Michelle Green, a 47-year-old credit controller, experienced severe pain, itching, and swelling in her left leg due to varicose veins. The condition worsened over two years, leading to a golf-ball-sized lump in her groin, which she initially feared was cancer. Doctors informed her the lump was an extension of her varicose vein, but she was told by an NHS vascular team that she would need to wait until her veins developed ulcers before qualifying for treatment.
Green's experience highlights a broader issue where NHS treatment for varicose veins can be difficult to access, even for those with significant symptoms. Experts warn that some NHS trusts consider varicose veins a cosmetic issue until they lead to ulceration, a condition that can cause infections and severely impact a patient's quality of life.
Varicose veins affect up to 40% of adults. They occur when valves within veins become faulty, causing blood to pool. Early symptoms can include restless legs and itching at night, while untreated veins can progress to leg ulcers. These ulcers are fragile and difficult to heal, often leading to chronic conditions, repeated infections, and potentially sepsis.
Recent research has also suggested links between varicose veins and other serious health concerns, including heart failure, ischemic stroke, and even cognitive decline. Inflammation associated with pooled blood in the legs may spread throughout the body, potentially increasing the risk of blood clots. A 2025 study published in PLOS One indicated that treating varicose veins was associated with a reduced risk of vascular dementia.
Despite guidance from the National Institute for Health and Care Excellence (NICE) recommending treatment for symptomatic varicose veins, including pain, swelling, and itching, many NHS trusts reportedly do not offer these interventions. NICE guidelines suggest treatments like endovenous ablation or foam sclerotherapy for affected saphenous veins.
Professor Stephen Black, a vascular surgeon, noted that NHS trusts often fail to recognize the importance of treating varicose veins as outlined by NICE, viewing them as merely cosmetic. This reluctance to treat can lead to significant patient suffering and increased healthcare costs associated with managing complications like leg ulcers, which are expensive to treat and can require extensive wound care and prolonged hospital visits.
The difficulty in obtaining NHS treatment has led to a rise in patients seeking private care. Data from the Private Healthcare Information Network shows a 38% increase in private endovenous ablations between 2019 and 2023-24. However, private treatment can be costly, with prices starting around £2,500 for one leg, making it inaccessible for many.
Michelle Green ultimately paid £2,600 for private endovenous laser ablation in July 2024, after her father offered to fund the treatment. She underwent a six-week course of compression stockings and a subsequent foam sclerotherapy session to address smaller affected veins. Following the treatment, her protruding vein and groin lump disappeared, and the pain and itching resolved, significantly improving her quality of life and allowing her to be more active.