Varicose Vein Treatment: A Consultant-Led Guide to Modern Options
If you are considering varicose vein treatment, the first thing worth knowing is that you are far from alone. Varicose veins affect up to a third of adults at some point in their lives, most often appearing in the legs and feet, and most commonly developing from around age fifty onwards. They are particularly common in people who stand for long periods, in those who have a family history of vein problems, and in women during and after pregnancy. Some patients seek treatment for cosmetic reasons, but many do so because the veins have started to cause pain, itching or swelling, or because they are concerned about progression to varicose eczema or ulceration.
This guide explains what varicose veins are, why they develop, and the range of modern, non-surgical options available at Array Aesthetics in Belfast under the care of consultant vascular surgeon Ms Gemma McKevitt.
What are varicose veins?
Varicose veins are enlarged, dilated veins that most often appear on the legs and feet. They typically present as prominent veins that look dark purple or blue, and they are often described as twisted, ropey, or bulging. Smaller, finer thread veins (sometimes called spider veins) sit closer to the surface of the skin and have a slightly different appearance, but the underlying mechanism is similar.
To understand why they form, it helps to understand what veins are doing in the leg. Unlike arteries, which have the help of the heart’s pumping action, leg veins have to move blood upwards against gravity. They rely on a combination of muscle contraction and a series of one-way valves to keep blood travelling towards the heart.
What causes varicose veins?
When the small valves inside the veins weaken or fail, blood that should be traveling upwards begins to flow backwards instead. This pooling of blood causes the affected veins to enlarge, distend, and eventually become visible at the surface as varicose veins. The process is gradual rather than sudden, which is why varicose veins often appear and worsen over a number of years.
A range of factors can increase the likelihood of developing varicose veins. Family history is one of the strongest predictors. Pregnancy, particularly multiple pregnancies, places additional pressure on the veins of the lower body. Occupations that involve long periods of standing, such as nursing, teaching and hospitality, are linked with higher rates of varicose veins. Age, weight, and hormonal changes can all contribute as well.
Signs and symptoms
Some people with varicose veins experience no symptoms beyond the visible appearance of the veins themselves, but others find them genuinely troublesome. Common signs and symptoms include:
- Aching, throbbing or heavy legs, particularly at the end of the day
- Itching around one or more veins
- Swelling in the feet, ankles or lower legs
- Muscle cramps, especially at night
- Skin discolouration around the affected vein
- Veins that are dark purple or blue and appear twisted or bulging
- Bleeding from a vein, in more advanced cases
Symptoms often worsen after long periods of sitting or standing and may improve when the legs are elevated. If you have noticed changes in the skin around a varicose vein, persistent swelling, or any bleeding, it is worth seeking medical advice rather than treating the issue as purely cosmetic.
Modern varicose vein treatment options
There are several non-surgical treatment options for varicose vein available, and the right one for you will depend on the size, depth and distribution of the affected veins, as well as the symptoms you are experiencing. At Array, all treatment is carried out by Ms Gemma McKevitt, a consultant vascular surgeon and the first trainee in Northern Ireland to complete training solely in vascular surgery.
The most commonly used techniques fall into two broad categories. The first uses an injected solution or foam to close the affected vein from within, a process known as sclerotherapy. The second uses heat energy delivered through a thin probe to seal larger veins, a process known as endovenous ablation.
Microsclerotherapy
Microsclerotherapy is typically used for smaller varicose and thread veins close to the surface of the skin. A fine needle is used to inject a sclerosant solution directly into the affected vein. The solution irritates the inner lining of the vein, causing it to swell, clot, and gradually be reabsorbed by the body. The result is a vein that fades from view over the weeks following treatment.
The procedure is quick, causes only minimal discomfort, and most patients are able to resume normal activities the same day. Veins can occasionally appear slightly more prominent for a few weeks immediately after treatment before fading, and most patients require a course of two to six sessions spaced four to eight weeks apart to achieve the best results.
Foam sclerotherapy
Foam sclerotherapy uses a similar principle but employs a foam preparation rather than a liquid. The foam is more effective at displacing blood within the vein, which makes it particularly suitable for larger varicose veins. Like microsclerotherapy, it is performed in a clinic, requires no general anaesthetic, and allows patients to walk out and resume normal life on the same day.
Radiofrequency ablation (endovenous ablation)
For larger and deeper varicose veins, particularly those causing aching, swelling, itching, or skin discolouration, radiofrequency ablation is often the most appropriate option. Also known as endovenous ablation or RFA, this procedure uses ultrasound to guide a thin radiofrequency probe into the affected vein. Local anaesthetic is administered along the length of the vein, and radiofrequency energy is then used to heat the vessel from within, causing it to close, shrink, and eventually scar down.
Endovenous ablation is significantly less invasive than traditional vein stripping surgery. Most patients can walk immediately after treatment and return to normal activities within one to two days. At Array, RFA can be performed on one leg (unilateral) or both legs (bilateral), with the choice depending on the pattern of vein involvement identified at consultation.
What to expect at the consultation
Every treatment plan at Array begins with a consultation with Ms Gemma McKevitt. The consultation includes a full clinical assessment, ultrasound imaging where appropriate, and a discussion of which treatment or combination of treatments is most likely to deliver the result you are looking for. Treatment is never recommended without first identifying the underlying pattern of vein involvement, because successful long-term results depend on treating the source of the problem rather than only the visible veins.
Consultation pricing, microsclerotherapy, foam sclerotherapy, and unilateral and bilateral RFA pricing is published in full on the vein clinic page so that there are no surprises ahead of booking.
Varicose vein treatment at Array Aesthetics in Belfast
Array Aesthetics is a doctor-led clinic on Belfast’s Lisburn Road, regulated by RQIA and recognised as Best Clinic Ireland and Northern Ireland at the Aesthetics Awards in 2023, 2024 and 2026. The vein clinic combines consultant vascular surgery expertise with a calm, patient-focused environment, and welcomes enquiries from patients across Northern Ireland and Ireland.
To learn more about the available varicose vein treatment options, current pricing, or to arrange a consultation with Ms Gemma McKevitt, visit the vein clinic page or contact the team directly.