FAQs: varicose veins and deep vein thrombosis

Written by: Mr Harpaul Flora
Edited by: Bronwen Griffiths

Varicose veins occur when superficial veins, which are located just under the skin, have become tortuous and dilated because the one-way valves in them are no longer working. Therefore, the blood is able to flow backwards and collect in the vein creating a downward pressurisation in the leg. Mr Harpaul Flora, a leading vascular surgeon, answers your frequently asked questions on both varicose veins and deep vein thrombosis.

As a result of the valve failure within the veins you could experience any of the following symptoms:

  • Pain
  • Limb swelling
  • Leg heaviness and fatigue
  • Night cramps
  • Skin changes
  • Ulcers

Varicose veins usually get worse over time but the rate at which this happens in individuals is unpredictable. Most people with varicose veins won’t get a leg ulcer, but if you have skin changes already you are at an increased risk of this. If you injure your leg at your ankle with a break in the skin, healing may well be delayed because of your veins.

Am I at higher risk of deep vein thrombosis (DVT)?

Having varicose veins does slightly increase the risk of DVT and there is also a slightly increased risk of DVT from long-haul flights.

What are the treatments available?

The objective is to either destroy or remove the vein that has the valve failure in order to depressurise the leg and improve the symptoms. The majority of treatments are minimally invasive and we favour the endovenous techniques, but a full assessment by a vascular surgeon will determine which treatment is best suited to your needs. The key treatments available include:

How does the blood return from the leg if the vein has been destroyed?

The varicose veins aren’t helping as they allow blood to stay in your legs. There are plenty of other veins to get the blood out, and checking that these are working is part of the scan that we do before advising you on treatment.

What is my recovery after surgery?

Recovery is dependent on the treatment type you are having. You will generally have your legs bandaged after the procedure for 24-48 hours and then wear an elastic stocking for a further two weeks. You will also be given painkillers and anti-inflammatory medication for seven days. During this time it will be recommended that you stay active and mobile. Specific aspects of aftercare and recovery will be given by the vascular surgeon depending on the treatment that has been undertaken.


If you have varicose veins and are concerned about them, make an appointment with a specialist.

By Mr Harpaul Flora
Vascular surgery

Mr Harpaul (Paul) Flora is a consultant vascular surgeon with a special interest in endovascular and advanced laparoscopic, or keyhole, surgery. Mr Flora practises at a number of private clinics in London and can offer a range of treatments for aneurysms, varicose veins, deep vein thrombosis, and carotid artery disease.

After qualifying from the London Hospital Medical College in 1995 with a distinction, Mr Flora trained at the major vascular centres in London, before receiving a fellowship to study advanced laparoscopic sugery in Hong Kong. In 2007 Mr Flora was appointed consultant surgeon at St Barts and The Royal London NHS Trust. In addition to running a busy clinical vascular practice, Mr Flora acts as clinical director and network director of vascular surgery at the Trust.

As Honorary Senior Lecturer at Queen Mary University of London, Mr Flora is actively involved in the teaching of new surgical trainees. He is also a pioneer of new forms of treatment for cardiovascular disease, being the first surgeon in the UK to perform the Barostim procedure for the regulation of hypertension. Mr Flora is widely published within vascular surgery literature and has presented his work at national and international conferences.

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