Varicose veins: all you need to know
- Martin Gannon
- 3 days ago
- 3 min read
Varicose veins are swollen, twisted veins that sit close to the surface of the skin—most commonly in the legs. They happen when the tiny valves inside your veins stop working properly, allowing blood to flow backwards and pool. For some people they’re mainly a cosmetic concern; for others they can cause aching, heaviness, swelling, skin changes, and complications that need treatment.
What are varicose veins?
Your veins carry blood back to your heart. In the legs, they’re working against gravity, so they rely on:
Muscle contractions (especially the calf muscles) to “pump” blood upwards; and
One-way valves inside the veins to stop blood falling back down.
When those valves weaken or fail, blood can collect in the vein. Over time, the vein stretches and becomes enlarged, lumpy, and visible—this is a varicose vein.
You might also hear related terms:
Spider veins (thread veins): smaller, fine red/blue veins near the surface.
Venous reflux/venous insufficiency: the underlying problem—blood flowing the wrong way due to valve failure.
What do varicose veins look and feel like?
Varicose veins often appear as:
Bulging, rope-like blue or purple veins
Twisted or raised veins, usually on the calf or thigh
Symptoms can include:
Aching, throbbing, or burning discomfort
Heaviness or tired legs (often worse after standing)
Swelling around the ankles
Itching or irritated skin over the vein
Night cramps or restless legs in some people
Some people have obvious veins with few symptoms; others have significant symptoms with less visible veins.
Why do varicose veins happen?
Varicose veins are common and usually develop due to a mix of genetics and pressure on the leg veins over time. Common risk factors include:
Family history (often the biggest factor)
Pregnancy (hormonal changes and increased pressure)
Age (valves can weaken over time)
Standing or sitting for long periods
Being overweight
Previous blood clots or vein inflammation (in some cases)
Are varicose veins dangerous?
Many varicose veins are not dangerous, but they can progress and sometimes lead to complications—especially if symptoms are increasing or there are skin changes. Potential complications include:
Skin staining (brown discolouration) around the ankle
Eczema-like irritation or persistent itching
Hardening of the skin/fat (lipodermatosclerosis)
Superficial thrombophlebitis (painful inflammation/clot in a surface vein)
Bleeding from a vein close to the skin
Venous leg ulcers (usually near the ankle, after long-term venous disease)
If you notice skin changes, recurrent swelling, sudden pain/redness, or any bleeding, it’s worth getting assessed.
How are varicose veins diagnosed?
A clinician will usually:
Ask about symptoms, lifestyle, and family history
Examine your legs (often standing)
Arrange a venous duplex ultrasound scan to map blood flow and identify reflux (the “leaky valve” areas)
The ultrasound is key because it helps match the right treatment to the underlying vein problem.
Can you prevent varicose veins?
You can’t always prevent them—especially if genetics play a role—but you can reduce symptoms and slow progression by:
Keeping active (walking is excellent)
Avoiding long periods of standing still; taking movement breaks
Maintaining a healthy weight
Elevating your legs when resting
Wearing graduated compression stockings if recommended
What treatments are available?
Treatment depends on symptoms, scan findings, and your goals (symptom relief, appearance, preventing complications). Common options include:
Radiofrequency ablation (RFA): a minimally invasive treatment that seals the faulty vein from the inside
Foam sclerotherapy: a medication foam injected into targeted veins to close them
Avulsions (phlebectomies): removing surface varicose veins through tiny incisions
Many modern treatments are walk-in, walk-out procedures with a quick return to normal activity.
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