Varicose veins are swollen veins that you can see through your skin. They may look blue, bulging, or
twisted. If left untreated, varicose veins may worsen over time. Varicose veins can cause aching and
feelings of fatigue as well as skin changes like rash, redness, or sores. As many as 40 million
Americans, most of them women, have varicose veins.
When you are in the upright position, the blood in your leg veins must work against gravity to return
to your heart. To accomplish this, your leg muscles squeeze the deep veins of your legs and feet.
One-way flaps, called valves, in your veins keep blood flowing in the right direction. When your leg
muscles contract, the valves inside your veins open. When your legs relax, the valves close. This
prevents blood from flowing in reverse, back down the legs. The entire process of sending blood back to
the heart is called the venous pump.
When you walk and your leg muscles squeeze, the venous pump works well. But when you sit or stand,
especially for a long time, the blood in your leg veins can pool and the pressure in your veins can
increase. Deep veins and perforating veins are usually able to withstand short periods of increased
pressures. However, if you are a susceptible individual, your veins can stretch if you repeatedly sit
or stand for a long time. This stretching can sometimes weaken the walls of your veins and damage your
vein valves. Varicose veins may result.
What are spider veins?
Spider veins are mild varicose veins. They look like a nest of red or blue lines just under your skin.
Spider veins are not a serious medical problem, but they can be a cosmetic concern to some people, and
they can cause symptoms of aching pain and itching in others. Please see our information about treatment options for spider veins.
Symptoms of varicose veins
If you have varicose veins, your legs may feel heavy, tired, restless, or achy. Standing or sitting for
too long may worsen your symptoms. You may also experience night cramps.
You may notice small clusters of veins in a winding pattern on your leg, or soft, slightly tender knots
of veins. Sometimes, the skin on your legs may change color, become irritated, or even form sores.
Varicose veins can worsen without treatment.
If you have severe varicose veins, you have slightly increased chances of developing deep vein
thrombosis (DVT). DVT may cause sudden, severe leg swelling. DVT is a serious condition that requires
immediate medical attention.
What causes varicose veins?
High blood pressure inside your superficial leg veins causes varicose veins. Factors that can increase
your risk for varicose veins include having a family history of varicose veins, being overweight, not
exercising enough, smoking, standing or sitting for long periods of time, or having DVT.
Women are more likely than men to develop varicose veins. Varicose veins usually affect people between
the ages of 30 and 70.
Pregnant women have an increased risk of developing varicose veins, but the veins often return to
normal within one year after childbirth. Women who have multiple pregnancies may develop permanent
Tests for varicose veins
We will first conduct a physical exam, and also ask you questions about your symptoms, medical history
and general health. We will examine the texture and color of any prominent veins. We then may apply a
tourniquet or direct hand pressure to observe how your veins fill with blood. To confirm a diagnosis of
varicose veins, we may order a duplex ultrasound test.
Duplex ultrasound uses painless, high-frequency waves to measure the speed of blood flow and to see the
structure of your leg veins. The test can take approximately 20 minutes for each leg. Besides showing
varicose veins, duplex ultrasound may help us decide whether your varicose veins could be related to
some other condition rather than the veins themselves.