Varicose Veins

What are varicose veins?

Varicose veins are swollen, twisted blood vessels that bulge just under your skin’s surface. These blue or purple bulges usually appear in your legs, feet and ankles. They can be painful or itchy. Spider veins, which may surround varicose veins, are smaller red or purple lines that appear close to your skin’s surface.

Although they can be unsightly and uncomfortable, varicose veins aren’t dangerous for most people. In some cases, severe varicose veins can lead to serious health problems, such as blood clots. You can relieve most varicose vein symptoms at home or your healthcare provider can treat them with injections, laser therapy or surgery.

What is the difference between varicose veins and spider veins?

Varicose veins and spider veins are both types of venous disease, but they look different. Spider veins are smaller and thinner than varicose veins. They look like red or blue spider webs or branches of a tree, and they are close to the skin’s surface.

Spider veins aren’t usually painful. They can appear anywhere on your body, most often behind your knee, on your feet or on your face. Varicose veins usually appear on your feet and legs.

Who is likely to get varicose veins?

Anyone can develop varicose veins. Certain factors increase your chances of developing varicose veins, including:

• Age: Because of the aging process, vein walls and valves don’t work as well as they once did. Veins lose elasticity and stiffen.
• Gender: Female hormones can allow the walls of the veins to stretch. People who are pregnant, taking the birth control pill or going through menopause have a higher risk of varicose veins because of changes in hormone levels.
• Family history: This condition can be inherited (runs in families).
• Lifestyle: Standing or sitting for long periods decreases circulation. Wearing restrictive clothing, such as girdles or pants with tight waistbands can decrease blood flow.
• Overall health: Certain health conditions, such as severe constipation or certain tumors, increase pressure in the veins.
• Tobacco use: People who use tobacco products are more likely to develop varicose veins.
• Weight: Excess weight puts pressure on blood vessels.

How common are varicose veins?

Varicose veins are very common. Around 1/3 of all adults have varicose veins. They are more common in people assigned female at birth than in people assigned male at birth.

What are the symptoms of varicose veins?

The most recognizable sign of varicose veins is a gnarled, blue or purple vein just under your skin’s surface. Symptoms include:

• Bulging veins: Twisted, swollen, rope-like veins are often blue or purple. They appear just below the surface of the skin on your legs, ankles and feet. They can develop in clusters. Tiny red or blue lines (spider veins) may appear nearby.
• Heavy legs: Muscles in your legs may feel tired, heavy or sluggish, especially after physical activity.
• Itching: The area around varicose veins may itch.
• Pain: Legs may be painful, achy or sore, especially behind your knees. You might have muscle cramps.
• Swelling: Your legs, ankles and feet can swell and throb.
• Skin discolorations and ulcers: If left untreated, varicose veins can cause brown discolorations on your skin. Severe varicose veins can cause venous ulcers (sores) on your skin.

Where do varicose veins usually appear?

Most often, varicose veins develop on the lower half of your body, usually on your calves, ankles and feet. They can also develop in the pelvic area (pelvic congestion syndrome), especially in people who have had children. Varicose veins in the testicles (varicocele) can lead to infertility.

What causes varicose veins?

Varicose veins occur when the walls of your veins weaken. As blood pressure in your vein increases, the weakened walls allow your vein to get bigger. As your vein stretches, the valves that keep blood moving in one direction in your vein can’t work like they should. Sluggish blood backs up or pools in your vein, causing your vein to swell, bulge and twist.

Vein walls and valves can become weak for several reasons, including:

• Hormones.
• The aging process.
• Excess weight.
• Restrictive clothing.
• Pressure inside the vein from standing for long periods.

How are varicose veins diagnosed?

Varicose veins are close to the surface of your skin and easy to see. Healthcare providers can diagnose the condition during a physical examination. They’ll feel your veins and examine them while you’re sitting and standing.

To see detailed images of your veins and check for complications, your provider may recommend an ultrasound. This safe, painless test uses sound waves to produce pictures of tissues inside your body. Ultrasounds can show blood clots and how your valves are working.

What is the treatment for varicose veins?

Although there isn’t a cure for varicose veins, these treatments can reduce their appearance and relieve discomfort:

• Elevation: To increase blood flow and decrease pressure in your veins, you should elevate your legs above your waist several times throughout the day.
• Elastic stockings: Supportive stockings or socks compress your veins and reduce discomfort. The compression stops your veins from stretching and helps blood flow.
• Injection therapy (sclerotherapy): During sclerotherapy, a healthcare provider injects a solution into your vein. The solution causes the vein walls to stick together. Eventually, your vein turns into scar tissue and fades away.
• Laser therapy: In a minimally invasive procedure called endovenous thermal ablation, healthcare providers use a catheter (a long, thin tube) and laser to close off a damaged vein.
• Vein surgery: During these procedures, also called ligation and stripping, the surgeon ties off your affected vein (ligation) to stop blood from pooling. The surgeon may remove (strip) the vein to prevent varicose veins from reappearing.

Complications/side effects of the treatment

Half of the people who have surgical stripping get varicose veins again within five years, and varicose veins can happen again after endovenous ablation as well.

Potential side effects of these treatments include:

• Scarring.
• Skin burns.
• Infection.
• Injury to a nerve.
• Deep vein thrombosis (a blood clot in a vein deep inside your body).

Sclerotherapy can cause side effects that include:

• Redness or bruising for a few days where a needle went into your skin.
• Brown areas (for several months) on skin where the needle touched.
• Lumps or hardness for a few months.

With sclerotherapy, new varicose veins can happen and need treatment.

How can I prevent varicose veins?

You may not be able to prevent varicose veins. You can reduce your chances of developing them by living an active, healthy lifestyle. Healthcare providers recommend many of the same measures to prevent and treat varicose veins:

• Avoid long periods of standing: To encourage blood flow, take regular breaks to stretch and walk around, especially if you have a job that requires you to be on your feet.
• Elevate your legs: Raising your feet above your waist helps blood flow to your heart.
• Maintain a healthy weight: Getting rid of excess pounds reduces pressure inside your blood vessels.
• Quit tobacco use: Smoking damages blood vessels, decreases blood flow and causes a wide range of health problems.
• Stay active: To improve circulation, move frequently and avoid sitting still for prolonged periods.
• Try compression stockings: Support socks and pantyhose compress your veins and help blood circulate, which can prevent varicose veins from getting worse.
• Wear clothes that fit properly: To encourage blood flow, make sure your waistband isn’t too tight.

What is the outlook for people with varicose veins?

Usually, varicose veins aren’t dangerous and don’t cause long-term health problems. Most people with the condition are concerned with the way varicose veins look. They may experience discomfort but don’t develop complications.

How long varicose veins last

Most of the time, varicose veins that happen while you’re pregnant go away on their own within two or three weeks after you have your baby. For other people, varicose veins may keep coming back after treatment.

What are the complications of varicose veins?

Varicose veins can cause ulcers (open sores), bleeding and skin discoloration if left untreated. Severe varicose veins may be a sign of chronic venous insufficiency. This condition affects your veins’ ability to pump blood to your heart.

People who have varicose veins may be more likely to develop blood clots. It’s important to tell your healthcare provider about varicose veins. Your provider should evaluate and monitor you for clotting disorders such as:

• Superficial thrombophlebitis: Blood clots can form inside varicose veins, causing a condition called superficial venous thrombosis or superficial thrombophlebitis. Thrombophlebitis is painful but isn’t usually dangerous. It’s also treatable.
• Deep vein thrombosis (DVT): People with varicose veins have a higher risk of deep vein thrombosis, a blood clot in a vein deep inside your body.
• Pulmonary embolism: A blood clot in your body (usually resulting from DVT) can become lodged in your lung. Pulmonary embolism is a life-threatening condition that requires immediate treatment.

Do varicose veins return after treatment?

Although treatments are effective, varicose veins can return. They’re more likely to come back in people who become pregnant after treatment. You have a higher chance of varicose veins reappearing if you have obesity or have a sedentary lifestyle.

When should I talk to my doctor about varicose veins?

Although varicose veins aren’t usually dangerous, you should visit your healthcare provider for an exam. If you’re concerned about how varicose veins look, or if they’re uncomfortable, treatments can help. You should see your provider as soon as possible if the skin or veins are:

• Bleeding.
• Discolored.
• Painful, red or warm to the touch.
• Swollen.

Millions of people live with varicose veins. For most people, varicose veins don’t cause serious health problems. Lifestyle changes and at-home remedies can relieve symptoms and prevent them from getting worse. Talk to your healthcare provider about safe, minimally invasive treatments that can reduce pain and improve the appearance of varicose veins.

When should I go to the ER?

Call 911 if you have a varicose vein that’s bleeding heavily.

What questions should I ask my doctor?

• Which treatment is best for me?
• Can you do treatments in your office?
• What’s the most cost-effective treatment?

A note from Cleveland Clinic

You’re not alone in dealing with varicose veins. Many people have them and don’t have complications from them. However, if varicose veins bother you, you can try home treatments that may help. Or you can ask your healthcare provider about different treatments that are available. Just keep in mind that varicose veins can happen again, even after treatment. Talk to your provider about which treatment is best for you.