clot, so in time your body destroys the vein and it disappears.

Larger veins usually need either surgery or ultrasound guided foam sclerotherapy, where medication in the form of foam is injected into the affected vein to shrink it. 

Wearing compression tights after treatment can help recovery. Mr. Scurr advises ‘the best compression stockings are graduated exerting a greater pressure at the ankle than at the thigh. Class one is used to prevent blood clot's when lying down. Class two is typically worn by patients who have vein problems. That can include varicose veins, deep vein problems or in severe cases patients with ulcers around the ankles. They generally help all these patients.’

There are several reliable brands available from any good pharmacist, including Mediven, Venosan and Sigvaris. ‘They are available online but you should be measured for the right size so the correct pressure is exerted,’ Mr. Scurr cautions. ‘They should be worn as much of the time as possible but you can leave them off at night.’

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