varicose veins that comes and goes

Overview

Varicose veins are swollen, twisted veins that you can see just under the skin, usually in your legs. Sometimes these veins may appear and disappear, or their size may change throughout the day. This is common and often related to factors like standing for long periods or hormonal changes.

Yes, varicose veins are very common. They affect about 1 in 3 adults in the UK, especially as people get older.

Anyone can get varicose veins, but they are more common in women, people over 40, those who are pregnant or overweight, and people who stand or sit for long periods at work.

Symptoms

Common symptoms

• Bulging, twisted, or rope-like veins on your legs or feet, which may appear and go away or change with activity.
• A heavy, aching, or tired feeling in your legs, especially after standing or at the end of the day.
• Swelling in your ankles or feet, which often improves after resting with your legs up.
• Itching or a burning sensation around the vein.
• Mild muscle cramps in your legs at night.

Symptoms in children

• Varicose veins are rare in children. If they appear, they may be linked to an underlying condition and should be checked by a doctor.

Symptoms in older adults

• The same symptoms as common ones, but may be more pronounced due to age-related changes in veins and skin.
• Skin changes like dryness, thinning, or darkening near the veins are more likely.
• Legs may feel heavier or more tired, and swelling can be more persistent.

Causes

Main causes

• Weakened or damaged valves inside the veins that allow blood to flow backwards and pool.
• Increased pressure in the veins, often from standing or sitting for long periods, pregnancy, or carrying extra weight.
• Hormonal changes (such as during pregnancy or menopause) can affect vein walls and valves.

Risk factors

• Getting older (over 40).
• Being female, especially during pregnancy or menopause.
• Having a family history of varicose veins.
• Being overweight or obese.
• Standing or sitting for many hours each day at work.
• Having a job that involves heavy lifting or prolonged standing.

When to see a doctor

See a doctor urgently if:

• If you have sudden pain, swelling, redness, or warmth in a leg, as these could be signs of a blood clot.
• If you develop bleeding from a varicose vein that doesn't stop.

Book a routine appointment if:

• If your varicose veins cause persistent discomfort, aching, or swelling that affects your daily life.
• If you have any skin changes like ulcers, darkening, or a rash near the veins.
• If you are worried about the appearance of your veins or want to explore treatment options.

Diagnosis

A doctor can often diagnose varicose veins by looking at your legs while you are standing. They will ask about your symptoms and medical history.

Tests that may be done

• A simple ultrasound scan of the veins in your legs (called a venous duplex ultrasound) to see how well the valves are working and check for blood clots.

What to expect at your appointment

If your doctor thinks you need further assessment, they may refer you to a specialist in vein problems (a vascular specialist). The ultrasound test is painless and takes about 15–30 minutes. You may be asked to stand for part of the examination.

Treatment

Treatment for varicose veins aims to relieve symptoms, prevent complications, and improve appearance. Many people find that self-care measures are enough. If needed, there are several effective medical treatments available.

Self-care at home

• Wear compression stockings or socks – they help squeeze your legs and improve blood flow. Your doctor can advise on the right type and fit.
• Elevate your legs when resting – aim to have your feet higher than your hips to help blood flow back to your heart.
• Avoid standing or sitting for long periods – take breaks to move around and stretch your legs.
• Exercise regularly – walking, swimming, and cycling are great for circulation.
• Maintain a healthy weight to reduce pressure on your veins.

Medical treatments

If self-care isn't enough, a specialist may offer treatments like sclerotherapy (injecting a solution to close the vein), laser or radiofrequency treatment (using heat to seal veins), or a procedure called endovenous ablation. These are usually done as day procedures and have a good success rate. Your doctor will recommend the best option for you.

When is surgery considered?

Surgery (called ligation and stripping) is sometimes needed for very large or severe varicose veins, though it is less common now thanks to newer, less invasive treatments. Your specialist will discuss if surgery might be helpful for you.

Living with this condition

Living with varicose veins that come and go usually means paying attention to your legs and making small changes to your daily routine. Most people manage well with self-care and staying active.

Lifestyle tips

• Take short walks every hour if you have to sit or stand at work.
• Put your feet up on a stool or cushion when sitting at home.
• Wear comfortable, supportive footwear instead of high heels or tight boots.
• Avoid crossing your legs when sitting, as this can slow circulation.
• Stay hydrated – drinking plenty of water helps keep your blood flowing.

Diet and exercise

Eating a balanced diet rich in fibre (like fruits, vegetables, and whole grains) helps prevent constipation, which can put extra pressure on your veins. Regular exercise, especially walking, swimming, or cycling, improves your circulation and helps manage your weight.

Mental health and emotional wellbeing

Some people feel self-conscious about the appearance of their varicose veins. It's normal to have these feelings. Talking to your doctor or a trusted friend can help. Remember that the veins do not affect your overall health in most cases, and many treatment options are available.

Prevention

You cannot always prevent varicose veins, especially if you have a family history. But you can reduce your risk by keeping a healthy weight, exercising regularly, avoiding long periods of standing or sitting, and wearing compression stockings if you are at high risk (e.g., during pregnancy).

Complications

If left untreated

• Skin changes like dryness, itching, and darkening around the vein.
• Swelling that may become long-lasting (oedema).
• Varicose eczema – a red, scaly rash on the skin near the veins.
• Venous ulcers – open sores that can develop, especially near the ankle.
• Superficial thrombophlebitis – a small blood clot in a superficial vein causing redness and pain.
• Rarely, deep vein thrombosis (a clot in a deep vein) or bleeding from a varicose vein.

Long-term outlook

The outlook for varicose veins is generally very good. They are not life-threatening and can often be managed with simple lifestyle changes. If complications develop, treatments are available and effective. With proper care, most people can keep symptoms in check and continue their normal activities.

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