Varicose veins on the NHS: who qualifies and what is excluded

The line the NHS draws

The NHS states it directly: 'Treatment to improve how varicose veins look is not usually available on the NHS if they're not causing any other problems. You may be able to pay for it privately.' It also says varicose veins do not always need treatment, and that a GP may refer you to a specialist for tests and treatment if you have symptoms such as pain, heaviness, swollen legs, itching or skin changes, or any complications such as ulcers on your legs (nhs.uk, page last reviewed 1 July 2024).

The referral criteria, as NICE sets them out

NICE guideline CG168 tells clinicians to refer people to a vascular service if they have any of the following. This is the list worth taking to a GP appointment.

• Symptomatic primary or symptomatic recurrent varicose veins, which NICE defines as veins found in association with troublesome lower limb symptoms, typically pain, aching, discomfort, swelling, heaviness and itching
• Lower-limb skin changes such as pigmentation or eczema thought to be caused by chronic venous insufficiency
• Superficial vein thrombosis, characterised by the appearance of hard, painful veins, with suspected venous incompetence
• A venous leg ulcer, which NICE defines as a break in the skin below the knee that has not healed within 2 weeks
• A healed venous leg ulcer

NICE also says people with bleeding varicose veins should be referred to a vascular service immediately, and the NHS advises asking for an urgent GP appointment or contacting NHS 111 if your varicose veins are bleeding.

What the NHS says you can do meanwhile

• Keep to a healthy weight, and put your legs up when you can, for example lying down with your legs on cushions
• Exercise regularly, such as running or walking, to improve blood flow
• Use a moisturising cream or lotion if the skin is dry, flaky or itchy, and try not to injure your legs
• Avoid standing for long periods, and avoid sitting for long periods unless your feet are raised

If you are pregnant

The NHS says that if you get varicose veins during pregnancy you may be able to use compression stockings, but that procedures or surgery are not usually recommended while you are pregnant, and that varicose veins often get better or go away after the baby is born. NICE puts the same point as a recommendation not to carry out interventional treatment during pregnancy other than in exceptional circumstances. A clinic quoting you for a procedure while you are pregnant is worth questioning.

If you meet the NICE referral criteria, a GP referral costs nothing and is worth pursuing before paying privately, even if the wait is long. Waiting times differ by hospital, and in England you have a legal right to start non-urgent consultant-led treatment within 18 weeks of referral and to ask for another provider if you are likely to wait longer (nhs.uk).