What are varicose veins?
Veins carry blood from the leg back up to the heart against gravity. They manage it with one-way valves that open to let blood pass upward and close to stop it falling back. When those valves fail, blood pools in the superficial veins, pressure rises, and the veins stretch into the visible, twisted cords called varicose veins.
Untreated, the raised pressure is passed on to the skin at the ankle. Over years that produces brown staining, hardening of the skin (lipodermatosclerosis), eczema and eventually a venous ulcer that is slow to heal. Varicose veins are therefore not only a cosmetic problem — they are the early, easily treated stage of chronic venous disease.
Symptoms to watch for
- Bulging, rope-like or twisted veins on the calf or thigh
- Aching, heaviness or throbbing that worsens through the day and with standing
- Ankle swelling that settles overnight and returns by evening
- Night cramps, restless legs or itching over a vein
- Brown or purple staining of the skin around the ankle
- Hard, tight skin at the inner ankle, or an ulcer that will not heal
- Bleeding from a vein close to the skin surface
When to seek urgent care
Sudden bleeding from a varicose vein, a hot painful lump along a vein, or a rapidly swelling and painful calf needs same-day assessment.
How it is diagnosed
Investigation is chosen to answer a specific question rather than as a blanket screen. For varicose veins that usually means:
- Clinical examination of the leg, standing, to map the distribution of the veins
- Venous duplex ultrasound — the key test, showing which valves leak, in which vein, and over what length
- Assessment of the deep venous system, since deep vein disease changes the plan
- Photographic and clinical grading (CEAP) to record severity and track change
Treatment options at Siva Sakthi
Which of these applies to you depends on what the assessment shows. The options are discussed with you, including what each involves and what recovery looks like.
- Compression therapyGraduated compression stockings of the correct class reduce venous pressure and control symptoms, and are used both as treatment on their own and after any procedure.
- Endovenous laser ablation (EVLA)A fine laser fibre is passed inside the faulty vein under ultrasound guidance and the vein is sealed from within, through a needle puncture rather than a groin incision.
- Radiofrequency ablationThe same principle using controlled radiofrequency heat to close the refluxing vein segment.
- Sclerotherapy and foam sclerotherapyAn agent injected into smaller varicosities and reticular veins collapses and closes them; used alone for small veins and to finish after ablation.
- Ambulatory phlebectomyBulging surface tributaries are removed through punctures of a few millimetres that usually need no stitches.
- Open surgeryLigation and stripping remains appropriate for particular anatomy, recurrent disease or where ablation is unsuitable.
- Ulcer careWhere a venous ulcer has formed, treatment combines compression bandaging and wound care with correction of the underlying reflux.
Common questions
Endovenous ablation and phlebectomy are usually done under local or regional anaesthesia with sedation. Most patients describe pressure rather than pain during the procedure and manage afterwards on simple analgesia.
Walking is encouraged the same day — it is part of the recovery, not against it. Desk-based work is commonly resumed within a few days, though this depends on the extent of treatment and your surgeon's advice.
Correctly ablated veins stay closed. New varicose veins can still develop elsewhere over the years, because the underlying tendency remains, which is why compression and follow-up are advised.
Yes. Compression, lifestyle measures and sclerotherapy treat many patients, and modern ablation is performed through a needle puncture rather than an open operation. The duplex scan decides what is appropriate.
Book a consultation in Guntur
Varicose Veins is assessed and treated by Dr. Vijay Kumar Vishnumolakala, MS, MCh, at our Kothapeta clinic. Request an appointment or call +91 00000 00000.