Are you concerned that you might have varicose veins? Varicose veins are common, affecting about 23 percent of adults in the U.S., impacting women twice as often as men. Varicose vein symptoms include the appearance of swollen, twisted veins visible through the skin of the legs and feet, and occasionally on other parts of the body. For some people, the cosmetic aspect is the primary concern, but others experience pain and discomfort from their varicose veins. So, what causes varicose veins? And what, exactly, are they?
Quick Answer: Varicose veins are caused by weakened vein walls and faulty one-way valves in the leg veins. When the wall stretches, the valve leaflets stop meeting, blood flows backward with gravity, and pressure builds in the veins below, making them bulge and twist. The biggest risk factors are family history, female hormones and pregnancy, age, excess weight and long hours standing or sitting. Less often, a previous deep vein clot, pelvic vein reflux or a compressed pelvic vein is the underlying cause.
Just as they appear, varicose veins are twisted, enlarged veins. Their gnarled appearance is the result of blood pooling inside the veins that are weak or damaged. Within the circulatory system, arteries transport the blood from the heart to the rest of the body, and it’s the veins’ job to return that blood to the heart. In the legs, veins must work against gravity to do this, and muscle contractions in the legs work with the valves in the veins to keep the blood flowing in the right direction. In veins with weak or damaged valves, this isn’t done effectively, and the blood can flow backward, which is what creates the pooling in the veins that causes them to stretch and twist.
Aside from cosmetic problems, some varicose veins symptoms can be extremely troublesome. The legs may feel achy or heavy, there may be burning, throbbing, muscle cramping, and swelling in the lower legs, and the pain may get worse when the person has been standing or sitting for a long time. The skin may change color around a varicose vein, and it may also itch. These symptoms are harmless, but more advanced varicose veins stages can involve serious problems like blood clots, skin ulcers, and bleeding. If your veins are not twisted and ropy but rather smaller and web-like, they are probably spider veins. Spider veins are like varicose veins, but they’re smaller, closer to the surface of the skin, and don’t typically hurt. If they do hurt, they may be signs of a deeper problem of venous insufficiency or varicose veins.
Meet your vein specialist
Dr. Syed Raza, MD
Vascular & Interventional Radiology · Founder, Premier Vein & Vascular Center
Fellowship-trained interventional radiologist certified by the American Board of Radiology and the Royal College of Radiologists (UK). Former Chief of Interventional Radiology at UTMB Galveston and Memorial Hermann Memorial City, with 15+ years treating varicose veins, venous reflux and peripheral arterial disease.
There Are Several Factors That Can Put You at a Higher Risk for Varicose Veins
- Your gender plays a role, as women are more likely than men to develop this condition. Hormonal fluctuation can be a factor, because the shifts in hormones before a menstrual period, during pregnancy, or in menopause can relax vein walls. Hormonal treatments like birth control pills can also increase the risk of varicose veins. What’s more, the blood volume in the body increases during pregnancy, enlarging the veins in the legs, and this can often lead to varicose veins.
- Age is also a factor. As we get older there is natural wear and tear on the valves in our veins. Sometimes, that erosion can impede the valves’ function, allowing blood to flow backward and collect in the veins.
- Your family history matters. If your mother or grandmother had varicose veins, you are likely to have them as well. A family history of vein problems is a risk factor.
- Being overweight raises your chances of varicose veins. Excess weight, particularly obesity, puts additional pressure on the veins.
- Inactivity can increase your risk of varicose veins. A sedentary lifestyle is bad for your veins, but so is a lifestyle in which you’re always on your feet. Keep moving to help your blood flow the way it’s meant to flow.
There are also steps you can take to prevent varicose veins. Improving your muscle tone and blood flow is one proactive measure to take to reduce your risk. Additionally, the same things that help alleviate discomfort caused by varicose veins can help prevent them. These include:
- Avoiding wearing tight hosiery or high-heeled shoes.
- Moving regularly, and not sitting or standing in one position for very long.
- Eating a healthful diet that’s high in fiber and low in salt.
- Getting regular exercise.
- Keep your legs elevated when sitting or lying down.
- Maintaining a healthy weight.
For varicose veins, treatment is not always necessary. However, if they’re causing you discomfort, it’s important that you see a doctor that knows how to treat varicose veins. Your doctor may recommend that you wear compression stockings or hosiery, designed to encourage upward blood flow. He or she may also suggest over-the-counter pain relievers, like ibuprofen and aspirin to alleviate pain and reduce swelling. However, if the problem is more serious, there are several minimally invasive treatment options available. Sometimes laser treatment is used to collapse, close, and cauterize the varicose vein so that blood can be rerouted into a healthier vessel. Another option is endovenous thermal ablation, in which a catheter is inserted into the affected vein and as it’s withdrawn, radiofrequency energy is used to seal the vein shut. Ambulatory phlebectomy is a minimally invasive tactic for addressing varicose veins. In this surgical procedure, under local anesthesia, the damaged portion of the vein is removed via incisions too small to require stitches. The doctor might opt for sclerotherapy, injecting a chemical into the vein to cause it to close, or non-thermal vein ablation, which uses glue or medication rather than heat to close the damaged vein.
If you’d like to determine which treatment is the right one for you, the first step is scheduling a consultation with a qualified doctor like the doctors at Premier Vein & Vascular Center. Our experienced and skilled team specializes in treating vein disease, not just to improve your comfort level but also to help you find long-term positive results. At our two clinics in the Houston and Cypress area, our board-certified doctors use the latest advances in vascular treatment to address the underlying cause of your symptoms. Contact us through our website or call [company-phone id=2] to schedule a free vein screening and consultation.
What Causes Varicose Veins Inside the Vein Wall
For a long time, varicose veins were explained simply as broken valves. We now understand that the vein wall itself is usually where the trouble begins. In people prone to varicose veins, the wall has a slightly different balance of collagen and elastic fibers, which makes it more stretchable. Under the steady pressure of standing, the wall widens a little. As it widens, the two leaflets of each valve no longer meet in the middle, and the valve starts to leak.
Once one valve leaks, the segment of vein below it carries extra blood and extra pressure, which stretches that segment and pulls the next valve apart. Reflux can spread downward from the groin or upward from smaller branches. Over time, low-grade inflammation in the vein wall and the surrounding tissue keeps the process going. This is why varicose veins tend to slowly increase in number and size, and why they rarely disappear once established.
Less Obvious Causes of Varicose Veins
Heredity, hormones, age and weight explain most cases, but some varicose veins have a specific underlying cause that changes how they should be treated:
- A previous deep vein clot. A deep vein thrombosis can scar deep vein valves, raising pressure throughout the leg and creating secondary varicose veins, sometimes years later.
- Pelvic vein reflux. Refluxing ovarian or pelvic veins can feed varicose veins on the vulva, buttocks and back of the thighs, a pattern linked to pelvic congestion syndrome.
- Iliac vein compression. A large vein in the pelvis, usually on the left, can be squeezed by the artery crossing over it, causing left-leg swelling and varicose veins.
- Leg injury or previous surgery. Trauma can damage veins and valves locally.
- Occupation. Jobs involving long hours standing in one place, such as nursing, teaching, hairdressing, retail, cooking and factory work, keep vein pressure high for most of the day.
- Rare congenital conditions. A small number of people are born with abnormal veins and develop varicose veins in childhood or adolescence.
Varicose Vein Myths vs. Facts
| Common belief | What we tell patients |
|---|---|
| Crossing your legs causes varicose veins | There is no good evidence for this. Long periods of sitting still matter more than leg position. |
| Running or exercise causes varicose veins | Exercise strengthens the calf muscle pump and helps veins. It does not cause varicose veins. |
| Only women get varicose veins | Women are affected more often, but many men have them and often seek care later. |
| Varicose veins are only a cosmetic problem | They often cause aching, heaviness, swelling and cramps, and can progress to skin damage and ulcers. |
| Removing the veins hurts circulation | Faulty veins work against circulation. Closing them usually improves blood flow in the leg. |
| Varicose veins always come back after treatment | A properly treated vein rarely reopens, though new veins can form over the years. |
Do Varicose Veins Get Worse Over Time?
In most people, yes, gradually. Untreated reflux tends to progress from visible veins to evening swelling, then to skin changes around the ankle such as brown discoloration, itching, eczema and hardening, and in some people to a venous ulcer. The pace varies greatly. Some patients stay stable for many years, while others progress faster, particularly with weight gain, further pregnancies or jobs that keep them on their feet. Typical vein disease symptoms to watch for include heaviness, aching that improves with elevation, ankle swelling, restless legs and night cramps.
How We Find the Cause of Your Varicose Veins
- Focused history. We ask when the veins appeared, how they have changed, what symptoms you have, and about pregnancies, previous clots, leg injuries, your work and family history.
- Examination. We examine both legs standing and note where the veins run, any swelling and skin changes. An unusual pattern, such as veins on the back of the thigh or only the left leg, prompts a closer look at the pelvic veins.
- Venous duplex ultrasound. Our IAC-accredited vascular lab maps every refluxing segment and checks the deep veins for old clot or obstruction.
- A clear plan. We explain what is causing your varicose veins, whether treatment is medically needed, which procedure suits each vein, and what you can do day to day to slow progression.
Seek urgent medical care if you notice:
- A varicose vein that bleeds heavily; lie down, raise the leg and press firmly while you get help
- A painful, hot, red, hard vein, especially near the groin or behind the knee
- Sudden swelling and pain in one leg
- Chest pain or sudden shortness of breath
When to See a Vein Doctor in Houston About Varicose Veins
If your varicose veins ache, swell or itch, are getting larger, or have caused skin changes near the ankle, it is worth having them assessed even if you are not sure you want treatment yet. Finding the cause tells you whether the veins are likely to progress and which options make sense.
Dr. Syed Raza is a fellowship-trained interventional radiologist with more than 15 years of experience treating varicose veins and venous reflux. As a vein clinic in Houston, we usually offer same-week appointments and accept most insurance plans, including Medicare. You can find more answers in our varicose vein FAQs or call (832) 321-5355.
Talk With a Specialist at Premier Vein
Have questions about your symptoms or treatment options? Dr. Syed Raza and the team at Premier Vein & Vascular Center can evaluate your concerns and explain your options clearly. Same-week appointments are usually available, and most insurance plans are accepted.
Frequently Asked Questions
Are varicose veins genetic?
Family history is one of the strongest risk factors for varicose veins. If one or both parents had them, your chance of developing them is noticeably higher, likely because vein wall structure and valve strength are partly inherited.
Can standing all day cause varicose veins?
Long hours of standing do not cause varicose veins on their own, but they keep vein pressure high and can speed up the process in people who are already prone. Regular movement breaks, calf exercises and compression stockings help reduce the strain.
Why do I have varicose veins in only one leg?
It is common for one leg to be affected more than the other, because valve failure starts in individual veins. Varicose veins mainly in the left leg, especially with swelling, can sometimes point to compression of a pelvic vein, which an ultrasound or other imaging can check.
Can varicose veins be prevented?
You cannot change genetics or age, but you can lower the strain on your veins by staying active, maintaining a healthy weight, avoiding long periods without movement and wearing compression stockings during long shifts or travel. These steps may slow the development of new varicose veins.
Do varicose veins mean I have poor circulation?
Varicose veins reflect a problem with blood returning to the heart, not with blood flowing to the legs through the arteries. However, some people have both vein and artery disease, so persistent leg pain, especially when walking, should be evaluated.
Can weight loss make varicose veins go away?
Losing excess weight reduces pressure on the leg veins and can ease symptoms like aching and swelling, but it does not repair damaged valves. Existing varicose veins usually remain and need treatment if they are troublesome.
Trusted Health Resources
- Chronic Venous Insufficiency, Society for Vascular Surgery
- Venous Insufficiency, MedlinePlus Medical Encyclopedia (NIH)
- Varicose Veins and Spider Veins, MedlinePlus (NIH)