Varicose veins are enlarged, swollen, twisting veins that often appear blue or dark purple in color.

They develop when faulty or damaged valves in the veins allow blood to flow in the wrong direction or to pool.

More than 23% of all adults are thought to be affected by varicose veins. Approximately 1 in 4 adults in the United States have varicose veins.

If a person has no symptoms or discomfort and does not mind the sight of the varicose veins, treatment might not be necessary. Most people with varicose veins can get enough relief from home remedies, such as compression stockings.

However, if a person has symptoms that do not improve easily, they may require medical treatment to reduce pain or discomfort or to address complications such as leg ulcers, skin discoloration, or swelling.

Some individuals may also want treatment for cosmetic reasons, wanting to get rid of the “ugly” varicose veins.

Surgery

If varicose veins are large, they may need to be removed surgically. This is usually done under a general anesthetic. In most cases, the patient can go home the same day. However, if surgery is required on both legs, they may need to spend one night in the hospital.

Laser treatments are often used to close off smaller veins and also spider veins. Strong bursts of light are applied to the vein, which gradually fades and disappears.

Ligation and stripping

Two incisions are made: one near the patient’s groin at the top of the target vein, and the other farther down the leg, either at the ankle or knee. The top of the vein is tied up and sealed. A thin, flexible wire is threaded through the bottom of the vein and then pulled out, taking the vein with it.

This procedure does not usually require a hospital stay. Ligation and stripping can sometimes result in bruising, bleeding, and pain. On extremely rare occasions, there may be deep vein thrombosis (DVT), which is when a blood clot forms in the vein of the leg.

After surgery, most patients will begin to recover within a few days, but they may need a few weeks before going back to work and other regular duties. During the recovery time, they will need to wear compression stockings.

Sclerotherapy

A doctor injects a chemical into small- and medium-size varicose veins, which scars and closes them. A few weeks later, they should fade. A vein may need to be injected more than once.

Radiofrequency ablation

A doctor makes a small incision either above or below the knee with the help of an ultrasound scan. They then thread a narrow tube, or catheter, into the vein.

The doctor then inserts a probe into the catheter, which emits radiofrequency energy. The radiofrequency energy heats up the vein, causing its walls to collapse, effectively closing it and sealing it shut. This procedure is preferred for larger varicose veins.

Radiofrequency ablation is usually done with a local anesthetic.

Endovenous laser treatment

A doctor inserts a catheter into the patient’s vein. They then thread a small laser through the catheter and position it at the top of the target vein, which delivers short energy bursts that heat up the vein, sealing it shut.

With the aid of an ultrasound scan, the doctor threads the laser all the way up the vein, gradually burning and sealing all of it. This procedure is done under local anesthetic. There may be some nerve injury, which is usually brief.

Transilluminated powered phlebectomy

A doctor threads an endoscopic transilluminator, which is a special light, through an incision under the skin so that they can see which veins need to be taken out. They then cut and remove the target veins with a suction device through the incision.

A general or local anesthetic may be used for this procedure. There may be some bleeding and bruising after the operation.

A person can take measures at home to improve pain and prevent their varicose veins from worsening.

These measures include:

There are also many over-the-counter natural treatments, usually topical creams, and emollients available. They can help soothe pain and promote comfort. They may also improve the general appearance of varicose veins.

Compression stockings

Compression stockings squeeze a person’s legs and improve circulation.

They are tight around the ankles and loose farther up the leg. In this way, compression stockings encourage proper blood flow upward, against gravity, and back toward the heart.

Compression stockings may help with discomfort, pain, and swelling, but research has not confirmed whether they stop the varicose veins from worsening or even prevent them. Studies have yielded mixed and conflicting results.

The stockings make some people’s skin dry and flaky. If this happens, it is important to contact a doctor.

The veins have one-way valves so that the blood can travel in only one direction. If the walls of the vein become stretched and less flexible, or elastic, the valves may get weaker.

A weakened valve can allow blood to leak backward and eventually flow in the opposite direction. When this occurs, blood can accumulate in a vein or veins, which then become enlarged and swollen.

The veins farthest from the heart, such as those in the legs, are most often affected. This is because gravity makes it harder for the blood to flow back to the heart.

Any condition that puts pressure on the abdomen has the potential to cause varicose veins. Examples include:

Another example is chronic venous insufficiency, which is when the skin does not exchange oxygen, nutrients, and waste products with the blood properly, because the blood flow is not strong enough.

Health experts are not sure why the walls of veins stretch or why the valves become faulty. In many cases, this occurs for no clear reason.

However, some potential risk factors include:

  • going through menopause
  • being pregnant
  • being over 50 years old
  • standing for long periods
  • having a family history of varicose veins
  • having obesity

There is a link between the following risk factors and a higher risk of having varicose veins:

  • Gender: Varicose veins affect females more often than males. It may be that female hormones relax veins. If so, taking birth control pills or hormone therapy might play a role.
  • Genetics: Varicose veins often run in families.
  • Obesity: Having overweight or obesity increases the risk of varicose veins.
  • Age: The risk increases with age due to wear and tear on vein valves.
  • Some jobs: An individual who has to spend a long time standing at work may have a higher likelihood of developing varicose veins.

Pregnancy and varicose veins

People who can get pregnant are much more likely to develop varicose veins during pregnancy than at any other time in their lives. Pregnant people have much more blood in their bodies, which places extra pressure on the circulatory system.

Additionally, changes in hormone levels can lead to a relaxation of the blood vessel walls. Both these factors raise the risk of having varicose veins.

As the uterus, or womb, grows, there is more pressure on the veins in the person’s pelvic area. In the majority of cases, the varicose veins go away after the pregnancy is over. However, this is not always the case, and sometimes, even if the varicose veins improve, there may be some left visible.

Varicose veins are large, swollen veins that often appear on the legs and feet. They develop when the valves in the veins do not work properly, and the blood does not flow as effectively.

The varicose veins rarely need treatment for health reasons, but if swelling, aching, and painful legs result, and if there is considerable discomfort, treatment is available. There are various options, including some home remedies.

In severe cases, a varicose vein may rupture, or it can develop into varicose ulcers on the skin. These will require treatment.

While in most cases varicose veins tend to be just uncomfortable and unsightly, sometimes, they can be dangerous if left untreated.

If a person does not get proper treatment, their varicose veins can prevent proper blood circulation. This can cause blood clots to form, which can lead to DVT, a life threatening condition.

Moreover, if untreated, varicose veins can burst. This is also a medical emergency.

In the majority of cases, there is no pain, but the veins may look twisted, swollen, and lumpy, or bulging, and they may be blue or dark purple in color.

Some individuals may also experience:

  • aching legs
  • a feeling of heavy legs, especially after exercise or during sleep time
  • a minor injury to the affected area possibly resulting in longer bleeding than normal
  • lipodermatosclerosis, where fat under the skin just above the ankle can become hard, resulting in the skin shrinking
  • swollen ankles
  • telangiectasia in the affected leg (spider veins)
  • a shiny skin discoloration near the varicose veins
  • venous eczema, or stasis dermatitis, where skin in the affected area is red, dry, and itchy
  • leg cramps when suddenly standing up
  • restless legs syndrome
  • atrophie blanche, which is when irregular whitish patches that look like scars appear at the ankles
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Varicose veins are large, bulging veins that usually present in the legs and thighs and can be very painful.
zlikovec/Getty Images.
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Varicose veins are large veins that look as though they are protruding from your lower legs. They may cause no symptoms at all, or they may cause pain, discomfort, and burning.
zlikovec/Getty Images.
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Compression stocking provide pressure, which helps prevent blood from pooling in your legs. This helps reduce pain and discomfort. Ablation therapy and sclerotherapy are alternative, more invasive options to treat varicose veins.
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Varicose veins are most commonly caused by chronic venous insufficency. When the valves in veins do not function correctly, blood collects, causing varicose veins.
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Varicose veins can cause complications, such as clots or deep vein thrombosis in the lower extremities. Clots can travel to a lung or the heart and cause a pulmonary embolism or heart attack. licsiren/Getty Images.
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In severe cases of varicose veins, ulceration of the skin can occur. This can lead to infection and increased pain.
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Any condition in which proper blood flow is undermined has a risk of complications. However, in the majority of cases, varicose veins produce no complications.

If complications do occur, they may include:

  • venous ulcers
  • poor circulation
  • thrombophlebitis, which is when blood clots in the vein of the leg cause inflammation of the vein
  • DVT

People with chronic venous insufficiency may develop:

  • varicose eczema
  • lipodermatosclerosis
  • venous ulcers

Venous ulcers classically form around ankles and are often preceded by a discolored area. It is important to get a medical evaluation for chronic venous insufficiency.

To reduce the risk of developing varicose veins, it is advisable to:

  • get plenty of exercise, such as walking
  • reach or maintain a moderate body weight
  • avoid standing still for too long
  • avoid sitting with the legs crossed
  • sit or sleep with the feet raised on a pillow

Anyone who has to stand for their job should try to move around at least once every 30 minutes.

A physical examination, mainly visual, by a doctor will help determine whether or not a person has varicose veins. The person will be asked to stand while the doctor checks for signs of swelling.

A doctor may also order a doppler test, also known as a duplex ultrasound. The technician may perform one or both forms of this test. These are gray scale B-mode ultrasound and color-flow doppler ultrasound.

Gray scale B-mode ultrasound shows the anatomical structure of the veins. By contrast, color-flow doppler ultrasound provides color images of the structure of veins and measures the speed of blood flow.

A person may also be asked questions about the symptoms. In some cases, a doctor may refer them to a vascular specialist.

Varicose veins are veins that become too big, swell, and twist. They typically develop when blood flow is obstructed, and the blood cannot flow as effectively. They usually affect the legs and feet, but they may occur in other parts of the body as well.

In many cases, varicose veins only cause mild discomfort, and a person can manage them with home remedies. Sometimes, however, they may cause pain and require more serious treatment.

If a person has varicose veins, they may want to contact a doctor, even if their symptoms are not severe, in order to make sure they can avoid serious complications, such as DVT.