Varicose veins are a common yet often misunderstood condition affecting millions of people worldwide. They are enlarged, swollen and often twisted veins that typically appear on the legs and feet. Although some people consider them a cosmetic concern, varicose veins can also cause discomfort and signal more serious health issues. In this article, we take a deep dive into varicose veins. We look at what causes them, how to avoid getting them and the best treatments for removal.
What Are Varicose Veins?
Varicose veins (or varicosities, to use their medical name) are, put simply, veins that have become enlarged and twisted. These veins bulge beneath the skin and are usually blue or dark purple. They occur when the valves inside the veins become weakened or damaged. These valves normally keep blood flowing in one direction towards the heart. This causes blood to pool in the veins, which expands them and makes them look swollen. Although varicose veins can form anywhere in the body, they are most commonly found in the legs and feet. This is because of the increased pressure in the lower body when standing and walking. That pressure makes the veins expand and become more visible.
What’s the Difference Between Varicose Veins and Thread Veins?
Although varicose veins are commonly confused with thread veins, the two differ significantly in appearance, causes and health implications. It is even more confusing because you can have both at the same time.
Varicose veins are larger, bulging veins that appear blue or purple and often cause symptoms like aching, heaviness and swelling. They result from weakened or damaged valves in the veins. Left untreated, they can lead to serious health issues such as skin ulcers or blood clots. Thread veins, also known as spider veins, are smaller and red or blue in colour. They lie closer to the skin’s surface, so they are less bulgy, and they are generally harmless and primarily a cosmetic concern. Factors like genetics, sun exposure and hormonal changes cause thread veins. Varicose veins may need removal with medical treatments such as sclerotherapy or surgery because of their risk of ulcers or clots. Thread veins, however, do not need removal, though they are often treated with laser therapy or sclerotherapy for cosmetic reasons.
What Are the Symptoms of Varicose Veins?
Varicose veins may manifest in several ways, and the symptoms can vary from person to person. You may experience one symptom or several. It is important to recognise the symptoms and seek medical help early on, as timely intervention can prevent them from worsening. The most common varicose veins symptoms are:
- Visible bulging twisted veins: The most obvious symptom is the appearance of the veins themselves. They often look swollen, twisted and bulging, and resemble cords running along the legs beneath the surface of the skin.
- Swelling in the legs and ankles: People with varicose veins may notice swelling, particularly around the ankles and feet. This can be a result of fluid buildup due to poor circulation in the affected veins.
- Aching or heaviness in the legs: Many people feel heaviness or aching in the legs, especially after standing or sitting for long periods. This discomfort is often worse at the end of the day and can improve with rest or by elevating the legs.
- Itching or burning sensation: The skin around the varicose veins may become itchy or develop a burning sensation. This can be due to inflammation in the veins or skin irritation from the condition.
- Muscle cramps and restlessness: Some people experience muscle cramps, particularly at night, or a restless sensation in the legs.
- Skin discolouration or ulcers: In more severe cases, varicose veins can change the skin, causing discolouration, thinning or even ulcers. This is particularly likely around the ankles.
What Causes Varicose Veins?
Several factors can contribute to the development of varicose veins and increase your risk of getting them. Knowing the causes can also help in managing and preventing the condition. The most common causes and risk factors are:
- Genetics: Family history is a significant predictor of your risk. If your parents or close relatives have varicose veins, you are more likely to develop them too.
- Age: This is a natural cause of varicose veins. As we age, the valves in our veins can weaken and lose elasticity. This makes it harder for them to work properly.
- Gender: Women are more likely than men to develop varicose veins. This is because hormonal changes during pregnancy, menstruation or menopause can weaken the vein walls. Hormone treatments or birth control pills may also increase the risk.
- Pregnancy: As well as the hormonal changes that affect the veins, pregnancy also increases the amount of blood in the body. On top of that, the growing uterus puts pressure on the veins in the legs. Together, these make the veins enlarge and varicose veins develop.
- Obesity: Excess weight puts additional pressure on the veins, which can increase the risk of getting varicose veins.
- Prolonged standing or sitting: Occupations or lifestyles that involve long periods of standing or sitting can increase your risk. Staying in one position for a long time reduces circulation and lets blood pool in the veins.
- Lack of physical activity: A sedentary lifestyle can contribute to poor circulation, which raises the likelihood of varicose veins. Regular exercise helps improve blood flow and reduces the risk.
Can You Prevent Varicose Veins?
Unfortunately you cannot completely prevent varicose veins, especially if you have a genetic predisposition or are a woman. However, there are steps you can take to reduce your chances of getting them:
- Stay active: Regular exercise, such as walking or swimming, helps improve circulation and strengthen the veins.
- Maintain a healthy weight: Keeping your weight in check reduces the pressure on your veins.
- Avoid prolonged standing or sitting: Try to move around every 30 minutes to promote healthy blood flow.
- Elevate your legs: When resting, raise your legs to improve circulation.
- Wear compression stockings: If you are at risk of developing varicose veins, compression stockings can help support vein function.
What Are the Best Treatments for Varicose Veins?
If you are experiencing discomfort from varicose veins, or are concerned about their appearance, there are several treatment options available. A doctor may also recommend removal if they are worried that your varicose veins could lead to ulcers or clotting. The choice of treatment depends on the severity of the condition, your symptoms and your overall health. The best treatments for varicose veins removal are:
- Lifestyle changes and self-care: For mild cases, three simple measures can help reduce symptoms and prevent them from getting worse. These are regular physical activity, elevating the legs when sitting or resting, and wearing compression stockings.
- Sclerotherapy: This is a minimally invasive procedure that involves injecting a solution directly into the varicose vein. The solution causes the vein to scar and close, which forces the blood to reroute through healthier veins. Over time the treated vein fades and the body absorbs it. This procedure is effective for smaller varicose veins and spider veins.
- Laser treatment: High-intensity light from laser removal therapy can destroy varicose veins. This is a non-invasive treatment that works well for smaller veins just under the skin’s surface. It usually requires multiple sessions to achieve the desired result.
- Endovenous ablation therapy: This involves using heat, usually from radiofrequency or laser energy, to close off varicose veins. A specialist inserts a small catheter into the vein, and the heat damages the vein walls so they collapse and seal shut. Endovenous ablation therapy is a minimally invasive procedure that works well for larger varicose veins. You can normally have it under local anaesthesia.
- Ambulatory phlebectomy: This procedure involves removing small varicose veins through tiny skin punctures. Ambulatory phlebectomy is useful for superficial veins and only requires local anaesthesia.
- Vein stripping and ligation: This surgical procedure is best for severe cases. Vein stripping and ligation involves tying off a vein before it joins a deep vein and removing it through small incisions. It is more invasive, but highly effective for extensive varicose veins, and you will usually need to have it under general anaesthesia.
Varicose veins are a common condition that can arise from a variety of causes. Although the appearance is distinctive, the symptoms can vary greatly. There are several good removal options if the veins bother you. They help if you have discomfort, are at risk of skin complications or dislike how they look. However, prevention is always better than cure, so understanding the risk factors is key to avoiding them in the first place. Early intervention is also key to the best outcomes. So seek medical advice if you suspect you have any of the symptoms.
City Skin Clinic is an online skin and hair clinic, so we do not diagnose or treat varicose veins. These are a vascular condition, not a skincare one. If you are worried about yours, especially with pain, swelling, skin changes or ulcers, the best place to start is your GP. They can refer you to a vascular specialist if needed. What our doctors do offer is personalised topical prescription skincare for facial and skin concerns like acne, hyperpigmentation, melasma and skin ageing. If one of those is on your mind, you can use our online skin consultation form or book a video consultation. The journey towards great skin starts here.
This article is intended for general informational purposes only and is not a substitute for medical advice, diagnosis or treatment. Always consult a qualified medical professional with any concerns about your skin or treatment options.
