What Are Varicose Veins? A Plain-Language Guide to the Bulging, Twisted Veins That Most Often Show Up on the Legs
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026
TL;DR
Varicose veins are bulging, enlarged veins that form when tiny valves inside a vein weaken and let blood pool instead of flowing back to the heart. They most often appear on the legs because standing and walking raise the pressure in the veins of the lower body. For many people they are only a cosmetic concern, but they can cause aching, heaviness, cramping, and — rarely — more serious problems such as ulcers, blood clots, or bleeding. Treatment usually starts with self-care and compression stockings, and only moves to procedures such as sclerotherapy, laser treatment, or vein removal if symptoms persist or the veins are more severe.
Quick Answer
What are varicose veins? Bulging, enlarged veins that sit close to the skin's surface, most often on the legs, caused by weak or damaged valves that let blood flow backward and pool.
Do they always hurt? No. Many people have no pain at all, but when symptoms appear they include aching, heaviness, burning, throbbing, cramping, swelling, itching, and skin color changes.
Who gets them most? Women, older adults, pregnant people, those with a family history, and people carrying extra weight or who stand or sit for long periods.
Can they cause serious problems? Rarely. Complications include skin ulcers near the ankles, deep vein blood clots, bleeding from a burst vein, and long-term leg swelling.
What is the first treatment? Self-care — exercise, leg elevation, and wearing compression stockings all day — before any surgery or procedure.
What the research says
Compression stockings help after a vein procedure, too. A meta-analysis of 6 randomized trials (1,045 people) found that wearing compression stockings after endovenous thermal ablation of varicose veins significantly reduced pain over the first 10 days (mean difference -4.98, 95% CI -8.71 to -1.24) and shortened the time to return to normal activities (mean difference -1.01, 95% CI -1.97 to -0.06). Complications, quality of life, and vein closure rates did not differ significantly between the groups. (Ma et al., Ann Vasc Surg, 2021)
Age, weight, and low activity are linked to leg ulcers from vein disease. A systematic review of risk factors for a first venous leg ulcer found that higher age, higher body mass index, low physical activity, high blood pressure, deep vein reflux, deep vein thrombosis, and a family history of leg ulcers were significantly associated with ulcers in most of the five studies reviewed. The authors note that the number of studies was small and their methods varied, so how much each factor contributes remains unclear. (Meulendijks et al., J Eur Acad Dermatol Venereol, 2019)
What are varicose veins?
Varicose veins are bulging, enlarged veins. Any vein that lies close to the skin's surface — called a superficial vein — can become varicosed, but they most often affect the veins in the legs. That happens because standing and walking increase the pressure in the veins of the lower body.
The reason comes down to how veins move blood. Veins return blood from the rest of the body to the heart, and the veins in the legs must do this work against gravity. Tiny valves inside the veins open as blood flows toward the heart, then close to stop blood from flowing backward. When these valves are weak or damaged, blood can flow backward and pool in the veins, causing the veins to stretch or twist until they show under the skin.
What is the difference between varicose veins and spider veins?
Spider veins are a common, mild form of varicose veins. They appear as thin, red lines or weblike networks of blood vessels on the surface of the skin. Spider veins sit closer to the skin's surface, occur on the legs and feet (and sometimes the face), and vary in size.
What are the symptoms of varicose veins?
Varicose veins might not cause pain at all. When they do, the signs fall into two groups: how the veins look, and how the legs feel.
What you see | What it looks like |
Vein color | Dark purple, blue, or the same color as the skin — the changes may be harder or easier to see depending on your skin color |
Vein shape | Twisted and bulging; often look like cords on the legs |
What you feel | Description |
Achiness | An achy or heavy feeling in the legs |
Burning and cramping | Burning, throbbing, muscle cramping, and swelling in the lower legs |
Worse with stillness | Pain that gets worse after sitting or standing for a long time |
Itching | Itching around one or more of the veins |
Skin changes | Changes in skin color around a varicose vein |
When should you see a doctor?
If you worry about how your veins look and feel, and self-care measures haven't helped, see your healthcare professional. Two warning signs deserve faster attention:
Warning sign | Why it matters |
A discolored spot near the ankle | A painful ulcer can form on the skin near varicose veins, mostly near the ankles, and a discolored spot often begins before an ulcer forms |
Ongoing leg pain or swelling | Veins deep within the legs can get larger and cause leg pain and swelling, which can mean a blood clot, so ongoing pain or swelling should be checked |
What causes varicose veins?
Weak or damaged valves are the root cause. To understand why that matters, it helps to know how blood travels through the legs. Arteries carry blood from the heart to the rest of the body, and veins return it. Muscles in the lower legs tighten and act as pumps, while vein walls help blood return to the heart. The tiny valves open as blood flows toward the heart, then close to block backflow. If a valve is weak or damaged, blood flows backward and pools, and the vein stretches or twists around the pooled blood.
Who is at risk for varicose veins?
Two factors stand out as the main risk drivers, with several others adding to the odds.
Main risk factor | How it raises the risk |
Family history | If other family members have varicose veins, there is a greater chance you will too |
Obesity | Being overweight puts added pressure on veins |
Other risk factor | How it raises the risk |
Age | Aging causes wear and tear on the valves that control blood flow; over time they allow blood to flow back and collect in the veins |
Sex | Women are more likely to get the condition because hormones tend to relax vein walls; hormone changes before a menstrual period, during pregnancy, or at menopause might play a role, and hormone treatments such as birth control pills might increase the risk |
Pregnancy | Blood volume in the body increases to support the growing baby, which can also make the veins in the legs bigger |
Long periods of standing or sitting | Movement helps blood flow, so stillness works against it |
Can varicose veins cause complications?
Complications are rare, but they are worth knowing because some need prompt medical help.
Complication | What happens | What to do |
Ulcers | Painful ulcers form on the skin near varicose veins, mostly near the ankles; a discolored spot on the skin often begins before an ulcer forms | See your healthcare professional right away if you think you have a leg ulcer |
Blood clots | Veins deep within the legs sometimes get larger and might cause leg pain and swelling | Seek medical help for ongoing leg pain or swelling — it can mean a blood clot |
Bleeding | Veins close to the skin rarely burst; this mostly causes only minor bleeding, but it needs medical help | Get medical help if a vein near the skin bursts |
Leg swelling | Longtime varicose veins can cause the legs to swell | Discuss ongoing swelling with your healthcare professional |
How are varicose veins diagnosed?
Diagnosis starts with a simple exam. A healthcare professional looks at your legs while you are standing to check for swelling and asks you to describe the pain and aching in your legs.
A healthcare professional might also use a venous Doppler ultrasound of the leg. It is a painless test that uses sound waves to look at blood flow through the valves in the veins. A leg ultrasound can also help find a blood clot.
What are the treatment options for varicose veins?
Treatment may include self-care measures, compression stockings, and surgeries or other procedures. Procedures are often outpatient, which means you most often go home the same day. One practical note: if treatment is done only to make your legs look better, it is considered cosmetic, and your insurance might not cover it, so it is worth asking your insurer whether treatment is a covered cost.
Do self-care and compression stockings work?
For most people, this is the first line. Exercising, raising your legs when sitting or lying down, and wearing compression stockings can ease the pain, and self-care measures might also keep the veins from getting worse.
Compression stockings worn all day are often the first approach to try. They squeeze the legs, helping veins and leg muscles move blood. The amount of pressure varies by type and brand. They are sold at most pharmacies and medical supply stores, and prescription-strength stockings are also available. Insurance might cover prescription ones if your varicose veins cause symptoms.
What procedures are available?
If self-care steps and compression stockings don't work, or the varicose veins are more severe, a healthcare professional might suggest one of the following.
Procedure | How it works | Key facts |
Sclerotherapy | The veins are injected with a solution or foam that scars and closes them | Treated veins should fade in a few weeks; some veins might need shots more than once; done in an office with no need to be asleep |
Laser treatment | Strong bursts of light are sent onto the varicose vein | The vein slowly fades until it can't be seen; no cuts or needles are used |
Catheter-based radiofrequency or laser energy | A thin tube called a catheter is put into an enlarged vein; the energy heats the tip, and as the catheter is removed, the heat destroys the vein by causing it to cave in and seal shut | The treatment most used for larger varicose veins |
High ligation and vein stripping | The varicose vein is tied off before the place where it joins a deep vein, then removed through small cuts | Outpatient for most people; veins deeper in the leg take care of the larger amounts of blood, so flow in the leg is not lost |
Ambulatory phlebectomy (fluh-BEK-tuh-me) | Smaller varicose veins are removed through tiny pricks in the skin | Only the pricked areas are numbed; outpatient; most often there is not much scarring |
What lifestyle changes help?
Lifestyle change | Why it helps |
Get regular exercise | Walking is a great way to help blood flow in the legs; your healthcare professional can suggest a good activity level |
Manage weight | Losing excess pounds takes pressure off the veins |
Avoid salt | A low-salt diet prevents swelling caused when the body holds in water |
Choose proper footwear | Don't wear high heels; low-heeled shoes work calf muscles more, which is better for your veins |
Don't wear tight clothes | Tight clothing around your waist, legs, or groin can reduce blood flow |
Raise your legs | Take a few short breaks daily to raise your legs above the level of the heart — for example, lie down with your legs on three or four pillows, or raise the foot of the bed six inches |
Change position often | Don't sit or stand for long periods; moving helps blood flow |
What should you ask at your appointment?
A healthcare professional needs to look at your bare legs and feet to diagnose varicose veins and find the best treatment. Your primary provider might refer you to a phlebologist or vascular surgeon (doctors who specialize in vein conditions), or a dermatologist or dermatology surgeon (a doctor who treats skin conditions).
Before the appointment, make a list of your symptoms (including any that may not seem linked to varicose veins, and when they began), important personal information such as a family history of varicose veins or spider veins, all medicines, vitamins, and supplements you take with their doses, and the questions below.
Questions to ask your doctor |
What's the most likely cause of my symptoms? |
What else could cause my varicose veins? |
What tests will I need? |
What treatment do you suggest? |
How can I best manage varicose veins along with other health conditions I have? |
Do I need to restrict any activities? |
Are there any brochures or other printed materials I can have? What websites do you suggest? |
Your healthcare professional is likely to ask you questions, too, including when you noticed the varicose veins, whether you have pain and how bad it is, what makes your symptoms better, and what makes them worse.
What can you do in the meantime?
Before your appointment, you can begin self-care: try not to stand or sit in one position for a long time, raise your legs when you are seated, and don't wear shoes that fit poorly or tight socks or stockings — other than compression stockings.
How can you prevent varicose veins?
Getting better blood flow and muscle tone might lower your risk of having varicose veins. The same measures that treat the discomfort can help prevent the veins in the first place.
Prevention step | Details |
Avoid high heels and tight stockings | Except for compression stockings |
Change how you sit or stand often | Movement helps blood flow |
Eat a high-fiber, low-salt diet | Supports healthy circulation and reduces water-retention swelling |
Exercise | Builds the muscle tone that helps pump blood |
Raise your legs when sitting or lying down | Helps blood return toward the heart |
Keep a healthy weight | Reduces pressure on the veins |
The Bottom Line
Varicose veins start with a simple plumbing problem: weak valves let blood pool, and the vein stretches and bulges in response. Most of the time they are a cosmetic concern, but aching, heaviness, cramping, and skin changes are common when symptoms develop, and serious complications — though rare — do happen. Starting with daily self-care and compression stockings gives many people meaningful relief, and effective outpatient procedures are available when more is needed. If you are unsure whether your veins are worth checking, a quick exam with a healthcare professional settles the question.
Take the Next Step
If varicose veins are causing you discomfort, changing how your legs look or feel, or not improving with self-care, it is time for an evaluation. A venous Doppler ultrasound is painless, treatment options range from stockings to same-day procedures, and an early conversation can keep the veins — and your legs — healthier for years to come.
Frequently Asked Questions
What exactly are varicose veins?
Varicose veins are bulging, enlarged veins. Any vein close to the skin's surface (a superficial vein) can become varicosed, though they most often affect the veins in the legs, where standing and walking raise the pressure in the lower body.
What causes varicose veins to form?
Weak or damaged valves inside the veins. The tiny valves open as blood flows toward the heart and close to stop backflow. When they are weak or damaged, blood flows backward and pools, causing the veins to stretch or twist.
Do varicose veins always cause pain?
No. For many people they are simply a cosmetic concern. When they do cause symptoms, the legs may feel achy or heavy, with burning, throbbing, muscle cramping, swelling, itching, and skin color changes — often worse after sitting or standing for a long time.
What are spider veins, and how do they differ?
Spider veins are a common, mild form of varicose veins. They appear as thin red lines or weblike networks near the skin's surface, most often on the legs and feet, and sometimes on the face.
Who is most likely to develop varicose veins?
Women are more likely to develop them, because hormones tend to relax vein walls. Other risk factors include family history, obesity, aging (which wears down the valves), pregnancy, and long periods of standing or sitting.
Can varicose veins cause serious health problems?
Complications are rare but possible: painful skin ulcers near the ankles, blood clots in deeper veins, bleeding from a burst surface vein, and long-term leg swelling. Ongoing leg pain or swelling, and any discolored spot near the ankle, should be checked promptly.
How are varicose veins diagnosed?
With a standing leg exam to check for swelling, plus a venous Doppler ultrasound — a painless sound-wave test that looks at blood flow through the vein valves and can also help find a blood clot.
What is the first treatment to try?
Self-care: exercise, raising your legs when sitting or lying down, and wearing compression stockings. Wearing compression stockings all day is often the first approach to try. They squeeze the legs and help veins and leg muscles move blood.
What procedures treat varicose veins if self-care isn't enough?
Options include sclerotherapy (injections that scar and close the vein), laser treatment, catheter-based radiofrequency or laser energy (the treatment most used for larger veins), high ligation and vein stripping, and ambulatory phlebectomy (removing small veins through tiny pricks). Most are outpatient procedures.
Will insurance cover varicose vein treatment?
Sometimes. Insurance might cover prescription-strength stockings if your varicose veins cause symptoms, and you should ask your insurer whether a treatment is a covered cost. Treatment done only to make your legs look better is considered cosmetic and might not be covered.
Can you prevent varicose veins?
Getting better blood flow and muscle tone might lower your risk. Helpful steps include exercise, keeping a healthy weight, a high-fiber low-salt diet, avoiding high heels and tight clothing, changing position often, and raising your legs when sitting or lying down.
What can I do before my appointment?
Try not to stand or sit in one position for a long time, raise your legs when seated, and don't wear shoes that fit poorly or tight socks and stockings, other than compression stockings.
Related Reading
References
Mayo Clinic Staff. Varicose veins: Symptoms and causes. Mayo Clinic. Last updated February 6, 2024. Accessed October 14, 2026. https://www.mayoclinic.org/diseases-conditions/varicose-veins/symptoms-causes/syc-20350643
Mayo Clinic Staff. Varicose veins: Diagnosis and treatment. Mayo Clinic. Last updated February 6, 2024. Accessed October 14, 2026. https://www.mayoclinic.org/diseases-conditions/varicose-veins/diagnosis-treatment/drc-20350649
Ma F, Xu H, Zhang J, et al. Compression therapy following endovenous thermal ablation of varicose veins: a systematic review and meta-analysis. Ann Vasc Surg. 2022;80:302-312. PMID: 34774690. https://doi.org/10.1016/j.avsg.2021.09.035
Meulendijks AM, de Vries FMC, van Dooren AA, et al. A systematic review on risk factors in developing a first-time venous leg ulcer. J Eur Acad Dermatol Venereol. 2019;33(7):1241-1248. PMID: 30422345. https://doi.org/10.1111/jdv.15343
Disclaimer: This guide is for general information only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a physician or other qualified health provider with any questions about a medical condition. Never disregard professional medical advice or delay seeking it because of something you have read here.
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