Living with varicose veins

Overview

Varicose veins are swollen, twisted veins that appear just under the skin, usually in the legs. They happen when the tiny one-way valves inside your veins stop working properly. This allows blood to flow backwards and pool in the vein, making it stretch and bulge.

Yes. Varicose veins affect up to about 3 in 10 adults at some point in their lives. They become more common with age.

Anyone can get varicose veins, but they are more common in women, especially during pregnancy or after menopause. You are also more likely to develop them if you are older, have a family history, are overweight, or have a job that requires long periods of standing.

Symptoms

Common symptoms

• Aching, heavy, or tired legs, especially after standing or sitting for a long time
• Swelling in your feet and ankles
• Itching or burning around the veins
• Visible, bulging, twisted veins that are blue or dark purple
• Muscle cramps in your legs, especially at night

Symptoms in older adults

• Skin changes around the veins, such as thinning, dryness, or discoloration
• Legs feeling heavy and aching more often
• Swelling that worsens by the end of the day
• Increased risk of sores or ulcers on the skin near the veins

Causes

Main causes

• Weak or damaged valves inside the veins
• Weakened vein walls that allow the vein to stretch and lose its normal shape
• Increased pressure in the leg veins, often from standing for long periods or from pregnancy

Risk factors

• Getting older
• Family history of varicose veins
• Being female
• Pregnancy, especially multiple pregnancies
• Being overweight or obese
• Standing or sitting for many hours each day
• Lack of regular physical activity

When to see a doctor

See a doctor urgently if:

• If a varicose vein bleeds or bursts — apply firm pressure and get medical help immediately
• If you have a leg ulcer or open sore that is not healing
• If you notice signs of a blood clot, such as sudden swelling, warmth, or severe pain in one leg

Book a routine appointment if:

• If your legs feel increasingly heavy, achy, or sore
• If swelling in your legs is getting worse or does not go down when you elevate them
• If you feel self-conscious about the appearance of your veins and want to talk about treatment options
• If you have other symptoms like skin changes or itching over the veins

Diagnosis

Your doctor will ask about your symptoms and medical history, then examine your legs while you are standing and while you are lying down. They will look for visible veins, swelling, skin changes, and tender areas.

Tests that may be done

• A physical exam of your legs and feet
• A Doppler ultrasound scan, which uses sound waves to check blood flow and see how well your vein valves are working
• In rare cases, a venogram — an X-ray test with a special dye — may be used for a more detailed view

What to expect at your appointment

A diagnosis is usually straightforward. Your doctor will give you advice on managing symptoms and may refer you to a specialist if treatment is needed. The ultrasound is painless and takes about 15 to 30 minutes. You do not need to do much to prepare, but you may be asked to wear loose clothing so your legs can be examined easily.

Treatment

Treatment for varicose veins depends on your symptoms, the size of the veins, and how much they affect your daily life. Many people find relief with self-care measures alone. Others need a minor procedure to remove or close the affected veins. Most treatments are quick, safe, and effective.

Self-care at home

• Wear medical-grade compression stockings to help push blood back up your legs
• Elevate your legs above the level of your heart for 15 to 30 minutes several times a day
• Avoid standing or sitting for long periods — take breaks and move around
• Exercise regularly, especially walking or swimming, to improve circulation
• Keep your weight in a healthy range

Medical treatments

Several medical procedures are available to treat varicose veins. These are generally performed as outpatient treatments, meaning you can go home the same day. They include endothermal ablation (using heat to seal the vein), sclerotherapy (injecting a foam or liquid to make the vein collapse), laser therapy, and surgery to remove the vein. Your doctor will explain which option is suitable for your condition and what to expect. Medications are not typically used to cure varicose veins, but pain relievers may be suggested for discomfort.

When is surgery considered?

Surgery is usually considered when veins are large, very painful, or causing complications such as ulcers or bleeding. The most common type is called vein stripping or ligation, where the affected vein is tied off and removed. This is less common today because less invasive procedures are effective for many people.

Living with this condition

Living with varicose veins can be managed with a few simple habits. Try to keep moving regularly, avoid crossing your legs when sitting, and put your feet up when you can. Wear comfortable shoes and loose clothing that do not restrict blood flow. If you stand for work, shift your weight from one leg to the other and take short walks every hour. Listen to your body — when your legs feel heavy and tired, give them a rest and elevate them.

Lifestyle tips

• Exercise your legs regularly — walking, cycling, and swimming are excellent choices
• Take frequent breaks from sitting or standing
• When sitting, do simple ankle exercises like flexing and pointing your feet
• Wear compression stockings if they help and your doctor agrees
• Stay hydrated and avoid excessive salt, which can make swelling worse

Diet and exercise

A balanced diet rich in fiber and low in salt can help prevent constipation and reduce swelling. Aim for plenty of fruits, vegetables, and whole grains. Foods with vitamin C and flavonoids, such as berries and citrus fruits, may support vein health. Regular exercise, even like a 30-minute walk most days, improves blood flow and strengthens the muscles that help push blood upward in your legs.

Mental health and emotional wellbeing

Living with varicose veins can make some people feel self-conscious about their legs, especially in warm weather when covering up is not comfortable. The aching and heaviness can also affect your sleep and energy. It is normal to feel frustrated. Remember that varicose veins are a common health condition and treatment is available. If you feel anxious or low because of your veins, talk to your healthcare provider about your feelings — they can offer support and refer you to resources if you need them.

Prevention

Varicose veins cannot always be prevented, especially if you have a strong family history or other risk factors. However, you can reduce your chances of developing them or prevent symptoms from getting worse by staying active, keeping a healthy weight, avoiding long periods of standing or sitting, elevating your legs when resting, and wearing loose clothing. Regular exercise is one of the best preventive measures.

Vaccines

There is no vaccine for varicose veins.

Screening programmes

There is no routine screening test for varicose veins. You do not need to be tested unless you have symptoms or your doctor finds something during a physical exam.

Complications

If left untreated

• Skin changes and discoloration around the affected veins
• Persistent swelling and aching that interferes with daily life
• Skin ulcers (open sores) that form near the veins
• Bleeding from a varicose vein, which can be hard to stop
• Superficial thrombophlebitis — inflammation and blood clots near the skin surface
• In rare cases, deep vein thrombosis (a blood clot deeper in the leg)

Long-term outlook

The outlook for varicose veins is very good. Most people can manage their symptoms with simple self-care measures and do not need any medical procedure. For those who do, treatments are safe and effective, and most people notice a significant improvement in how their legs look and feel. While varicose veins can come back over time, staying active and following your doctor's advice can help keep symptoms under control. You can live a full and active life with varicose veins.

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