Varicose Veins: Symptoms, Causes, Risk Factors, Diagnosis, Complications, Treatment and Prevention

They are large, swollen veins that often appear on the legs and feet.

Varicose veins are enlarged, swollen, and twisted, usually appearing blue or deep purple. They happen when faulty valves in the veins allow blood to flow in the wrong direction or pool.


In most cases, there is no pain, but the signs and symptoms of varicose veins can include:

  • The veins look twisted, swollen, and bulging.
  • The veins are dark blue or purple.

Some patients may also experience:

  • Sore legs
  • The legs feel heavy, especially after exercise or at night.
  • A minor injury to the affected area can lead to more extended bleeding than usual.
  • Lipodermatosclerosis: The fat under the skin, just above the ankle, can become complex, and the skin shrinks.
  • Swollen ankles.
  • Telangiectasia in the affected leg (spider veins).
  • There may be a bright skin discoloration near the varicose veins, usually brown or blue.
  • Eczema venoso.
  • When they stand up, some people experience leg cramps.
  • A high percentage of people with varicose veins also have restless leg syndrome.
  • Irregular whitish patches that look like scars appear on the ankles.


Veins have one-way valves so that blood can travel in only one direction. The valves can weaken if the vein walls are stretched and less flexible (elastic).

A weakened valve can allow blood to drip backward and eventually flow in the opposite direction. When this happens, blood can pool in the vein, which becomes enlarged and swollen.

Veins farther from the heart are most often affected, such as those in the legs. Any condition that puts pressure on the abdomen can cause varicose veins, for example, pregnancy,  constipation, and, in rare cases, tumors.

Risk factor’s

In many cases, varicose veins appear for no apparent reason. However, some potential risk factors include:


  • Menopause.
  • Pregnancy.
  • Be over 50 years old.
  • Standing for long periods.
  • Family history of varicose veins.
  • Obesity.

The following risk factors are linked to an increased risk of varicose veins:

  • Gender:  Varicose veins affect women more often than men. Female hormones may relax the veins. Taking birth control pills or hormone therapy (HT) could help.
  • Genetics:  Varicose veins often run in families.
  • Obesity: Being overweight or obese increases the risk of varicose veins.
  • Age:  the risk increases with age due to the wear of the vein valves.
  • Some jobs – People who spend a lot of time on their feet at work may have a higher chance of varicose veins.

Pregnancy and varicose veins

Pregnant women are more likely to develop varicose veins, as they have much more blood in their body; This puts additional pressure on the circulatory system.

Also, changes in hormone levels can lead to a relaxation of the blood vessel walls. Both of these factors increase the risk of varicose veins.

As the uterus grows, more pressure is on the mother’s pelvic area veins. In most cases, varicose veins disappear once the pregnancy ends; This is not always the case, and sometimes even if the varicose veins improve, there may be something visible.


Any condition in which proper blood flow is undermined has a risk of complications. Possible complications may include:

  • Bleeding
  • Thrombophlebitis: Blood clots in the leg vein cause inflammation of the veins.
  • Chronic Venous Insufficiency: The skin does not correctly exchange oxygen, nutrients, and waste products with the blood because blood flow is weak. Varicose veins do not cause chronic venous insufficiency, but the two entities are closely related.

People with chronic venous insufficiency can develop varicose eczema, lipodermatosclerosis (hard, tight skin), and venous ulcers. Venous ulcers classically form around the ankles and are usually preceded by a discolored area. It is essential to get a medical evaluation for chronic venous insufficiency.


Veins rarely need treatment for health reasons, but if swelling, pain, and painful legs occur, treatments are available if there is considerable discomfort.

If the patient has no symptoms or discomfort and is not bothered by the appearance of varicose veins, treatment may not be necessary. However, if there are symptoms, treatment may be required to reduce pain or discomfort and address complications such as leg ulcers, skin discoloration, or swelling.

Some patients may also want treatment for cosmetic reasons – they want to get rid of “ugly” varicose veins.


If the varicose veins are large, they may need to be removed surgically. This is usually done under general anesthesia. In most cases, the patient can go home the same day; if surgery is required on both legs, you may need to spend one night in the hospital.

Laser treatments are often used to close smaller veins and also spider veins. Intense bursts of light are applied to the vein, which gradually fades and disappears.

Ligation and stripping

Two incisions are made, one near the patient’s groin at the top of the target vein and the other under the leg, either at the ankle or knee. The top of the grain is tied and sealed. A thin, flexible wire is threaded through the bottom of the vein and then pulled out, carrying the vein with it.

This procedure generally does not require a hospital stay. Ligation and removal can sometimes lead to bruising, bleeding, and pain. Very rarely, there may be a deep vein thrombosis.

After surgery, most patients will need 1 to 3 weeks to recover before returning to work and other everyday tasks. During the recovery time, compression stockings are worn.


A chemical is injected into small and medium-sized varicose veins, healing and closing. A few weeks later, they should disappear. A vein may need to be injected more than once.

Radiofrequency ablation

A small incision is made above or below the knee, and with the help of an ultrasound, A narrow tube (catheter) is threaded into the vein.

The doctor inserts a probe into the catheter, transmitting radiofrequency energy. Radiofrequency energy heats the vein, causing its walls to collapse, effectively closing and sealing it. This procedure is preferred for more prominent varicose veins. Radiofrequency ablation is usually done under local anesthesia.

Endovenous laser treatment

A catheter is inserted into the patient’s vein. A small laser is threaded through the catheter and placed on top of the target vein, producing short bursts of energy that heat the vein and seal it off.

With the help of an ultrasound, the doctor passes the laser through the entire vein, gradually burning and sealing the laser as a whole. There may be some nerve injury, which is usually brief.

Transilluminated potentiated phlebectomy

An endoscopic transilluminator (special light) is threaded through an incision under the skin so the doctor can see which veins need to be removed. The target veins are cut and released with a suction device through the incision.

A general or local anesthetic can be used for this procedure. There may be some bleeding and bruising after the operation.

Home remedies

Steps can be taken at home to improve pain and prevent varicose veins from worsening. These include:

  • Work out.
  • Lose weight.
  • Raise your legs.

There are also many over-the-counter natural treatments, usually topical creams and emollients.

These can help soothe pain, improve comfort, and improve varicose veins’ overall appearance.

Compression socks

Compression stockings tighten the patient’s legs and improve circulation. They work tight around the ankles and loosen higher up the leg. In this way, compression stockings promote proper blood flow upward, against gravity, and toward the heart.

Compression stockings can help with discomfort, pain, and swelling, but research has not confirmed whether they stop varicose veins from worsening or even prevent them. Studies have had mixed and conflicting results.

Stockings make some people’s skin dry and flaky. If this happens, it is essential to see a doctor.


To reduce the risk of developing varicose veins:

  • Get a lot of exercises, for example, walking.
  • Keep a healthy weight.
  • Avoid standing for a long time.
  • Sit or sleep with your feet on a pillow.


A doctor’s physical examination, mainly visual, will decide whether a patient has varicose veins or not. The patient will be asked to stand while the doctor looks for signs of swelling.

The following diagnostic tests are sometimes ordered:

  • Doppler test:  an ultrasound to check the direction of blood flow in the veins. This test also checks for blood clots or blockages in the veins.
  • Color duplex ultrasound –  Provides color images of the structure of the veins, helping the doctor identify any abnormalities. It can also measure the speed of blood flow.

The patient may also be asked questions about the symptoms. A doctor may refer the patient to a vascular specialist in some cases.