Varicose Veins

Many adults suffer from dilated unsightly varicose or spider veins.

With modern treatment, vein sufferers no longer need to resign themselves to the pain and discomfort, restrictions to daily activities and the embarrassment associated with unsightly legs.

Varicose Veins (VVs)

Abnormal connections from deep to superficial leg veins result in increased pressure and downward reverse blood flow, causing distension and eventually prominent veins. Surface veins can be quite uncomfortable and sometimes there can be very little to see on the skin. If left untreated, poor oxygenation and nutrition to the skin can result, with long term complications of itchy eczema, ulcers or haemorrhage. Varicose veins have a significant impact on quality of life.

Symptoms of VVs

  • Aching
  • Swelling
  • Heavy or Tired Legs
  • Blue lower legs/feet
  • Restless Legs Syndrome
  • Cramps
  • Burning Pain
  • Varicose eczema
  • Pigmentation changes
  • Ulcers

Varicose veins affect 50% of men and women. They worsen with multiple pregnancies, in less active occupations and if standing for long periods.  Most are genetic - if they are in your family, you are likely to get them.

Assessment Process

A thorough assessment of your symptoms and general health is done at your initial consultation with a Vein Physician.  Your superficial leg veins are then mapped with an ultrasound – to document the flow pattern, size, and connections of your leg veins. This is essential prior to any treatment.

After mapping, the most appropriate treatment options will be discussed with you.


Nonsurgical options are safe popular and effective – and usually include Endovenous Laser Ablation (EVLA) or Ultrasound Guided Foam Sclerotherapy.

Endovenous laser ablation (EVLA) has become the gold standard for treatment of varicose veins worldwide in all western countries for over 10 years.  Our team has pioneered this in NZ, with extensive experience since 2004.  EVLA simply welds shut the inner vein lining using laser heat. Under ultrasound guidance a laser fibre is introduced into the vein, which is surrounded and compressed with dilute local anaesthetic. The fibre is slowly and painlessly withdrawn, sealing the inside of the vein immediately.  This shuts off the main pressure from above, and the vein scars away naturally.  Bruising and discomfort are minimal.  Veins of any size can be treated - even large diameter vessels.

Foam ultrasound guided sclerotherapy (UGS) is used to remove the downstream and branch vessels in combination.  This is minimally invasive and patients can immediate return to activity or work.  An irritant sclerosant foam is introduced carefully into diseased veins under ultrasound guidance.  Veins close by the natural healing process.  2-3 treatment sessions are needed. Symptoms associated with varicose veins resolve readily after treatment and varicose eczema and ulcers heal. Treating the underlying cause of the symptoms is the key.

After treatment, compression stockings are worn for 10 days. Ongoing ultrasound surveillance is important for safety and to ensure the successful completion of treatment.

Any remaining small spider veins may later be treated with microsclerotherapy or a vascular laser to improve cosmetic appearance.


  • Veins of any size can be treated.
  • Diseased veins removed have no useful function, other veins take over
  • Veins worsen with pregnancy and are ideally treated beforehand
  • New veins may appear in time and non-surgical treatments are easy to repeat
  • Ultrasound mapping is essential for safe and complete treatment
  • UGS and EVLA are safe, easy, and cost effective office procedures
  • Treatments are virtually painless
  • Early treatment avoids vein complications

What happens without treatment?

  • Hard painful red areas of overlying skin can arise
  • Heavy bleeding, or non-healing ulcers may occur
  • Eczema and pigmentation from poor circulation are common
  • Higher risk of DVT, especially with surgery or flying

What treatments are possible?

  • Compression hose alone – a temporary measure for comfort and swelling
  • Ultrasound Guided Sclerotherapy, UGS
  • Endovenous Laser Ablation, EVLA
  • Surgery - now outdated, is less effective, causes scars, has a higher DVT risk, higher recurrence rates, and carries the increased risk of general anaesthesia

Laser or Intense Pulsed Light (IPL)

Fine facial veins, spider naevi, rosacea and birthmarks are treated with a powerful vascular laser (Laserscope “Gemini”, or a “Medlite C6”), and occasionally intense pulsed light, IPL. Unsightly blood vessels coagulate, fade and disappear.  Several treatments may be required. This is suitable for smaller veins only, especially fine red vessels.