Those blue, meandering tracks of varicose veins just under the surface of the skin on your legs may seem unsightly, but in most cases, they don’t pose a major health risk.
“In general, varicose veins are a cosmetic problem,” said Dr. Elliott M. Antman, a cardiologist and professor of medicine at Brigham and Women’s Hospital at Harvard Medical School in Boston. “Health risks are really related to extremely severe cases.”
To understand what causes varicose veins, it’s important to understand how veins work. Veins carry blood back to the heart and have one-way valves that keep the blood from flowing backward. If those valves become weakened from extended periods of increased pressure, the blood can back up and collect in a section, causing the veins to become swollen and twisted.
Varicose veins can occur in men and women and can develop anywhere in the body, but are most common in the legs and pelvic region, Dr. Antman said.
Many things can increase your risk for varicose veins, including carrying extra weight, pregnancy, lack of movement and age. Family history may also play a role, Dr. Antman said.
“Child-bearing is an important risk factor because the pressure on the veins around the pelvis as the baby grows can cause the valves to become weakened,” Dr. Antman said.
Carrying extra weight around the pelvis as well as abdominal tumors can also create elevated pressure that can lead to varicose veins. Working in a job that requires long periods of standing may also put added pressure on the veins.
Dr. Antman said patients with cardiovascular disease who also have varicose veins and other risk factors such as high blood pressure, too much water retention and/or congestive heart failure may be more susceptible to swelling in the legs, skin breakdown and infections in the skin that may occur from varicose veins.
The weakening of the valves that causes varicose veins occurs over a long period of time and isn’t caused by short-term activities, such as crossing your legs while seated, Dr. Antman said.
Varicose veins are usually detected by their blue, twisted appearance just below the surface of the skin. Another symptom is swelling of the feet, which can occur because the veins aren’t transporting the blood back to the heart efficiently.
Some patients with varicose veins experience itching, burning or throbbing sensations. If varicose veins become severe, the pressure can cause the blood to penetrate through weak areas of the vein walls and bleed into the tissue, causing a brown discoloration.
“If a patient’s legs become extremely swollen, which is unusual, there can be skin breakdown and infections,” Dr. Antman said.
Although varicose veins occur in secondary veins, and don’t usually pose major health risks, once a weakened valve causes a vein to become varicose, it cannot repair itself, Dr. Antman said.
Treatment may include surgery to remove or collapse the vein so it’s no longer visible. Laser treatment may also be used to shut down a varicose vein.
Varicose veins are different from a serious condition called deep vein thrombosis, which occurs when a clot forms in the deeper vein system and can travel into the main pulmonary artery.
Spider veins are similar to varicose veins, but occur in smaller veins and get their name from their arachnid-like appearance.
What can you do?
Certain lifestyle changes can minimize the development of varicose veins, or their severity.
- Maintain a healthy weight or work to lose those extra pounds to avoid putting extra pressure on the veins in the pelvis and legs.
- Avoid long periods of standing. If you do have to stand for long periods, rest periodically with your legs elevated.
- Wear support hosiery or socks, but avoid wearing socks or stockings that have a very tight band at the mid or upper calf.