Varicose veins are swollen and enlarged veins that are usually blue or dark purple. They may also be lumpy, bulging or twisted in appearance.
Varicose veins develop when the small valves inside the veins stop working properly. In a healthy vein, blood flows smoothly to the heart. The blood is prevented from flowing backwards by a series of tiny valves that open and close to let blood through. If the valves weaken or are damaged, the blood can flow backwards and can collect in the vein, eventually causing it to be varicose (swollen and enlarged).
How common are varicose veins?
Varicose veins are a very common condition, affecting up to three in 10 adults. Usually, women tend to be more affected than men.
Any vein in the body can become varicose, but they most commonly develop in the legs and feet, particularly in the calves. This is because standing and walking puts extra pressure on the veins in the lower body.
For most people, varicose veins do not present a serious health problem. They may have an unpleasant appearance, but they should not affect the circulation or cause any long-term health problems. Most varicose veins do not require any treatment.
For some people, varicose veins can cause aching, swollen and painful legs. In rare cases, they can also cause complications, such as skin discolouration and leg ulcers (see Varicose veins – Complications). Varicose veins are more likely to require treatment if they are causing significant discomfort or if complications develop.
There are now a number of different surgical procedures to remove varicose veins, although the first treatment is usually compression stockings. These are stockings that have been specially designed to squeeze the legs and improve circulation. See Varicose veins – Treatment for more information about the different treatment options.
Types of varicose veins
Some types of varicose veins are explained below.
- Trunk varicose veins are near to the surface of the skin and are thick and knobbly. They are usually visible, often quite long and can look unpleasant.
- Reticular varicose veins are red and are sometimes grouped close together in a network.
- Telangiectasia varicose veins, also known as thread veins or spider veins, are small clusters of blue or red veins that sometimes appear on your face or legs. They are harmless and, unlike trunk varicose veins, do not bulge underneath the surface of the skin.
Symptoms of varicose veins
Varicose veins are dark purple or blue in colour and they are usually twisted and bulging in appearance. Some people with varicose veins do not experience any pain or discomfort, while others are more severely affected.
As well as their distinctive appearance, symptoms of varicose veins can include:
- aching, heavy and uncomfortable legs
- swollen feet and ankles
- burning or throbbing in your legs
- muscle cramp in your legs, particularly at night
- dry, itchy and thin skin over the affected vein
These symptoms will usually be worse during warm weather or when you have been standing up for long periods of time. Your symptoms may improve when you walk around or if you rest and raise your legs up, on some pillows (for example).
Varicose veins usually develop on the legs, either on the back of your calf or on the inside of your leg. However, they can also sometimes occur in other parts of your body, such as your:
- gullet (oesophagus)
- womb (uterus)
- rectum (back passage)
The vagina is a tube of muscle that runs from the cervix (the opening of the womb) to the vulva (the external sexual organs).
Veins are a type of blood vessel that carry blood back to the heart.
Causes of varicose veins
To understand what causes varicose veins it is first useful to understand how blood is circulated around your body.
The system that controls your circulation is made up of arteries and veins. Your arteries carry blood from your heart to the organs and tissues in your body. Veins return the used blood back to your heart.
In order to return the blood, your veins must work against gravity. The muscles in your leg contract, helping to pump the blood back towards your heart.
Inside your veins are tiny one-way valves that open to let the blood through and then close to prevent it flowing backwards.
Sometimes, the walls of the veins can become stretched and lose their elasticity, causing the valves to become weakened. If the valves do not function properly, this can cause the blood to leak and flow backwards. If this happens, the blood will collect in your veins, which will become swollen and enlarged.
The reasons why the walls of the veins stretch and the valves in your veins weaken are not fully understood. Some people develop the condition for no obvious or apparent reason.
If arthritis is not treated on time it may turn into chronic disease. Some of the common symptoms of arthritis are
There are a number of risk factors that can increase your likelihood of developing varicose veins, including:
- being overweight
- being pregnant
These risk factors are discussed in more detail below.
Women are more likely to be affected by varicose veins than men. Research suggests that this may be because female hormones tend to relax the walls of veins, making the valves more prone to leaking. Hormones are chemicals that are produced by the body.
Your risk of developing varicose veins is increased if a close family member has the condition. This suggests that varicose veins may be partly caused by your genes (the units of genetic material that you inherit from your parents).
As you get older, your veins start to lose their elasticity and the valves inside them stop working as well.
Being severely overweight puts extra pressure on your veins, which means they have to work harder to send the blood back to your heart. This can put increased pressure on the valves, making them more prone to leaking.
Some research suggests that jobs that require long periods of standing may increase your risk of getting varicose veins. This is because your blood does not flow as easily when you are standing for long periods of time.
When a woman is pregnant, the amount of blood in her body increases to help support the developing baby. This puts extra strain on your circulatory system. Increased hormone levels during pregnancy also cause the muscular walls of the blood vessels to relax. Both of these factors may increase your risk of developing varicose veins.
Varicose veins may also develop during pregnancy as the womb (uterus) begins to grow. As the womb expands it puts pressure on the veins in your pelvic area, which can sometimes cause them to become varicose.
Although being pregnant can increase your risk of developing varicose veins, most women find that the condition significantly improves after their pregnancy.
Some of the tests that are performed to diagnose arthritis are
- Complete blood count
- C-reactive protein
- Joint X-ray
- Bone scan
- HLA antigens for HLA B27
- Electrocardiogram (ECG)
- Synovial fluid analysis
- Joint ultrasound or MRI
- Rheumatoid factor
- Uric acid- urine
- Uric acid- blood
- Tear test
- A physical examination can detect:
- Joint movement causing crackling sound known as Crepitation
- Limited mobility
- Pain during normal movement
- Tenderness felt when joints are moved
- Swelling of joints that is bone seems to be larger than usual.
- Diagnosis of some kinds of arthritis is difficult and cannot be detected accurately. Sometimes they are detected as normal joint problems.
Diagnosing varicose veins
If you have varicose veins and they do not cause you any discomfort, you may not need to visit your GP. Varicose veins are rarely a serious condition and they do not usually require any treatment.
However, you should seek advice from your GP if:
- Your varicose veins are causing you pain or discomfort.
- The skin over your veins is sore and irritated.
- The aching in your legs is causing irritation at night and disturbing your sleep.
Varicose veins are diagnosed by their appearance. Your GP will examine your legs while you are standing to check for any signs of swelling. They may also ask you to describe any pain that you have and whether there are any situations that make your varicose veins worse. For example, some women find that their menstrual cycle (periods) affect their varicose veins.
Your GP will also ask about any risk factors that could make varicose veins more likely, such as:
- having a family history of varicose veins
- being pregnant
- having a healthy (BMI)
- having deep vein thrombosis (a blood clot in one of the deep veins of the body)
- a history of leg injury (for example, having previously broken a bone in your leg)
If your GP feels it is necessary to investigate your varicose veins further, they may refer you to a vascular specialist (a doctor who specialises in veins). After examining your veins, the specialist will decide whether any further investigations are necessary.
There are a few tests that can be used to investigate varicose veins. These are:
- Doppler test
- colour duplex ultrasound scan
These are briefly outlined below.
A Doppler test uses an ultrasound scan to provide information about the direction of blood flow in your veins. It provides an indication of how well the valves in your veins work.
An ultrasound scan is a painless procedure that uses high-frequency sound waves to produce an image of the inside of your body. A Doppler test can also be used to check for any blood clots or obstructions in your veins.
Colour duplex ultrasound scan
A colour duplex ultrasound scan provides colour images of your vein structure. This allows the specialist to look for any abnormalities in your veins. A colour duplex ultrasound scan can also measure the speed of your blood flow.
See the Health A-Z topic about Ultrasound scans for more information about this type of procedure.
Veins are a type of blood vessel that carry blood back to the heart.
Preventing varicose veins
There is little evidence to suggest that you can stop varicose veins from getting worse, or prevent new ones developing. However, if you already have varicose veins, there are a number of things that you can do that may help to relieve any pain or discomfort.
Sitting or standing still
If you can, avoid sitting or standing still for long periods of time. If you are unable to avoid sitting or standing, make sure that you change position frequently and try to move around at least once every 30 minutes.
Do not cross your legs because this can make your symptoms worse.
Take regular breaks
If possible, take regular breaks throughout the day. Try also to keep your legs raised while you are resting, because this will help to improve blood flow.
Ideally, raise your legs above the level of your heart. When resting, you may find that lying down and placing your legs on three or four stacked pillows will help to relieve any pain and discomfort.
Regular exercise is a great way of keeping your legs active and it will help to improve your circulation.
Exercise will also enable you to maintain a healthy weight, help prevent serious health conditions, such as coronary heart disease, as well as improving your overall general health and fitness.