What causes varicose veins?

Have you ever wondered: Why am I getting varicose veins on my leg? These bulging red or blue veins can be unsightly at best. For some people, they cause pain and other health problems.

Here’s what you need to know about why varicose veins occur — and what you can do about them.

What Are Varicose Veins?

Varicose veins are swollen, enlarged veins. They may have a knotty, twisted look. They often develop on the thighs, calves, the back of the knee, and around the ankles.

Varicose veins are common. About 20% of adults will get varicose veins at some point in their lives. Spider veins are like varicose veins but not as big. They look more like a spiderweb and don’t bulge out from the skin.

Both men and women can get varicose veins, but they are more common in women. Hormonal changes from puberty, pregnancy, and menopause can lead to varicose veins. They are also more likely to happen in older women and people who are overweight.

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What Causes Varicose Veins?

“Varicose veins happen when the tiny valves in your veins don’t work properly. Normally these one-way valves are like little flaps that keep blood moving toward your heart. When the valves don’t close well, blood leaks back into the vein,” said Brian Cronin, DO, vascular surgeon.

Over time, more and more blood gets trapped in the vein. The pressure inside the vein builds and it becomes swollen. It may eventually ache and cause discomfort.

Varicose veins usually occur in the legs because the veins are far away from the heart. They must move the blood a long way, working against gravity.

Risk factors for varicose veins include:

  • A family history of varicose veins.
  • Being older.
  • Being a woman.
  • Having defective valves from birth.
  • Pregnancy.
  • Taking birth control pills.
  • Taking hormone replacement.
  • Obesity.
  • A history of blood clots in your legs.
  • A job where you stand or sit for long periods of time.

Symptoms of Varicose Veins

Varicose veins are easy to spot because they are so visible. They bulge out from the skin, look swollen, and are blue or red in color. Other symptoms include:

  • A full, heavy feeling in your legs.
  • Aching or pain in your legs.
  • Nighttime cramping in your legs.
  • Itchiness.
  • Swelling of the feet or ankles.
  • Restless leg symptoms.
  • Leg pain after long periods of standing or sitting.
  • Dry, scaly skin.
  • Sores that don’t heal quickly.
  • Scaly, thick, or irritated skin.

Complications of Varicose Veins

For many people, varicose veins are merely unsightly. They don’t cause health problems. But for other people, they can lead to more serious issues, including:

  • Bleeding — the skin over the vein can be thin and easily damaged.
  • Skin ulcers — these sores can be painful and hard to heal.
  • Superficial thrombosis — blood clots that form just below the skin. Symptoms include redness, pain, and swelling.
  • Deep vein thrombosis (DVT) — blood clots that are deeper under the skin. They can be dangerous because a blood clot could break off and travel to the lungs, causing a blockage. Sitting still for hours (as on an airplane) increases your risk of DVT.

Can Varicose Veins Go Away?

Varicose veins don’t go away on their own. But you can take steps to manage the symptoms of varicose veins at home. These steps may also help prevent new varicose veins from forming.

To help relieve the symptoms of varicose veins:

  • Wear compression stockings. These special stockings put gentle pressure on your veins to move blood toward your heart.
  • Don’t cross your legs when sitting. It interferes with blood flow in your legs.
  • Take frequent breaks if you must sit or stand for long periods of time. The muscles in your legs will move the blood back to your heart more efficiently than when you’re standing or sitting.
  • Lose weight if you need to. Extra pounds can make it harder for the veins to move blood back to your heart.
  • Walk, swim, or bike. Exercising the muscles in your legs helps push blood back towards your heart and eases the pressure on your veins. Working out can also help you lose weight.
  • Put your feet up when you’re sitting. Placing your feet on a footstool helps the blood flow back to your heart.

When Should I See a Doctor for Varicose Veins?

Your varicose veins may not bother you or cause you pain. For many people, self-care at home is enough to manage their varicose vein symptoms.

However, you should see a doctor for varicose veins if:

  • They cause discomfort or achiness that keeps you from enjoying daily activities.
  • Self-care and lifestyle changes haven’t helped your varicose vein symptoms.
  • A varicose vein starts to bleed.
  • There is a sudden increase in pain or swelling.
  • The skin of your ankle or calf changes color.
  • You develop sudden sores or a rash on the leg.
  • You have leg sores that don’t heal.
  • You’re self-conscious about the appearance of varicose veins.

Medical Treatment for Varicose Veins

There are several non-invasive medical treatments for varicose veins. Doctors may use them for cosmetic purposes or to treat the discomfort of varicose veins.

Talk to your doctor about what’s right for you. The right procedure may depend on the size and severity of your varicose veins.

Non-surgical treatments for varicose veins include:

  • Endovenous laser therapy (EVLT). This procedure uses laser fibers to heat the inside of the vein, closing it off. Doctors usually perform EVLT in the office with anesthesia. Ultrasound helps guide the treatment.
  • Radio frequency ablation (RFA). This procedure uses radio frequency to heat the inside of the vein to close it off. RFA can be performed in the office with anesthesia. Ultrasound helps guide the treatment.
  • Sclerotherapy. Doctors put a liquid or foam chemical into the vein to seal it. The vein hardens and eventually dissolves into the body. Sclerotherapy is an outpatient procedure done with ultrasound guidance.
  • Simple laser treatments. These surface treatments are good for spider veins and smaller varicose veins. A laser sends small flashes of light through the skin onto the vein. The light makes the vein fade and eventually disappear.

For very large varicose veins, or varicose veins with medical complications, you may need surgery. Your doctor can remove the problem vein through small cuts in the skin. Healthy veins then take over the flow of blood through the leg.

National Heart, Lung, and Blood Institute, Varicose Veins, Link

National Library of Medicine, Varicose veins, Link

U.S. Department of Health & Human Services, Office on Women's Health, Varicose veins and spider veins, Link

National Institutes of Health, Bulging Veins: What to Do About Varicose Veins, Link

American Academy of Dermatology Association, Leg Veins: Why They Appear and how Dermatologists Treat Them, Link

About Heart and Vascular Institute

The UPMC Heart and Vascular Institute has long been a leader in cardiovascular care, with a rich history in clinical research and innovation. As one of the first heart transplant centers in the country and as the developer of one of the first heart-assist devices, UPMC has contributed to advancing the field of cardiovascular medicine. We strive to provide the most advanced, cutting-edge care for our patients, treating both common and complex conditions. We also offer services that seek to improve the health of our communities, including heart screenings, free clinics, and heart health education. Find an expert near you.