About this condition
Varicose veins develop when superficial veins in the legs enlarge and become twisted. One possible reason is venous valve dysfunction: some blood flows backwards and pressure rises within the superficial veins. Visible veins may be accompanied by aching, heaviness or swelling, although some people have no symptoms.
Why do varicose veins develop?
Several factors can contribute, including family history, age, pregnancy, excess body weight and long periods of standing. Having a risk factor does not mean a person will necessarily develop the condition.
Varicose veins versus spider veins
Varicose veins are generally larger, twisted and may bulge under the skin. Spider veins are small red, blue or purple blood vessels near the skin surface. Spider veins are not the same as varicose vein disease. If pain, swelling or skin changes are present, assessment is needed regardless of appearance.
Does everyone need an operation?
No. Management depends on symptoms, investigation findings, possible complications and patient preferences, not simply how the veins look. A clinician may recommend monitoring, measures to relieve symptoms or an intervention when indicated. The decision follows an assessment of the venous circulation.
Which clinician should I see?
Visible varicose veins, leg heaviness or swelling can be discussed with a family doctor, phlebologist or vascular surgeon. An appointment helps establish whether the symptoms are vein-related and whether ultrasound is appropriate. Not every painful or swollen leg is caused by varicose veins.
Possible complications
Long-standing venous disease can sometimes lead to discoloration and skin changes around the ankles, venous eczema or ulcers. Superficial vein thrombosis or bleeding from a varicose vein may also occur. These problems need individual clinical assessment.
Signs and symptoms
Symptoms vary and often become worse after prolonged standing or sitting, improving with rest and leg elevation.
- Enlarged, twisted veins visible or raised above the skin.
- Leg heaviness, aching or tiredness.
- Swelling around the feet and ankles, particularly in the evening.
- Itching, dry skin or changes in skin color on the lower legs.
- Sometimes burning, throbbing or night cramps, which may have other causes.
These findings alone do not confirm varicose vein disease. Other possible causes of pain or swelling must be considered, especially when symptoms begin suddenly.
Diagnosis and tests
Diagnosis begins with a history of symptoms, prior illnesses and risk factors followed by an examination of the legs, skin and visible veins.
Duplex ultrasound of the leg veins may be used to assess blood-flow direction, valve function and suitability for an intervention. It combines images of the vessels with blood-flow assessment. Other tests are chosen based on the clinical situation.
Sudden one-sided leg swelling and pain may suggest deep vein thrombosis and requires urgent medical assessment rather than routine management of chronic varicose veins.
Care and treatment approaches
Care aims to relieve symptoms, assess complications and, where appropriate, treat abnormal venous reflux. Management follows an examination and often duplex ultrasound.
Symptom-relief measures
- Stay active, including regular walking, and avoid sitting or standing motionless for long periods.
- Rest with the legs elevated when practical.
- Maintain a healthy body weight and care for dry or irritated skin.
- Ask whether compression stockings are appropriate; their type and pressure should account for arterial circulation and other medical conditions.
Possible medical procedures
Depending on the findings, a specialist may consider endovenous thermal ablation, ultrasound-guided foam sclerotherapy or a surgical procedure. The choice depends on vein anatomy, ultrasound results, overall health and contraindications. Listing these options is general medical information and does not imply that every procedure is offered by the MZ medical center.
Do not start blood-thinning medication yourself or agree to a procedure solely on the basis of photographs or symptoms. Follow-up may be advised because varicose veins can recur.
When to seek urgent care
Seek prompt medical evaluation for sudden one-sided leg swelling, significant pain, redness or a tender cord along a vein, since thrombosis needs to be ruled out.
If a superficial varicose vein bleeds, elevate the leg and apply direct pressure with a clean cloth. Heavy or persistent bleeding requires emergency help.
Sudden breathlessness, chest pain, fainting or coughing up blood means calling emergency services immediately on 103 or 112, especially if leg swelling or pain is also present.
A non-healing lower-leg wound or rapidly worsening skin changes should be reviewed by a clinician without delay.
Frequently asked questions
Does varicose vein disease always require surgery?
No. People without significant symptoms or complications may not need an intervention. A clinician discusses options based on examination and test results.
Which test assesses varicose veins?
Duplex ultrasound of the leg veins evaluates blood flow and valve function. A clinician recommends it when indicated.
When should I seek urgent help?
Sudden swelling or pain in one leg, a red tender vein or bleeding needs urgent assessment. Call emergency services for breathlessness or chest pain.
Information sources
Medical source links used when preparing this article.
Important information
A medical consultation is needed for diagnosis and treatment recommendations.
Self-treatment can be harmful to your health.
