Varicose veins affect people's quality of life and interventions greatly improve their symptoms.

While the majority will only suffer mild symptoms and cosmetic issues, some patients with varicose veins will go on to develop skin damage from their veins – venous disease.

This includes venous eczema or haemosiderin deposition, which is a brown staining of the skin. Also possible is lipodermato-sclerosis, which means an inflammation and hardening of the fat underneath the skin, even in the thinnest legs, resulting in hardening and reddening of the skin, pain and a tapering of the legs above the ankles and, most worryingly, venous leg ulcers.

Treatments are minimally invasive and include radiofrequency ablation, ultrasound guided foam sclerotherapy and phlebectomy which give excellent results.

They can be performed under local anaesthetic, have a rapid recovery and speedy return to work and activities.

Patients are most commonly concerned by either the cosmetic appearance of their veins or the symptoms from them, which includes heaviness, swollen and painful legs and the associated impact on their mental health. Indeed some people suffer from significant symptoms from varicose veins but do not have any visible veins - the only way to identify these people is with a careful history and examination by a vein expert and ultrasound imaging. Those that have done a bit of research into varicose veins often worry about skin damage and ulceration.

If patients are seeking treatment of cosmetic spider veins in the skin, they should have a venous ultrasound scan to ensure there are no underlying varicose veins that require treatment first (as these often feed the veins in the skin) as otherwise they will have rapid recurrence of their veins.

Varicose veins are very common and affect more than one in three adults, both men and women. Often hereditary in cause, they occur because the valves of the veins weaken and fail to work effectively.

The National Institute for Health & Care Excellence (NICE) advises minimally invasive surgery under local anaesthetic, where patients can walk in and walk out within a couple of hours, and quickly return to driving and normal activities.

Sadly for the majority of patients, the NHS in England and Wales no longer offers varicose vein treatment.

Varicose vein and leg ulcer treatment is available privately at Nuffield Health Cardiff and Vale Hospitals, which is a sponsor of the South Wales Health and Care Awards 2022.

Recently two consultant vascular surgeons have joined the team, working there in addition to their NHS practice, where they have already gained in-depth experience and research knowledge.

Venous disease specialists Huw Davies and Lewis Meecham have many research papers and a wealth of NHS and private patients who have benefitted from their skills and expertise. A range of walk in/walk out treatments, depending on the diagnosis, are available.

Huw Davies said: “Patients should definitely seek early attention for their veins if they are concerned - it's well documented that varicose veins affects people's quality of life and that interventions improve their symptoms.

"While the majority will only suffer mild symptoms and cosmetic issues, some patients with varicose veins will go on to develop skin damage from their veins - this includes venous eczema or haemosiderin deposition, which is a brown staining of the skin.

"Also possible is lipodermato-sclerosis, which means an inflammation and hardening of the fat underneath the skin, even in the thinnest legs, resulting in hardening and reddening of the skin, pain and a tapering of the legs above the ankles and of course most worryingly - leg ulcers.”

Treatments are minimally invasive, can be performed under local anaesthetic, have a rapid recovery and speedy return to work and activities.

Both of the new Nuffield Health consultants in Cardiff use radiofrequency ablation (RFA), which is similar to laser treatment but uses electricity to generate heat to surgically remove the vein rather than light and ultrasound guided foam sclerotherapy as well as the surgical treatment option of phlebectomy.

Huw Davies said: “I've developed a particular interest in ultrasound guided foam sclerotherapy - this minimally invasive technique is quick and effective in the right hands and is an excellent option to both RFA and phlebectomy.

"Having an intimate knowledge of these techniques allows me to combine them as appropriate and develop a bespoke treatment package for each individual patient. We were both trained in foam sclerotherapy in a UK unit which has published its results extensively and achieves excellent short, mid and long term results from this treatment.”

“Patients are most often concerned by either the symptoms or the cosmetic appearance of their veins. Some do not even have visible veins showing but suffer from significant symptoms such as pain, aching, heaviness and leg swelling on a daily basis, which reduces both their physical well-being and affects their mental health. The only way to identify these people is through taking a careful history and examination by a vein expert and ultrasound imaging. Even if the damage is mainly cosmetic, it is important to have a venous ultrasound to rule out underlying deep varicose veins that require treatment first, as otherwise they will have a rapid recurrence of their veins. These tools enable us to make the optimal recommendation for treatment”.

Vein specialists Huw Davies and Lewis Meecham are working on further improving services for patients in south east Wales.

Their international research in this area is vital. The NICE guidelines on superficial venous disease were a major step forward and it also recognised that compression stockings are not an adequate long term management option. Huw Davies ran an award winning and the largest multi-centre study across Europe on the safety of ultrasound guided scleropathy involving 8500 patients. Lewis Meecham is also a fluent Welsh speaker.

To make an appointment to have your visible veins or your symptoms checked, please ring Nuffield Health Cardiff and Vale Hospitals on 02920 836714 or go to: https://www.nuffieldhealth.com/hospitals/cardiff-and-vale