The presence of varicose veins is usually obvious and most people can “diagnose” varicose veins for themselves. The bulging veins may become more visible and tender in hot weather or after standing and sitting for a long period. They may itch and cause swelling of the ankle and foot.  More severe cases may have eczema and skin discolouration.

In healthy veins, blood flows freely towards the heart. In conditions where the flow is restricted or if the flow is in the wrong direction (reflux), the symptoms and signs may be more subtle and less obvious. Reflux is by far the commonest vein problem in the legs.

The precise source of reflux (abnormal backward flow of blood) which feeds the veins may be some distance from the varicose veins themselves. In some cases, reflux can cause ache, swelling and discomfort without the appearance of varicose veins.

Although varicose veins may only affect one leg, detailed examination often shows the early signs of problems in the other leg. Left untreated varicose veins may develop in this leg too.