Varicose veins

Varicose veins are enlarged and twisted veins, usually in the legs. Learn more about symptoms, causes and treatment options to help you manage discomfort and protect your leg health.

Varicose veins are swollen, twisted and enlarged veins that most often appear in the legs and feet. They occur when the one-way valves inside veins weaken or fail, allowing blood to flow backward and pool. This increases pressure inside the vein, causing it to stretch and become more visible under the skin.

Symptoms

  • Visible bulging blue or purple veins
  • Aching, heaviness or tiredness in the legs
  • Throbbing or cramping
  • Swelling of the lower legs and ankles
  • Itching or skin irritation near the veins
  • Worsening symptoms after long periods of standing
  • In more advanced cases, symptoms can include skin discoloration, hardening of the skin (lipodermatosclerosis) or venous ulcers.

Causes and Risk Factors
Varicose veins often run in families, but certain factors can increase your risk. These include:

  • Older age
  • Female gender and hormonal influences like puberty, pregnancy, menopause or hormone therapy
  • Pregnancy, due to increased blood volume and pressure on pelvic veins
  • Obesity
  • Prolonged standing or sitting
  • Previous leg injury or deep vein thrombosis (DVT)
  • Jobs that require long periods on your feet

Diagnosis
Diagnosis usually starts with a clinical exam focused on your symptoms, the appearance of your legs and your risk factors. Our team often uses a duplex ultrasound, which is a noninvasive test that checks blood flow, looks for reflux, maps the affected veins and rules out deep vein thrombosis. This imaging helps us determine which veins are causing symptoms and helps guide your treatment plan.

Prognosis and Approach
Varicose veins are common and often manageable. Many people find that their symptoms improve with simple steps, while others may need minimally invasive treatments or surgery to help reduce discomfort or prevent complications. Our specialists at TidalHealth can talk with you about options tailored to your symptoms, lifestyle and what your ultrasound shows.

What causes varicose veins?
Varicose veins happen when the valves in the veins become weak or damaged, allowing blood to move backward and pool in the veins. Factors like genetics, age, pregnancy, hormone changes, standing for long periods, obesity and previous blood clots can increase the risk.

Are varicose veins dangerous?
Most varicose veins are not life-threatening, but they can be uncomfortable and affect your quality of life. If left untreated for many years, complications can include painful inflammation, bleeding from a vein, skin changes and venous ulcers.

How are varicose veins diagnosed?
Our team at TidalHealth will check your symptoms and examine your legs. We often use a duplex ultrasound to assess how well the valves work, measure reflux and map out which veins are involved. This helps us choose the best treatment for you.

What treatment options are available?
Treatment can be as simple as wearing compression stockings, elevating your legs, staying active, managing weight and avoiding long periods of standing. TidalHealth also offers minimally invasive treatments such as sclerotherapy, foam sclerotherapy and endovenous thermal ablation. Some people may benefit from procedures to remove or close problematic veins. We will help you determine what fits best based on your symptoms and ultrasound results.

Will varicose veins come back after treatment?
It is possible for varicose veins to come back, either from a treated vein reopening or new veins developing over time. Modern treatments have lower recurrence rates than older surgeries. Following medical recommendations, such as wearing compression stockings and maintaining a healthy lifestyle, can help reduce recurrence.

Can pregnancy cause or worsen varicose veins?
Pregnancy can cause or make varicose veins worse due to increased blood volume, hormonal changes and pressure from the growing uterus. Many people see improvement after delivery, but some veins may persist and can be checked and treated after pregnancy if necessary.

Do compression stockings help?
Yes, compression stockings can help relieve symptoms like aching, swelling and heaviness. They support blood flow and may slow the progression of varicose veins. They are often the first treatment our specialists recommend, especially if procedures are not an option or are not preferred.

When should I see a doctor?
You should see a doctor if you have pain that affects your activity, ongoing swelling, skin changes like darkening or thickening, repeated bleeding from a vein or an open sore on your leg. You can also seek care if varicose veins bother you by how they look or affect your quality of life.

Are treatments covered by insurance?
Insurance coverage varies. Often, insurers may cover treatment if you have symptoms such as pain, swelling, skin changes or ulcers and ultrasound shows blood flow problems. Procedures done for cosmetic reasons are usually not covered. Our team can help you understand your options and any insurance requirements.

How can I reduce my risk or help prevent varicose veins?
There are some steps you can take to lower your risk or help prevent varicose veins from getting worse:

  • Maintain a healthy weight
  • Stay active, especially with walking and calf exercises
  • Avoid standing or sitting without breaks for long periods
  • Elevate your legs when resting
  • Wear compression stockings if you have mild symptoms or are at higher risk