varicose veins flare ups

Overview

Varicose veins are swollen, twisted veins that appear just under the skin, most often in the legs. A flare-up is a period when symptoms like pain, swelling, achiness, or itching become suddenly worse. Flare-ups are common, but they can usually be managed with simple steps.

Yes. Varicose veins are very common, especially in women. Many people have flare-ups on and off for years.

People of any age can get varicose veins, but they are more common in older adults, in women, during pregnancy, and in people whose jobs require long periods of sitting or standing.

Symptoms

Common symptoms

• A heavy, aching feeling in the legs, especially after standing
• Visible swollen or twisted veins, usually on the calf or thigh
• Swelling in the ankles and feet by the end of the day
• Itching, burning, or throbbing over a vein
• Muscle cramps in the legs, particularly at night

Causes

Main causes

• Weak or damaged valves inside the veins. These valves normally keep blood flowing back to the heart. When they fail, blood pools and the vein stretches.
• Increased pressure in the leg veins, which happens during pregnancy, when carrying extra weight, or when standing for a long time.
• Inflammation of the vein itself, which can make symptoms suddenly worse.

Risk factors

• Family history of varicose veins
• Being older
• Being female, especially during pregnancy or menopause
• Having a job that involves long periods of standing or sitting
• Obesity
• A history of blood clots in the legs

When to see a doctor

See a doctor urgently if:

• Your leg is painful and swollen and feels warm to the touch
• A varicose vein bursts and you cannot stop the bleeding
• You have signs of a skin infection, such as spreading redness, pain, heat, or a fever

Book a routine appointment if:

• Your symptoms are interfering with daily activities or sleep
• You have frequent flare-ups despite self-care
• You notice changes in the skin over your veins, such as hardening, discolouration, or an itchy rash

Diagnosis

A doctor can usually spot varicose veins by looking at your legs while you stand. They will also ask about your symptoms, medical history, and any family history.

Tests that may be done

• Most people do not need special tests.
• If symptoms are severe or there is a concern about blood flow, your doctor may request an ultrasound of your legs. This is a safe, painless scan that shows how blood is moving through your veins.

What to expect at your appointment

The doctor will examine both legs, feel your pulses, and look for swelling, skin changes, and tender areas. The appointment usually takes about 15 minutes. After that, they will recommend a plan based on your situation.

Treatment

Treatment for varicose veins focuses on relieving symptoms, improving the look of the veins, and preventing complications. For many people, self-care and lifestyle changes are enough. If symptoms are severe, a specialist can offer minimally invasive procedures.

Self-care at home

• Walk for 20 to 30 minutes each day to help pump blood back to your heart.
• Elevate your legs above heart level for 15 to 20 minutes a few times a day.
• Avoid standing or sitting still for long periods. Move around every hour.
• If you have been prescribed compression stockings, wear them during the day as directed. They help squeeze the veins and support blood flow.
• Cool, loose clothing and keeping the skin moisturized can reduce itching and discomfort.

Medical treatments

If self-care is not enough, doctors may suggest minimally invasive treatments to close off the damaged vein. Options include laser treatment, radiofrequency ablation, or injection therapy (sclerotherapy). These are usually done in an outpatient clinic and do not require a hospital stay. Your healthcare team will explain which option might suit you and what is involved. Some people need more than one session.

When is surgery considered?

Surgery to strip or tie off a vein is used less often today, but it may be recommended for very large veins, veins with severe bleeding, or when other treatments have not worked. Your doctor will discuss the risks and benefits with you.

Living with this condition

Living with varicose veins means finding a rhythm that works for you. Take breaks, put your feet up, and stay active. Small daily habits, like stretching your calves or doing a few laps around the house, can make a big difference.

Lifestyle tips

• Take regular breaks from sitting or standing — use an alarm to remind yourself to move.
• Keep your legs uncrossed when you sit, and sit on the edge of a chair so your calves are relaxed.
• Try to finish the day by lying down for 15 minutes with your legs raised.
• Wear comfortable shoes and avoid tight stockings that restrict circulation.

Diet and exercise

A balanced diet with plenty of fiber and water helps prevent constipation, which can put extra pressure on leg veins. Maintaining a healthy weight takes unnecessary pressure off your veins. Gentle exercises like swimming, cycling, and walking are excellent choices.

Mental health and emotional wellbeing

It is normal to feel self-conscious about the look of your legs. Some people with varicose veins feel embarrassed or worried. You don't have to hide it. Talk to people you trust, and remember that treatment options are available if it affects your self-esteem. If you ever feel overwhelmed or in crisis, please contact your local emergency number or mental health crisis line.

Prevention

You cannot always prevent varicose veins, especially if they are in your family. But you can reduce your chances of having frequent flare-ups by staying active, keeping a healthy weight, and taking breaks from standing or sitting.

Vaccines

There is no vaccine for varicose veins.

Screening programmes

There is no routine screening test for varicose veins. If you have symptoms or concerns, see a doctor.

Complications

If left untreated

• Skin changes: the skin around the vein may become darker, thickened, or itchy.
• Venous leg ulcers: a slow-healing sore that can develop near the ankle.
• Superficial thrombophlebitis: a painful, tender vein just below the skin, sometimes with a blood clot.
• Bleeding: a varicose vein can sometimes break and bleed, which requires immediate care.
• Deep vein thrombosis: a blood clot in a deeper vein. This is rare but serious and needs emergency treatment.

Long-term outlook

The outlook is very good. Most varicose veins do not cause serious problems. With simple management and regular check-ins with your healthcare provider, you can stay active and comfortable. Many people find that their flare-ups become fewer and less bothersome over time.

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