Complete Guide to Varicose Veins: Causes, Symptoms & When to Seek Help

Varicose veins are one of the most common vascular conditions, affecting millions of people. Yet many people don't fully understand what they are, why they develop, or when they should seek treatment. This comprehensive guide covers everything you need to know about varicose veins — from what causes them to recognising symptoms to deciding whether treatment is right for you.

What are varicose veins?

Varicose veins are enlarged, twisted veins that typically appear on the legs and feet. They develop when the one-way valves inside veins stop working properly, allowing blood to flow backward and pool in the vein. This causes the vein to enlarge and become visible through the skin.

The word varicose comes from the Latin word for “twisted,” which perfectly describes their appearance.

How veins normally work

Your arteries carry oxygen-rich blood from your heart to your body. Your veins carry oxygen-poor blood back to your heart. This is harder work in your legs because blood has to travel upward against gravity.

To solve this problem, veins have one-way valves that open to let blood flow upward and close to prevent it from flowing backward. When you walk or exercise, muscle contractions help push blood upward.

When these valves work properly, blood flows efficiently back to your heart. When they fail, blood pools in the vein, causing it to enlarge.

What causes varicose veins?

Several factors increase your risk of developing varicose veins:

Age

Veins naturally lose elasticity as you age, and valves become less effective. Varicose veins are more common in older adults.

Gender

Women are more likely to develop varicose veins than men, partly due to hormonal changes during pregnancy, menstruation, and menopause.

Pregnancy

Pregnancy increases blood volume and puts extra pressure on veins. Hormonal changes also weaken vein walls. Varicose veins often develop during pregnancy and may improve after delivery, though they sometimes persist.

Family history

If your parents or grandparents had varicose veins, you're more likely to develop them. Genetics play a significant role in vein health.

Prolonged standing or sitting

Jobs or lifestyles that involve long periods of standing or sitting reduce muscle contractions that help pump blood upward, increasing pressure in leg veins.

Obesity

Extra weight increases pressure on veins and makes it harder for blood to flow upward.

Injury or trauma

Damage to veins or valves from injury can lead to varicose veins.

Previous blood clots

A history of deep vein thrombosis (DVT) can damage valves and increase varicose vein risk.

Hormonal changes

Hormonal treatments like hormone replacement therapy or birth control can increase varicose vein risk in some women.

Recognising the symptoms

Varicose veins don't always cause symptoms, but when they do, they can include:

• Visible veins — enlarged, twisted veins on your legs or feet (often dark purple or blue)
• Leg pain or aching — often worse after standing for long periods
• Heaviness or fatigue — legs may feel heavy or tired, particularly in the evening
• Swelling — ankles and feet may swell, often improving when you elevate your legs
• Itching or burning — over the affected veins
• Skin changes — discolouration, thickening, or rash-like changes in more severe cases
• Muscle cramps — especially at night
• Restlessness — a restless sensation in the legs

When symptoms are worse

Symptoms often worsen:

• After standing for long periods
• During warm weather
• During menstruation (in women)
• Late in the day
• After exercise

Symptoms often improve:

• After lying down
• When you elevate your legs
• In cool weather
• After exercise (once you rest)

Are varicose veins dangerous?

For most people, varicose veins are a cosmetic concern or cause minor discomfort. However, in some cases, they can lead to complications:

• Bleeding — if a vein near the skin ruptures, it can bleed and should be evaluated
• Blood clots — rarely, blood can clot inside a varicose vein (superficial thrombophlebitis)
• Skin ulcers — in severe, long-standing cases, ulcers can develop and be slow to heal
• Skin damage — chronic venous insufficiency can cause permanent skin changes and discolouration

Most people don't develop these complications, but they're a good reason to seek advice if symptoms are bothersome.

When to seek help

You should consider seeking evaluation if:

• Symptoms are bothersome — pain, heaviness, or swelling affecting your quality of life
• Appearance concerns you — you're self-conscious about how your legs look
• Symptoms are worsening — the problem is getting worse over time
• You have skin changes — discolouration, thickening, or rashes around the veins
• You have a family history — especially if symptoms are developing
• You're planning pregnancy — evaluation before pregnancy can be helpful
• You have concerns — any concern about your vascular health warrants professional evaluation

Why treatment matters

While varicose veins aren't always dangerous, treatment offers real benefits:

• Symptom relief — many patients experience significant improvement in pain, heaviness, and swelling
• Appearance — treatment reduces visible veins and can improve confidence
• Prevention — treating varicose veins early can prevent progression and complications
• Quality of life — many patients report improved comfort and confidence

Treatment options

If you're diagnosed with varicose veins, several effective treatment options are available:

• Radiofrequency ablation (RFA) — heat seals the damaged vein shut (walk-in, walk-out)
• Foam sclerotherapy — injection treatment that seals selected veins
• Avulsions (phlebectomy) — removal of bulging surface veins through tiny incisions
• Compression stockings — helpful for symptoms, though not a cure

Lifestyle measures

Lifestyle changes alone won't cure varicose veins, but they can help manage symptoms:

• Exercise regularly (walking and low-impact exercise)
• Elevate your legs when resting
• Avoid prolonged standing or sitting
• Wear compression stockings if advised
• Maintain a healthy weight
• Avoid tight clothing that restricts blood flow
• Stay hydrated

Next steps

If you're experiencing symptoms of varicose veins, the first step is a consultation. We'll assess your condition, perform an ultrasound scan if needed, and discuss your treatment options.

We offer a free 5-minute telephone consultation to discuss your symptoms and answer any questions.