Varicose Veins

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► About

► Symptoms

► Causes

► Diagnosis

► Treatments

► Living With Varicose Veins

► Additional Resources

► Request a Vascular Specialist

About Varicose Veins

Varicose veins are bulging, enlarged veins. Any vein close to the skin's surface, called superficial, can become varicosed. Varicose veins most occur in the veins in the legs. That's because standing and walking increase the pressure in the veins of the lower body.

For some people, varicose veins are simply a cosmetic concern. Spider veins are also a common, mild form of varicose veins. But, varicose veins can cause aching pain and discomfort. Sometimes they lead to more serious health problems.

Symptoms of Varicose Veins

Person sitting on an exam table with physician pointing to the leg

Varicose veins might not cause pain. Symptoms of varicose veins include:

  • Veins that are dark purple, blue or the same color as the skin. Depending on skin color, these changes may be harder or easier to see.
  • Veins that look twisted and bulging. They often look like cords on the legs.

When there are painful symptoms of varicose veins, they might include:

  • An achy or heavy feeling in the legs.
  • Burning, throbbing, muscle cramping, and swelling in the lower legs.
  • Worse 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 like varicose veins, but they're smaller. Spider veins are found closer to the skin's surface and might look like a spider's web. Spider veins occur on the legs but also can be found on the face.

Causes and Risk Factors

Veins work with other blood vessels to provide proper blood flow throughout the body and return blood back to the heart. In the legs, veins have one-way valves that prevent blood from flowing backwards. One-way valves and muscle contractions work together to move blood upward toward the heart, counteracting gravity.

As a result of factors such as age, gender, genetics, and other health conditions, the walls of these veins can weaken, and the valves may fail to close properly. This leads to blood pooling, which causes the veins to bulge and twist. These changes can result in pain, leg fatigue, and a feeling of heaviness.

The pooling of blood can also lead to swollen feet and ankles, itching, skin changes, and increased bleeding from minor cuts. If not addressed, varicose veins can progress to more serious conditions, such as ulcerations.

Diagnosing Varicose Veins

  • A physical exam

  • Duplex Ultrasound

  • Venogram

A primary care doctor or vascular specialist will examine your legs while you’re standing and talk with you about your lifestyle, such as sitting or standing for long periods of time and your family’s medical history. This typically occurs during an office visit with a doctor.
A duplex ultrasound is a non-invasive test that uses sounds waves to create images of blood flow through your veins and can show if blood is pooling or flowing backwards in the legs (reflux). It’s the most common method used to diagnose varicose veins and is typically performed with the patient standing up to get the most accurate results. It’s focused on key areas like deep veins, the larger veins near the surface (such as the great and small saphenous veins), and smaller connecting veins. This imaging procedure can be performed at some BayCare Imaging Centers or in some vascular surgery offices.
A venogram is an imaging test that uses x-rays and contrast dye to create visual images of veins. Dye is injected into the foot or ankle vein and x-ray images are taken over time to show detailed images of a vein’s structure. Venograms are used for complex cases when duplex ultrasound imaging does not provide enough information or for recurring varicose veins. Venograms are performed at some BayCare Imaging Centers.

Treatments Options

While these various treatments frequently occur in a physician office or outpatient vascular center, your vascular surgeon or specialist will provide more detailed information based on your needs. These are various treatment options available including:

  • Sclerotherapy

  • Endovenous Laser Therapy (EVLT)

  • Radiofrequency Ablation (RFA)

  • Vein Stripping and Ligation

  • Ambulatory Phlebectomy

  • VenaSeal Closure System

This involves injecting a special liquid solution called a sclerosing agent into the varicose veins. The solution irritates the vein walls, causing them to collapse and eventually be absorbed by the body. The liquid solution is often used for smaller veins. For larger veins, a foam version of the sclerosing agent can be used. When this occurs, it’s called foam sclerotherapy.
A thin laser fiber is inserted into the varicose vein through a small incision. The laser heats and seals the vein, causing it to shrink, collapse, and seal over time. As the vein seals, healthy veins take over and redirect blood flow back to the heart. It’s commonly used for larger varicose veins.
Using ultrasound, a catheter is inserted into the vein, and radiofrequency energy is used to heat the vein wall, causing it to shrink and close. RFA is typically used for larger varicose veins.
This surgical procedure involves “tying off” or ligation the affected veins near the knee or groin to prevent blood from flowing into the vein. Next, a vascular surgeon makes a small incision and inserts a small flexible wire into the vein. The wire is then pulled to remove the vein. It’s often reserved for more severe cases of varicose veins.
Ambulatory phlebectomy is a surgical procedure where a vascular surgeon uses a series of small incisions near the vein and then uses surgical tools to remove the vein through the incisions. This is generally used for smaller, superficial veins.
A minimally invasive catheter-based treatment that uses ultrasound to inject a medical-grade adhesive to seal off a vein. After the adhesive is injected, the catheter is removed.

Living With Varicose Veins

Senior woman sitting on the beach at sunset smiling

Here are some practical tips for managing varicose veins:

  • Move your legs often to support blood circulation and talk with your doctor about what exercise options are best for you
  • Avoid tight clothing on your legs, waist, groin or pelvis area as it can restrict blood flow and worsen symptoms
  • Monitor your symptoms and call your primary care doctor or vascular specialist if you experience any increased pain, skin discoloration, swelling or develop any wounds on your skin around your varicose veins
  • For women, be aware of hormonal changes such as pregnancy, menopause, and talk with your primary care doctor or vascular specialist about the use of birth control medications and how those may affect varicose veins

Additional Resources


Frequently Asked Questions

  • Can varicose veins be prevented?
    While it’s not always possible to prevent varicose veins entirely, there are steps you can take to reduce the risk of developing them such as exercising regularly like walking, swimming, or cycling, which helps improve circulation and strengthens vein walls. Maintaining a healthy weight reduces pressure on the veins. If possible, avoid standing or sitting for long periods, or change positions often and elevate your legs whenever possible. Eating a balanced diet high in fiber and low in salt can help reduce pressure on the veins.
  • If I have one varicose vein, does that mean I will get more?
    While having one varicose vein does increase the likelihood of developing more over time, it doesn't guarantee you’ll develop more. Getting varicose veins is influenced by several factors, and if you already have one, there may be underlying issues with the vein function in your legs like weakened valves or poor circulation that could make you more prone to developing others in the future.
  • Do compression socks really help varicose veins?
    Compression socks or stockings help by applying gentle pressure to your legs to improve blood flow and reduce swelling. While they don’t treat the veins, they may help with symptoms. They come in different levels and your vascular specialist can help determine which level of support you may need.

Find a Vascular Surgeon

Think you have or may need further treatment for varicose veins? Let us help you find the right doctor. A primary care doctor such as an internal medicine or family practitioner can often start the diagnostic journey for varicose veins. If you’ve already been diagnosed and want to discuss additional treatment options, a vascular surgeon usually performs treatments for varicose veins. Use our referral form or call (855) 233-0888 and we’ll help you find a doctor that meets your needs.

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