2 Indications and current treatments
2.1 Varicose veins are a sign of underlying venous insufficiency and affect 20–30% of adults. Most people with varicose veins have no symptoms but venous insufficiency may cause fatigue, heaviness, aching, throbbing, itching and cramps in the legs. Chronic venous insufficiency can lead to skin discoloration, inflammatory dermatitis and ulceration. Great saphenous vein insufficiency is the most common form of venous insufficiency in people presenting with symptoms.
2.2 A NICE guideline describes recommendations for the diagnosis and management of varicose veins. Many people have varicose veins that do not cause any symptoms or need treatment on medical grounds. However, some people will need treatment for the relief of symptoms or if there is evidence of skin discolouration, inflammation or ulceration. Treatment options include endothermal ablation, ultrasound‑guided foam sclerotherapy and surgery (usually stripping and ligation of the great and small saphenous veins, and phlebectomies).