Management of varicose veins according to reason for presentation.

Of 229 newly referred patients with varicose veins, untoward symptoms were the most frequent reason for presentation (38%). Cosmetic concerns were significantly more common in women than in men (33% vs 8%, P < 0.001). Sclerotherapy was offered to 20 patients (8.7%). Surgical operation was offered in 113 (49.3%), mostly for symptoms. No invasive treatment was indicated in 96 patients (42%), more than half of whom had presented because of inappropriate fears of deterioration or with symptoms unrelated to their veins. We advocate that careful evaluation of the reasons for presentation should be used as a guide to the efficient management of varicose veins.