Varicose Veins: Symptoms, Causes & Treatment

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Varicose veins are swollen, twisted and bulging veins that appear just under the skin in your legs, feet or ankles. When your vein walls are weak and your valves aren’t working right, blood backs up in your vein. This causes blue and purple bulges. A healthcare provider can treat them to relieve symptoms and lower the risk of complications.

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Varicose veins are swollen blood vessels that bulge just under your skin’s surface and look blue or purple. They usually appear in your legs, feet and ankles. They can be painful or itchy. Spider veins, which are smaller red or purple lines, may surround the varicose veins.

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For many people, varicose veins are a cosmetic issue. But in some cases, they can mean you have a more serious health concern. A healthcare provider can help you determine if home remedies to relieve symptoms are enough or you need further treatment.

Weakening of your vein walls causes varicose veins. Normally, tiny valves in your leg veins keep blood moving back toward your heart. But if those valves weaken or break down, they can’t control blood flow as they should. Blood becomes “sluggish.” It backs up or pools in your vein. This raises the pressure against the vein walls, in turn, making your vein swell, bulge and twist.

Experts can’t always identify the exact reason why veins weaken in this way.

Some risk factors include:

Aging: Varicose veins are more likely as you get older. That’s because as you age, veins lose elasticity. That means they’re less stretchy and flexible than they used to be. As veins grow stiffer, their walls and valves can’t keep blood moving as well as before.
Hormone changes: Female hormones can allow vein walls to stretch. This is more likely to happen if you’re pregnant, taking estrogen-based birth control or going through menopause.
Family history: You’re more likely to get varicose veins if they run in your biological family.
Sitting or standing for long periods: When you’re inactive for a while, blood flow decreases. This can lead to varicose veins.
Tobacco use: Using tobacco products can make you more likely to develop varicose veins.
Having overweight/obesity: Excess weight puts pressure on blood vessels, which can lead to varicose veins.

Most often, varicose veins develop on the lower half of your body, usually on your calves, ankles and feet. They can also develop in the pelvic area, especially if you’ve given birth. Hemorrhoids, which form in your rectum, are also varicose veins.

Varicose vein symptoms include:

Bulging veins: Your veins may look twisted, swollen, gnarled or rope-like. They’re usually blue or purple and visible under your skin. They can develop in clusters.
Itching: The area around a varicose vein may itch.
Heavy feeling in your legs: Muscles in your legs may feel tired, heavy or sluggish, especially after physical activity.
Pain: Your legs may feel painful, achy or sore, especially behind your knees. Your legs may cramp up.
Swelling: Your legs, ankles and feet may swell and throb.
Skin discolorations and ulcers: Without treatment, varicose veins can cause discolored skin. Severe varicose veins can cause venous ulcers (sores).

Most people don’t have serious complications from varicose veins. But it’s possible to develop:

Skin changes: An untreated varicose vein can cause open sores (ulcers), bleeding, inflammation or skin discoloration.
Superficial thrombophlebitis: Blood clots can form inside varicose veins, causing this painful, but usually not dangerous, condition.
Deep vein thrombosis (DVT): If you have varicose veins, you have a higher risk of a blood clot forming in a vein deep inside your body.
Pulmonary embolism: A blood clot from DVT can travel to your lung and get stuck in a vein there. This is a life-threatening condition that requires immediate treatment.

Varicose veins are sometimes an early sign of chronic venous insufficiency (CVI), which can get worse over time.

Varicose veins are close to your skin’s surface and easy to see. Healthcare providers can diagnose them during a physical exam. They’ll feel and examine your veins while you’re sitting and standing. They’ll also ask about your medical history and symptoms you’ve noticed.

Providers usually don’t need additional diagnostic tests to diagnose varicose veins. But they may recommend an ultrasound to see detailed images of your veins and check for complications.

There isn’t a cure. But treatments — and in some cases, procedures — can help you feel better and lower the risk of complications. Your healthcare provider may recommend:

Compression stockings: These squeeze your lower legs to improve circulation. Always ask a healthcare provider before using compression stockings, bandages or wraps. They’ll recommend the level of pressure that’s safe and helpful for you.
Sclerotherapy: During this procedure, a healthcare provider injects a solution into your varicose vein. The solution causes the vein walls to stick together. Eventually, the vein turns into scar tissue and fades away.
Endovenous thermal ablation: In this minimally invasive procedure, a provider uses a catheter (long, thin tube) and laser to close off a damaged vein.
Ambulatory phlebectomy: A provider makes multiple cuts or punctures in your skin next to the varicose vein. Then, they tie off and remove one section of the vein at a time.
Ligation and stripping: This is a surgical option. Your surgeon ties off your affected vein (ligation) to stop blood from pooling. Then, they remove (strip) the vein to prevent varicose veins from reappearing.

There’s a lot you can do in your daily life to manage symptoms and prevent new varicose veins from forming:

Avoid long periods of standing or sitting: Take regular breaks to stretch and walk around. This helps blood flow better in your legs.
Stay active: The more movement you can fit into your routine, the better. Physical activity relieves varicose vein symptoms and improves blood flow throughout your body.
Elevate your legs: Try to lift your legs above your heart several times throughout the day. Gravity helps push blood from your lower legs back toward your heart.
Maintain a healthy weight: Losing excess pounds reduces pressure in your veins.
Quit tobacco: Smoking damages blood vessels, decreases blood flow and causes a wide range of other health problems.

Contact a provider if you notice new varicose veins. They’ll examine the veins and recommend treatments and/or home remedies that can help.

See your provider as soon as possible if varicose veins or nearby skin are:

Bleeding
Painful, red/discolored or warm to the touch
Swollen

Call 911 or your local emergency number if a varicose vein is bleeding heavily.

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Although you can effectively treat them, varicose veins can return. You have a higher chance of varicose veins reappearing if you:

Have obesity (a body mass index over 30)
Sit for too long every day
Get pregnant after varicose vein treatment

Your healthcare provider will discuss treatment options if varicose veins return.

Varicose veins may make you want to avoid wearing shorts. They may even cause discomfort. But the good news is that they’re manageable. Talking with a healthcare provider about varicose veins early on — even before they bother you — can help lower your risk of complications down the road.

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Cleveland Clinic’s health articles are based on evidence-backed information and review by medical professionals to ensure accuracy, reliability and up-to-date clinical standards.

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Peptide Therapy Guide Editorial Team