What Causes Varicose Veins?

Key Takeaways

Varicose veins occur due to poor blood flow when valves in the leg veins become weak or damaged. The leg veins stretch or enlarge due to all the blood that is collected in the veins.
Spider veins are similar to varicose veins but are smaller and milder. They do not develop into or cause varicose veins. In addition to the legs, spider veins can also occur anywhere in the body, including the face.
You can lower your risk of developing varicose veins with lifestyle changes, such as staying active with regular exercise, maintaining a healthy weight, and avoiding standing or sitting for too long.

Varicose veins are swollen, twisted veins that develop superficially, just under the skin’s surface, most commonly in the legs. They are very common. Almost 1 in 4 adults in the U.S. have varicose veins in one form or another. Sometimes, these swollen veins are no more than a cosmetic concern. However, severe varicose veins can cause debilitating symptoms and serious health complications.

Please continue reading to find out the risk factors for developing varicose veins, complications of varicose veins, tests for diagnosing varicose veins, and treatment options.

What is the main cause of varicose veins?

Research suggests varicose veins happen due to poor blood flow. They develop when valves in the veins become weak or damaged. Veins are blood vessels that carry blood back to the heart from different parts of the body against gravity. Vein walls and valves in healthy veins make sure blood flows in one direction (towards the heart). When the tiny valves in the leg veins weaken, or you have weak vein walls, varicose veins develop over time. The superficial veins stretch due to backward flow and pooling of blood in the legs. The increased blood pressure inside these veins causes swelling and enlargement of the veins that can lead to symptoms such as pain and itchiness.

What are the symptoms of varicose veins?

Varicose veins may cause the following symptoms:

Bulging, lumpy, twisted, enlarged veins that look like cords
Bluish or purplish skin color around the swollen veins
Itching, burning, and discomfort near the affected veins
An aching or throbbing pain, swelling, and heaviness in the legs
Muscle cramps in the legs, especially at night

Why have I suddenly got varicose veins?

You may feel like you developed varicose veins for no obvious or apparent reason. But if you look closely, you likely have some risk factors. Known risks for developing varicose veins include:

Age: Older adults are more likely to develop varicose veins due to weak or damaged valves with advancing age. As mentioned, valves in the veins check blood flow and keep blood flowing toward the heart.
Gender: Varicose veins occur more commonly in women because female hormones tend to cause the vein walls to be enlarged. Hormonal changes during menstrual periods, pregnancy, or menopause can make varicose veins worse. Taking hormonal treatments such as birth control pills is associated with an increased risk of varicose veins.
Family history: Having family members with varicose veins is a risk factor for developing the condition.
Pregnancy: In addition to the hormone fluctuation, the increased blood volume during pregnancy can lead to the formation of new varicose veins.
Obesity: Being overweight or obese puts extra pressure on the veins and increases the chances of developing varicose veins.
Sitting or standing for long periods: Contractions of the leg muscles during movement encourage blood flow. Standing or sitting for long periods is, therefore, a risk factor for varicose veins.
Other lifestyle factors: Wearing tight clothing, such as tight pants or girdles, reduces blood flow and can increase the risk of varicose vein formation.
Other health factors: Surprisingly, chronic severe constipation is another risk factor for varicose veins. Lastly, certain types of tumors can also increase the risk of developing venous disease.

Do spider veins develop into varicose veins?

Spider veins do not develop into or cause varicose veins. Spider veins are similar to varicose veins but are smaller and milder. They tend to occur more superficially and are typically red or blue in color, often resembling a spider’s web. In addition to the legs, spider veins can also occur pretty much anywhere in the body, including the face.

How are varicose veins diagnosed?

Doctors can diagnose varicose veins based on a physical exam and tests such as a venous Doppler ultrasound test. A leg ultrasound can also be done to diagnose a blood clot and the elasticity of the valves.

Can you make varicose veins go away?

You can make varicose veins go away. There are cosmetic treatments that can reduce the appearance of varicose veins. Minor surgical procedures can be done to seal shut or remove varicose veins.

How do doctors treat varicose veins?

Treatment options for varicose veins include lifestyle changes, self-care, home remedies, and minor surgery.

Compression stockings

Wearing compression stockings applies pressure on the blood vessels in your legs, encouraging blood flow back to your heart. Compression stockings help to reduce leg swelling and lower your risk of a blood clot. However, they do not change the way varicose veins appear.

Sclerotherapy

This is a common treatment done to relieve symptoms of small varicose veins. It is done in a doctor’s office, and there is no need for anesthesia. Sclerotherapy involves using ultrasound guidance to inject a chemical into damaged veins to irritate them, causing the vein walls to collapse, thereby blocking blood flow and scarring the treated vein, which eventually shrinks and fades away. You may need more than one sclerotherapy session. After sclerotherapy, spider veins and small varicose veins typically disappear in 3-6 weeks, and it may take 3-4 months to see results from sclerotherapy for larger veins.

Endovenous thermal ablation (laser therapy)

Laser light can be used to treat spider veins and smaller varicose veins. Small spider veins significantly improve immediately after treatment. Large spider veins and varicose veins become darker in color and disappear over a period of 1-3 months. You may need more than one laser treatment for varicose veins.

Vein stripping

This is a surgical procedure done under general anesthesia or spinal anesthesia. The surgeon makes 2-3 small incisions (cuts) in your leg, thread a flexible catheter up to the affected vein, and pulls the damaged vein out with the catheter.

Other treatments for varicose veins

Besides endovenous laser therapy, radiofrequency ablation (RFA) is another popular treatment for varicose veins. Similar to laser therapy, RFA is done using local anesthesia. The main difference between these two procedures is that laser therapy uses a laser, while RFA uses radiofrequency to treat the damaged vein without harming other veins in the area. Radiofrequency waves have been reported to cause less pain compared to laser therapy. However, both procedures are generally safe and effective.

You may need to wear compression stockings for some time after the procedure. Most people need more than one treatment to get the best results. It can take up to one year for a treated vein to disappear completely.

It can be challenging to choose the best treatment for your varicose veins. You should discuss different treatment options with your healthcare provider if varicose veins reduce your quality of life due to their appearance or associated symptoms such as pain and discomfort. Your doctor can help you choose the best treatment option for you depending on the severity of your venous disease, your medical history, and your personal preference.

What are the complications of varicose veins?

Rarely, a varicose vein can cause serious complications, such as:

Venous ulcers: Painful ulcers (open sores) can develop near varicose veins, particularly in the lower legs. Skin color changes usually precede the formation of skin sores. You should see your healthcare provider immediately if you suspect a leg ulcer.
Bleeding: A varicose vein can burst and cause bleeding, requiring medical care.
Blood clots: Leg pain and swelling are symptoms of varicose veins, but also of blood clots. Seek immediate medical attention if you develop leg pain or swelling because it could be from a blood clot in the deep veins of your leg (deep vein thrombosis or DVT). A blood clot can travel to the lungs, heart, and brain and cause pulmonary embolism, heart attack, and stroke, respectively. Risk factors for blood clots include a history of a previous blood clot, smoking, pregnancy, taking oral contraceptive pills, and being inactive, for example, due to a leg injury.

How to prevent varicose veins?

Some simple lifestyle changes can lower your risk of developing varicose veins.

Eat a high-fiber, low-salt diet or just a generally balanced, healthful diet to prevent constipation
Get regular physical exercise
Maintain a healthy weight
Avoid standing or sitting for long periods
Get up and walk every 30 minutes when sitting or standing for long periods
Change your position regularly
Raise your legs periodically when sitting or lying down
Avoid wearing tight leggings or high heels
Wear compression socks