Varicose veins are twisted, enlarged veins. Any vein that is close to the skin’s surface (superficial) can become varicosed. Varicose veins most commonly affect the veins in the legs. That’s because standing and walking increase the pressure in the veins of the lower body.
For many people, varicose veins and spider veins — a common, mild variation of varicose veins — are simply a cosmetic concern. For other people, varicose veins can cause aching pain and discomfort. Sometimes varicose veins lead to more-serious problems.
Treatment might involve self-care measures or procedures done by a health care provider to close or remove veins.
Symptoms
Varicose veins might not cause pain. Signs of varicose veins include:
Veins that are dark purple or blue
Veins that appear twisted and bulging, often appearing like cords on the legs
When painful signs and symptoms of varicose veins occur, they might include:
An achy or heavy feeling in the legs
Burning, throbbing, muscle cramping and swelling in the lower legs
Worsened pain after sitting or standing for a long time
Itching around one or more of the veins
Changes in skin color around a varicose vein
Spider veins are similar to varicose veins, but they’re smaller. Spider veins are found closer to the skin’s surface and are often red or blue.
Spider veins occur on the legs but can also be found on the face. They vary in size and often look like a spider’s web.
Causes
Weak or damaged valves can lead to varicose veins. Arteries carry blood from the heart to the rest of the body. Veins return blood from the rest of the body to the heart. To return blood to the heart, the veins in the legs must work against gravity.
Muscle contractions in the lower legs act as pumps, and elastic vein walls help blood return to the heart. Tiny valves in the veins open as blood flows toward the heart, then close to stop blood from flowing backward. If these valves are weak or damaged, blood can flow backward and pool in the veins, causing the veins to stretch or twist.
Risk factors
The following can increase the risk of developing varicose veins:
Age. Aging causes wear and tear on the valves in the veins that help control blood flow. Eventually, that wear causes the valves to allow some blood to flow back into the veins, where it collects.
Sex. Women are more likely to develop the condition. Hormonal changes before a menstrual period or during pregnancy or menopause might be a factor because female hormones tend to relax vein walls. Hormone treatments, such as birth control pills, might increase the risk of varicose veins.
Pregnancy. During pregnancy, the blood volume in the body increases. This change supports the growing baby but can also enlarge the veins in the legs.
Family history. If other family members had varicose veins, there’s a greater chance you will too.
Obesity. Being overweight puts added pressure on veins.
Standing or sitting for long periods of time. Movement helps blood flow.
Complications
Complications of varicose veins, although rare, can include:
Ulcers. Painful ulcers can form on the skin near varicose veins, particularly near the ankles. A discolored spot on the skin usually begins before an ulcer forms. See your health care provider immediately if you think you’ve developed a leg ulcer.
Blood clots. Occasionally, veins deep within the legs become enlarged and might cause leg pain and swelling. Seek medical attention for persistent leg pain or swelling because it can be a sign of a blood clot.
Bleeding. Occasionally, veins close to the skin burst. Although this usually causes only minor bleeding, it requires medical attention.
Diagnosis
our health care provider will do a physical exam, including looking at your legs while you’re standing to check for swelling. Your provider might also ask you to describe pain and aching in your legs.
Treatment
Treatment for varicose veins may include self-care measures, compression stockings, and surgeries or procedures. Procedures to treat varicose veins are often done as an outpatient procedure, which means you usually go home on the same day.
Ask your insurer if varicose vein treatment is a covered expense. If varicose vein treatment is done only to improve the appearance of the legs (cosmetic reason), the cost might not be covered by insurance.