Varicose Veins: Symptoms and Treatment, Explained

What Are Varicose Veins?

Varicose veins are enlarged, twisted veins that sit just under the surface of the skin, most often in the legs and ankles. They form part of a spectrum of vein conditions that also includes spider veins and reticular veins, which are smaller and closer to the surface. Varicose veins themselves are usually larger, more raised, and more likely to cause physical symptoms rather than purely cosmetic ones.

To understand why they happen, it helps to know how leg veins normally work. Veins carry blood back up towards the heart, against gravity, using a series of one-way valves that open to let blood through and then close to stop it flowing backwards. When these valves weaken or become damaged, blood can flow backwards and pool in the vein instead of moving on. Over time, that pooling stretches and weakens the vein wall, and the vein becomes enlarged, twisted and visible under the skin. This underlying process is sometimes referred to as venous insufficiency, and it is the mechanism behind almost all varicose veins.

Varicose veins are extremely common, and while they can appear at any age, they become more frequent as people get older. They are not usually dangerous, but they rarely improve on their own, and in a minority of cases they can lead to complications if left untreated for many years. For a closer look at MLVC's approach to assessing and managing varicose veins, see our dedicated varicose veins page.

What Causes Varicose Veins?

There is rarely a single cause. Instead, varicose veins tend to result from a combination of factors that put extra strain on the valves in your leg veins.

• Genetics and family history – A family history of varicose veins is one of the strongest risk factors. If a parent or close relative has had varicose veins, you are more likely to develop them too, likely reflecting an inherited tendency towards weaker vein walls or valves.

• Age – Veins, like the rest of the body, lose some elasticity over time. Valves that have worked well for decades can gradually weaken, which is part of why varicose veins become more common as people move through middle age and beyond.

• Pregnancy – Pregnancy increases blood volume substantially and raises pressure in the pelvic and leg veins, while hormonal changes also soften vein walls. Many women first notice varicose veins during pregnancy, and while some improve after birth, others persist.

• Prolonged standing or sitting – Jobs and lifestyles that involve long periods on your feet, or long periods sitting without moving, reduce the calf muscle pumping action that normally helps push blood back up the leg. Over months and years, this can contribute to vein enlargement.

• Body weight – Women are affected by varicose veins more often than men, a pattern generally linked to hormonal factors across puberty, pregnancy and menopause, alongside the additional venous pressure that pregnancy itself creates.

None of these factors act entirely alone, and many people who develop varicose veins have several of them together.

Varicose Vein Symptoms: What to Look Out For

Varicose vein symptoms sit on a spectrum. Some people have visibly enlarged veins with no discomfort at all, while others experience significant daily symptoms even when the veins themselves look relatively minor. Common symptoms include visible bulging or twisted veins, usually blue or purple, most often on the calves, thighs or behind the knees; aching or throbbing in the legs, often worse by the end of the day; a feeling of heaviness or fatigue in the legs, particularly after standing for long periods; swelling around the ankles or lower legs; itching over or around the affected veins; night cramps, especially in the calves; and skin changes in more advanced or long-standing cases, such as discolouration, dryness or thickening of the skin near the ankle.

Symptoms are often worse at the end of the day, after long periods of standing, or in warmer weather, and tend to ease overnight or after resting with the legs elevated. It is worth noting that the size of a varicose vein does not always match the severity of symptoms. Some people with small, cosmetically minor veins report significant aching, while others with larger, more visible veins have few complaints beyond appearance.

For an overview of how we assess and treat varicose veins at MLVC, visit our varicose veins page.

How Are Varicose Veins Diagnosed?

A consultation with one of our doctors usually starts with a physical examination of your legs, standing and lying down, along with a discussion of your symptoms, family history and any previous treatments. You do not need a GP referral to book a consultation with MLVC. A referral is only required if a detailed vein-mapping ultrasound scan is needed and you want to claim a Medicare rebate for that scan. This ultrasound helps map exactly which veins are affected and how the valves are functioning, which guides the choice of treatment.

Varicose Vein Treatment Options

The good news is that varicose veins no longer mean major surgery for most people. At Melbourne Leg Vein Centre, we offer six non-surgical treatments, and the right one for you depends on the size, location and pattern of the veins involved, which is why an individual assessment matters.

• Surface Sclerotherapy – A fine needle is used to inject a solution directly into smaller surface veins, causing them to close off and gradually fade from view.

• Surface Laser Vein Treatment – Laser energy is applied to the skin's surface to target very fine veins that are too small to inject, heating and closing the vein without needles.

• Ultrasound (Guided) Sclerotherapy – A more targeted version of sclerotherapy, where ultrasound imaging is used in real time to guide the injection into larger or deeper veins that cannot be seen or safely treated from the surface alone.

• Endovenous Medical Glue (VenaSeal) – A medical adhesive is delivered into the faulty vein through a thin catheter, sealing it closed so blood reroutes through healthier veins nearby.

• Radiofrequency Ablation (RFA) – A thin catheter delivers radiofrequency energy inside the faulty vein, heating the vein wall so it collapses and seals shut.

• Endovenous Laser Ablation (EVLA) – Similar in principle to RFA, EVLA uses laser energy delivered via a catheter inside the vein to heat and close it from within.

For a full side-by-side look at all six approaches, visit our leg vein treatments hub.

What about Medicare rebates?

Medicare item 32500 provides a rebate for injecting veins that measure over 2.5mm in diameter, up to a maximum of six treatments in any 12-month period. Veins smaller than 2.5mm do not qualify for a Medicare rebate and attract GST. Larger varicose veins treated with radiofrequency ablation or laser ablation may be eligible for specific Medicare item numbers, though significant out-of-pocket costs typically remain, and the Medicare Safety Net may reduce these costs once you reach the relevant annual threshold. Our fees page explains typical costs, and our team can talk you through what applies to your own situation at your consultation.

Self-Care: What You Can Do Yourself

Not every varicose vein needs immediate medical treatment, and there is plenty you can do at home to manage mild symptoms or support your legs alongside professional care: wear compression stockings (graduated compression helps push blood back up the leg and can ease aching and swelling); stay active (walking and other low-impact exercise engage the calf muscles, which act as a natural pump); elevate your legs above heart level for short periods, particularly at the end of the day; maintain a healthy weight to reduce excess pressure on the leg veins; and avoid prolonged standing or sitting where possible, taking regular breaks to move around or shift position.

These measures can genuinely help with mild symptoms, but they do not reverse existing varicose veins. Once a valve has failed and a vein has become enlarged, self-care can support comfort, but only a medical treatment actually closes off the faulty vein.

When to See a Doctor

It is worth seeing a doctor about your varicose veins if you notice any of the following: the veins are causing persistent aching, heaviness or swelling that affects your daily life; the skin near the vein is becoming discoloured, hardened or itchy; you notice a vein that is tender, warm or suddenly more prominent; or you have any bleeding from a varicose vein, however minor. Even if your symptoms are mild, an assessment can clarify what is happening beneath the skin and outline your options, so you are not left guessing.

As always, this article is general information only, and a proper diagnosis and treatment plan should come from seeing a doctor in person.

Frequently Asked Questions:

Are varicose veins dangerous?

Most varicose veins are not dangerous and are more of a cosmetic and comfort issue than a medical emergency. In a minority of long-standing or untreated cases, complications such as skin changes, ulcers or superficial blood clots can develop, which is one reason it is worth having persistent or worsening veins assessed by a doctor.

Do varicose veins get worse over time if untreated?

They generally do not improve on their own and often gradually worsen over time, particularly if risk factors like prolonged standing or pregnancy continue. The pace of progression varies a lot from person to person.

What is the difference between varicose veins and spider veins?

Varicose veins are larger, raised and twisted, and usually cause physical symptoms like aching or heaviness. Spider veins are smaller, flatter, and typically only a cosmetic concern. You can read more on our dedicated spider veins page.

Is treatment for varicose veins painful?

Modern non-surgical varicose vein treatment options are generally well tolerated, with most people describing mild discomfort rather than significant pain, and most procedures allow you to walk out and resume normal activities the same day. Your doctor will talk you through what to expect for your specific treatment.

Do I need a GP referral to see a doctor about varicose veins?

No referral is needed for an initial consultation at MLVC. A referral is only required if a detailed vein-mapping ultrasound scan is needed and you wish to claim a Medicare rebate on that scan.

Will Medicare cover my varicose vein treatment?

It depends on the vein size and treatment used. Medicare item 32500 covers injection of veins over 2.5mm in diameter, up to six treatments in a 12- month period, while veins under 2.5mm do not qualify for a rebate. Larger veins treated with radiofrequency or laser ablation may attract specific Medicare item numbers, though out-of-pocket costs often remain. Our fees page has more detail.

In Summary

Varicose veins are a common condition caused by faulty one-way valves that let blood pool in the leg veins, and they can range from a purely cosmetic concern to a source of real daily discomfort. Understanding varicose veins symptoms and treatment options, from genetics and pregnancy as common causes, through to aching, swelling and visible bulging as typical symptoms, puts you in a better position to decide what to do next. Melbourne Leg Vein Centre has been assessing and treating leg veins in Melbourne since 1986, and our doctors offer six non-surgical treatment options tailored to the size and pattern of your veins.

If you have been noticing symptoms or simply want an opinion on veins you have been living with, you can book a consultation with our team, no GP referral required.