NHS Varicose Vein Treatment Grades

Doctors and medical professionals in the NHS grade varicose vein severity on a scoring system of 1 to 6. 1 is the most minor grade of varicose veins which are generally cosmetic and 6 the most severe, which cause skin ulceration.

1. Grade 1
   Essentially tiny thread veins and mainly cosmetic.
   Most commonly seen on ladies with fair skin, where they are more visible.
   Not treated on NHS
2. Grade 2
   Isolated varicose veins – quite small with some minor swelling.
   Also mainly considered cosmetic and therefore not treated on NHS
3. Grade 3
   Larger bulging/bulky varicose veins that are being filled from a leaky vein deeper inside the leg that can’t be seen with the naked eye.
   Patient will report pain and discomfort including aching, throbbing, leg swelling and soreness; especially on standing for long periods.
   In the past, the NHS would treat grade 3 veins surgically, but now patients are not eligible for treatment. They are will be advised to use compression stockings instead.
4. Grade 4
   These are established varicose veins with  complications such as phlebitis (vein is inflamed, hard and lumpy) or venous eczema where the skin at the ankle becomes dry and itchy.
   Should be treated on the NHS
5. Grade 5
   Varicose veins with severe skin damage to the skin at the ankle which becomes discoloured with a brown pigment.
   Should be treated on the NHS
6. Grade 6
   Varicose veins are a venous ulcer. This is very painful and hard to heal.
   Should be treated on the NHS

While the NHS can be expected to treat varicose veins at levels 4-6, the patient will have often suffered with many years discomfort and inconvenience before finally reaching the qualification criteria.

That’s why many patients prefer to have their varicose veins treated privately, to avoid them getting worse.