Varicose veins explained: causes, symptoms and treatment

What varicose veins are

Veins carry blood back to the heart, and in the legs they must push blood upwards against gravity. To stop blood flowing backwards, veins contain tiny one-way valves. Varicose veins develop when these valves weaken and stop closing properly, so blood pools and the vein stretches, becoming enlarged, twisted and often bluish or bulging under the skin. They most commonly appear on the legs because these veins work hardest against gravity. Varicose veins are extremely common and usually not dangerous, but the underlying valve problem is why they tend to persist or worsen over time rather than simply going away on their own.

Symptoms and who gets them

Some people have varicose veins with no symptoms beyond their appearance. Others notice aching, heavy or uncomfortable legs, especially after standing for long periods, along with swollen feet and ankles, burning or throbbing, muscle cramps and itching over the vein. Symptoms often ease when the legs are raised. Varicose veins become more likely with age, and the risk is higher if close relatives have them, if you are overweight, if you are pregnant, or if your job involves long periods of standing. They are more common in women. Pregnancy-related varicose veins often improve in the months after giving birth without any treatment.

Self-care and when to see a doctor

For milder varicose veins, simple measures can ease symptoms even though they will not make the veins disappear. Staying active, keeping to a healthy weight, avoiding long periods of standing still, and raising the legs when resting all help blood flow. Compression stockings, which gently squeeze the legs, can relieve aching and swelling for some people. It is worth seeing your GP if the veins are painful, the skin over them changes colour or becomes dry and itchy, or if the symptoms are affecting your daily life. Getting checked matters because treating the underlying problem can prevent complications developing later.

Treatment options

When treatment is needed, several effective options exist and most are minimally invasive. Common approaches close off the faulty vein so blood reroutes through healthier veins: these include using heat delivered through a thin tube (such as laser or radiofrequency) or injecting a special foam that seals the vein. Some veins are removed through very small cuts. Traditional surgery to tie off and remove the vein is used less often now. Treatment is usually chosen based on the size and position of the veins and your symptoms. On the NHS, treatment is generally offered when varicose veins cause troublesome symptoms or complications, rather than for appearance alone.

Possible complications

Most varicose veins never cause serious problems, but complications can occasionally develop, which is why bothersome veins are worth checking. Over time, poor circulation can cause the skin around the ankle to become discoloured, dry, itchy or hardened, and in some cases a slow-healing sore called a leg ulcer can form. A vein near the surface can also become inflamed and tender, or bleed if knocked. Rarely, symptoms may overlap with a deeper clot in the leg, which is more serious. Seek prompt medical advice if a vein bleeds, if the skin breaks down or ulcerates, or if a leg becomes suddenly painful, swollen, red or warm.