Varicose veins are a very common condition that affects up to one in three adults to varying degrees. Varicose veins can cause both discomfort and pain and may also lead to other complications. Many people with varicose veins also see them as a cosmetic problem.
In this guide, we draw on our many years of experience from running over 20 varicose vein clinics to give you an overview of what varicose veins are, from what causes them to the symptoms and how they can be treated. In recent years, there has been significant development in both research and treatment of varicose veins, which we will discuss further below.
If you have varicose veins and are unsure about what caused them or whether you should do something about them, this article is a good place to start.
What Are Varicose Veins?
Although most people have seen varicose veins, knowledge about them and what they actually are is not particularly widespread. Below, you can see images of varicose veins in varying degrees on different individuals.
In general, varicose veins are a condition characterized by enlarged, twisted, and superficial blood vessels, most often on the inside of the lower legs. Varicose veins occur as a result of reduced blood circulation in the veins.
The veins in the body return blood from all parts of the body to the heart to be re-oxygenated. However, blood circulation can be reduced if the vein valves are weakened. It is these valves that are supposed to prevent the blood from flowing backwards when it is pumped. In the illustration below, you can see in the bottom circle that the vein valves are weakened, allowing blood to flow backwards.
This is especially common in the legs, as the blood in the legs struggles against gravity, which is why varicose veins occur in the legs.
When weakened vein valves cause reduced blood flow, the blood can become oxygen-poor, making it more bluish and leading to it accumulating in the veins. This is what forms varicose veins.
Many people also confuse varicose veins with spider veins. Spider veins are smaller and look like spider webs on the legs. Spider veins almost never cause physical problems for the person who has them, but many still wish to treat them for cosmetic reasons.
Symptoms of Varicose Veins
Symptoms of varicose veins can be divided into different types:
Visible Symptoms of Varicose Veins:
- Bulging and visible bluish or purple veins that are very noticeable. This is the most classic symptom.
- "Spider veins" are also a well-known symptom. These are also known as telangiectasias and can resemble a network of red, blue, and purple veins.
Noticeable Symptoms:
- Leg pain or heavy legs: This is also a very common symptom, where one may feel that their legs are heavy or tired and that pain occurs. This symptom is most noticeable after sitting or standing for extended periods.
- Swelling: A symptom can also be swelling in the legs, ankles, or feet, especially after standing for a long time.
- Cramps and contractions: Some people also experience cramps or contractions in their legs, which most often occur at night.
- Itching: Itching and skin irritation are also common symptoms. In some cases, this can lead to inflammation.
- A burning sensation: A somewhat rarer symptom is a burning or tingling sensation along the veins that have varicose veins.
- General discomfort in the legs: Another typical symptom is just a general feeling of discomfort in the legs.
Changes in the skin around varicose veins:
- The skin around varicose veins may lose colour and become more brownish or blue. This is due to the accumulation of blood in the veins.
- Thicker/harder skin around the varicose vein may also develop.
Which Varicose Vein Symptoms Are Serious, and When Should You Take Action?
When discussing the various symptoms of varicose veins, they are usually categorised as follows. The further to the right, the more serious the symptoms:
The following symptoms are not serious but can still be treated:
- Sore and heavy legs that feel better after being elevated for at least 15 minutes.
- A burning sensation at an enlarged vein.
- Muscle pain and restless legs during the night.
- Unexplained swelling in the lower part of the leg and ankle.
In our varicose vein clinics, we find that many people become so accustomed to their varicose veins and the discomfort they cause that they perceive it as normal, even though they gradually experience worsening symptoms. Once varicose veins are treated, many people feel relief in a way that makes them realise they didn't know they had such serious problems before.
The veins in the legs can be examined with ultrasound to detect varicose veins early on. A person who is concerned about their varicose veins or veins can undergo an ultrasound examination of the veins as a basis for a surgeon's assessment of the varicose veins. The appropriate type of varicose vein treatment can then be determined based on the individual patient's needs and what will provide the best result.
If you have the following symptoms, it is more serious, and you should definitely see a doctor and seek advice quickly:
- Pigmentation of the skin on the lower part of the leg and ankle, causing the skin to become significantly darker than the surrounding skin.
- Thick and hardened skin in the same area as above, which itches and is reddish, like eczema.
- A sore on the skin that is red and has appeared without being caused by an injury or accident.
Why Do People Get Varicose Veins?
It is important to point out that varicose veins are very common and that anyone can develop them. Older people are more likely to get varicose veins simply because the valves in the veins (those that prevent blood from flowing back) wear out over the years. This is why varicose veins can also worsen with age.
Varicose veins are so common that between 20-35% of adults experience varicose veins.
Varicose veins are more commonly seen in overweight individuals and women. In overweight people, varicose veins occur because excess weight worsens blood circulation.
Varicose veins or spider veins that occur during pregnancy can disappear on their own. The development of varicose veins during pregnancy is related to changes in blood circulation and hormone balance during pregnancy, as well as the significant increase in the woman's body weight.
A person who has had varicose veins or spider veins related to pregnancy should wait three to six months after pregnancy before seeking treatment, as these varicose veins or spider veins may disappear on their own.
Additionally, varicose veins can also be hereditary, so if one of your parents has varicose veins, there is an increased risk that you might develop them as well.
Another cause of varicose veins can be prolonged periods of sitting or standing still, often related to work.
Varicose Veins Can Cause Other Complications
Varicose veins often cause mild issues such as itching, heavy legs, and mild pain where the varicose veins are located. However, there is also a risk of skin damage due to the reduced blood circulation in the legs.
The damage that can occur to the skin first appears as dry skin, which can cause itching, but it can also lead to permanent sores, known as venous leg ulcers, which do not heal on their own. This could become a problem indirectly related to the varicose veins.
Another much more serious issue that can arise is blood clots in the legs. If these blood clots are released, they can travel through the bloodstream and lodge in places like the lungs, potentially creating an acute and life-threatening situation. However, this is very unusual, and most dangerous blood clots come from veins located deeper within the body.
Diagnosis: When Should You See a Doctor About Varicose Veins?
A doctor specialising in varicose veins can quickly perform an examination and advise on the next steps.
If you are unsure whether your varicose veins should be treated, it may be a good idea to book a preliminary examination. At UK Vein Care, a preliminary examination costs £250, takes about 20 minutes, and we have very short waiting times.
The preliminary examination includes a consultation where the doctor discusses your symptoms and history, followed by an ultrasound examination. The purpose of the preliminary examination is to present an accurate treatment plan.
It is important to highlight that many people have varicose veins treated for cosmetic reasons, and it is perfectly acceptable for this to be the basis for the preliminary examination and treatment.
We have created a comprehensive page about our preliminary examination where you can learn more about how we proceed and what happens next. You can find it here.
How Are Varicose Veins Treated?
The biggest myth about varicose veins must be that treatment is highly invasive. That used to be the case, but in recent years, there have been significant developments in varicose vein treatment. This means that most people today can be treated quickly, painlessly, and without any aftereffects.
Nowadays, treatment is so effective that you can leave the clinic the same day and return directly to your daily routine.
However, there are also some things you can do before considering a medical procedure.
What You Can Do to Prevent or Improve Varicose Veins
The areas you can work on yourself include:
- Compression stockings
- Exercise and weight loss
- Elevating your legs
- Diet changes
Treatment Methods for Varicose Veins
There are three main treatment methods, which are all minimally invasive. Minimally invasive means they do not require general anaesthesia, are virtually painless, and require minimal recovery time afterwards.
Below are brief descriptions of the three treatment methods, taken from our treatment page. You can read more about each treatment method on the full page.
Laser Treatment
Radial fibre laser treatment involves inserting a thin laser fibre into the diseased vein through a needle. The fibre is then heated, causing the vein to contract and eventually die over time. This eliminates the possibility of blood flowing backwards in the diseased vein, which would otherwise lead to visible varicose veins, spider veins, and related symptoms.
Foam Sclerotherapy
The principle behind foam sclerotherapy is similar to that of other treatment methods. It involves closing off blood flow in the diseased veins that cause varicose veins.
In foam sclerotherapy, a liquid medical agent (Aethoxysklerol) is mixed with air to create foam, which is then injected directly into the affected veins through a very thin needle. Aethoxysklerol chemically affects the inner lining of the vein, causing it to contract and stop blood flow. The foamy nature of the substance increases contact with the vein's inner lining, thereby enhancing the treatment's effectiveness.
Phlebectomy
Phlebectomy, also known as the hook technique, involves making very small incisions (2-3 mm) in the skin under local anaesthesia, corresponding to the visible varicose veins on the leg. Through these small incisions, the affected vein is removed using a small surgical hook.
This method mechanically removes the varicose veins. The incision is so small that it does not require stitches, leaving only a tiny scar that eventually becomes almost invisible. Phlebectomy is often performed in combination with, or as a supplement to, other treatment methods but can also be done on its own.
Surgical Interventions
There are also full surgical interventions, such as vein stripping and phlebectomy, but as minimally invasive methods have improved so much in recent years, it is rarely necessary. A preliminary examination will determine which treatment method is most suitable for the individual patient.
Myths and Frequently Asked Questions About Varicose Veins
We frequently encounter the same questions and find that there are some deeply ingrained myths about varicose veins. The most common ones are:
- Varicose veins are just a cosmetic issue. Varicose veins are not only a cosmetic concern; they can lead to more serious complications. However, it is true that many people seek treatment for varicose veins due to cosmetic reasons.
- Treating varicose veins is a major surgical procedure. As mentioned in this article, this is probably one of the biggest myths about varicose veins. Today's treatment methods have become so refined and gentle that they can be performed very quickly, without pain, and without the need for recovery time afterwards.
- Treating varicose veins requires general anaesthesia. No, our treatment methods only require local anaesthesia and are very gentle.
- Is it normal for pregnant women to get varicose veins? Yes, it is true that there is a higher risk of developing varicose veins during pregnancy. For most pregnant women, they disappear on their own after childbirth.
Learn More About Varicose Veins
The purpose of this article has been to provide a good starting point for people who want to learn more about varicose veins—primarily those affected by them and who are considering treatment.
If you are interested in learning more about varicose veins, we recommend reading our pages on causes and symptoms.
If you are interested in learning more about the treatment process, we suggest our three pages on preliminary examination, treatment methods, and follow-up care. These three pages will give you a comprehensive overview of the entire process.
If you want to learn more about varicose vein research, there is also a lot of relevant research available, such as the research project on varicose veins conducted by Lars H. Rasmussen and Martin Lawaetz, where various treatment methods are compared. You can also find an overview of all the available research on Google Scholar.
Conclusion
We hope that this article has provided you with a good overview and introduction to varicose veins. Hopefully, you are now better informed if you are unsure about your own varicose veins.
As we mentioned in the article, there has been significant development in varicose vein treatment in recent years. While many people still believe it involves major surgery, it is now possible for most to be treated quickly and painlessly.
We hope this article has given you some tips on what you can do yourself, but hopefully also a clear understanding of what can be done—and how manageable it is—if you want to have varicose veins treated.
You are always welcome to contact us with any questions, feedback on this article, or to book a non-binding preliminary examination.
This article was created in collaboration with UK Vein Carestaff, who help patients with their varicose veins every day. The article has also been reviewed by doctors specializing in varicose veins.
