Michelle Green, a 47-year-old credit controller, experienced severe cramping pain, itching, and restless legs due to a varicose vein in her left leg, which also led to a golf-ball-sized lump in her groin. Despite seeking medical help from her GP and later an NHS vascular team, she was told that treatment would only be offered if she developed an ulcer, a condition that could lead to infections and other serious health problems.
Green's experience highlights a broader concern raised by medical experts: that NHS treatment for varicose veins is often difficult to access, even for individuals with significantly affected limbs. These experts warn that many NHS trusts classify varicose veins as a cosmetic issue, delaying necessary interventions until ulcers form.
Varicose veins, which affect up to 40% of adults, occur when the valves within veins malfunction, causing blood to pool and leading to bulging, often dark-colored veins. In their early stages, they can manifest as restless legs and itching, as pressure from pooled blood irritates nerves and muscles. As highlighted by Nung Rudarakanchana, a consultant vascular surgeon, the skin can become fragile and break down into ulcers if left untreated, becoming chronic and difficult to heal.
Stephen Black, a professor of venous surgery, noted that these ulcers are costly to treat and can severely impact a patient's quality of life. They can lead to repeated infections, sepsis, and even sepsis, a life-threatening condition where the body's response to infection damages its own tissues.
Furthermore, research suggests links between varicose veins and other serious health conditions. Studies indicate that chronic inflammation associated with varicose veins may contribute to an increased risk of heart failure, ischemic stroke, and even cognitive decline. A 2025 study published in PLOS One suggested that treating varicose veins was significantly associated with a reduced risk of vascular dementia.
The National Institute of Health and Care Excellence (NICE) guidelines recommend treatment for individuals experiencing symptoms like pain, swelling, and itching due to saphenous vein involvement. Standard treatments include endovenous ablation (using heat energy to close veins) or foam sclerotherapy (injecting a solution to close veins). However, many NHS trusts reportedly do not adhere to these guidelines, often requiring patients to wait until ulcers develop.
This reluctance to provide early 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, the cost of private treatment, which can start at £2,500 for one leg, is prohibitive for many.
Michelle Green, unable to afford private treatment initially, eventually had her varicose veins treated privately with endovenous laser ablation and foam sclerotherapy. The procedure resolved her pain, itching, and the lump in her groin, significantly improving her mobility and quality of life. She emphasized the disparity in access to care, stating that many are forced to wait until their condition worsens due to financial constraints.