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Overview

What Are Varicose Veins?

Varicose veins are enlarged, twisted veins close to the surface of the skin. They usually develop in the legs when one-way valves inside the veins do not work properly, allowing blood to flow backward and collect. A varicose vein may be harmless and mainly affect appearance, but it can also cause aching, swelling, itching, or other symptoms. They are common in adults and are more likely with age, pregnancy, family history, or long periods of standing.

Symptoms

Varicose Veins Symptoms

  • Bulging, twisted veins that are visible beneath the skin
  • Aching in the legs
  • A feeling of heaviness or tiredness in the legs
  • Itching around the affected veins
  • Swelling in the ankles or lower legs
  • Muscle cramps in the legs
  • Skin discoloration near the affected veins
  • Skin changes, such as dryness, thickening, or irritation

Causes

What Causes Varicose Veins?

Leg veins normally carry blood back toward the heart, while small one-way valves help stop it from flowing backward. If the valves become weak or the vein walls lose strength, blood can pool in the vein instead of moving upward. The extra pressure stretches the vein, making it enlarged and twisted. These changes explain many varicose veins causes, although several factors may contribute at the same time.

  • Inherited vein weakness can make the valves or walls of the veins more likely to fail.
  • Hormonal changes may relax vein walls and affect blood flow.
  • Pregnancy increases blood volume and pressure on the veins in the pelvis and legs.
  • Increased pressure in the leg veins can occur with aging, prolonged standing, or other circulation problems.

Risk Factors

Risk Factors for Varicose Veins

Nonmodifiable and life-stage factors

  • Older age increases wear on the valves and walls of the veins.
  • A family history of varicose veins raises the likelihood of developing them.
  • Hormonal and sex-related factors can affect vein walls and circulation.
  • Pregnancy can temporarily increase pressure and blood flow in the leg veins.
  • A personal history of vein problems may increase the chance of recurrence or progression.

Modifiable or situational factors

  • Standing for long periods can increase pressure in the leg veins.
  • Sitting for long periods may reduce the calf-muscle pumping action that helps move blood.
  • Higher body weight can add pressure to the veins in the legs.
  • Low physical activity may reduce healthy circulation in the legs.

Complications

Varicose Veins Complications

  • Superficial thrombophlebitis is inflammation and clotting in a vein close to the skin, often causing tenderness and redness.
  • Bleeding can occur if an enlarged vein near the skin is injured or breaks.
  • Venous skin changes may include darkening, inflammation, dryness, or thickening around the ankle.
  • Leg ulcers are open sores that can develop when long-term vein problems impair skin healing.
  • A blood clot in a deeper vein can be serious and requires urgent medical evaluation.

SEEK URGENT CARE

Warning signs of a serious problem

Seek urgent medical care for sudden swelling in one leg, warmth, or severe leg pain. Chest pain or shortness of breath may signal a clot that has traveled to the lungs; call emergency services immediately.

Diagnosis

How Varicose Veins Are Diagnosed

A clinician usually examines the legs while you are standing and asks about your symptoms, when they began, and how they change during the day. They may also ask about your medical history and whether standing, sitting, activity, or leg elevation makes symptoms better or worse. The examination can help distinguish a varicose vein from other causes of leg pain or swelling.

  • Duplex ultrasound can check how blood moves through the veins and whether the valves are working properly.
  • Ultrasound may help identify a blood clot when pain or swelling raises concern.
  • Imaging can show the location and size of abnormal veins when treatment is being planned.
  • Additional testing may be considered when symptoms suggest another circulation problem.

Treatment & Management

Varicose Vein Treatment and Management

First-line management and self-care

  • Regular walking and calf-muscle movement can support blood flow from the legs.
  • Elevating the legs above heart level for periods of time may reduce swelling and discomfort.
  • Changing position and taking movement breaks can help avoid prolonged sitting or standing.
  • Weight-supportive eating and activity habits may reduce pressure on the leg veins.
  • Compression garments may improve symptoms, but they should be properly fitted and recommended by a clinician when appropriate.
  • Follow-up with a clinician can help monitor persistent symptoms, skin changes, or recurrence.

CHOOSING TREATMENT

Treatment should be individualized

Varicose vein treatment depends on your symptoms, vein anatomy, ultrasound findings, overall health, risk of recurrence, and personal goals. Options may include sclerotherapy, thermal ablation, adhesive or other catheter-based treatments, and surgery when appropriate. Cosmetic treatment is different from treatment for pain, skin problems, bleeding, or other medical complications.

Prevention

Can Varicose Veins Be Prevented?

Varicose veins cannot always be prevented because inherited factors, aging, and pregnancy play important roles. However, healthy circulation habits may reduce symptoms or delay worsening. These steps may help lower pressure in the leg veins, even when they cannot eliminate the risk.

  • Walk regularly or perform calf movements throughout the day to support circulation.
  • Change position often and take breaks from prolonged sitting or standing.
  • Elevate the legs when resting if swelling or aching develops.
  • Maintain a weight-supportive lifestyle with regular activity and balanced nutrition.
  • Ask a clinician whether compression garments are appropriate during higher-risk situations, such as long travel.

Outlook and Prognosis

Outlook for People With Varicose Veins

Varicose veins are often manageable, but they may persist, enlarge, or cause symptoms over time. New veins can also develop, and varicose veins may recur after treatment. The outlook is generally favorable when bothersome symptoms and complications are evaluated and treated appropriately. Ongoing habits and follow-up may help manage this long-term condition.

When Should You See a Doctor

When Should You See a Doctor for Varicose Veins?

  • Arrange a routine appointment for persistent leg pain or aching.
  • Seek medical advice for ongoing swelling or itching.
  • Have new or worsening skin discoloration or other skin changes evaluated.
  • Contact a clinician if a varicose vein bleeds.
  • Arrange an evaluation for a leg ulcer or sore that does not heal.
  • Discuss symptoms that interfere with walking, sleep, work, or daily activities.

GET MEDICAL HELP

Do not ignore sudden or severe symptoms

Seek urgent or emergency care for sudden one-sided leg swelling or severe pain, a leg that is red and warm, or bleeding that does not stop with direct pressure. Call emergency services for chest pain or trouble breathing.

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