The Complete Guide to Understanding Varicose Veins

If you’ve noticed bulging, twisted veins on your legs, you’re not alone. Varicose veins are incredibly common, affecting millions of people, especially as they age. 

While they’re often seen as a cosmetic concern, they can sometimes indicate underlying circulation issues or lead to discomfort.

The good news: whether your varicose veins are causing pain, swelling, or simply affecting confidence, there are effective treatment options to help you feel better and protect your vein health.

What Are Varicose Veins?

Varicose veins are enlarged, twisted veins that commonly affect the aesthetic appearance of the legs and feet. 

They develop when the valves inside the veins, which help regulate blood flow back to the heart, become weak or damaged, causing blood to pool in the affected area.

Several factors contribute to varicose vein development, including genetics, aging, prolonged standing or sitting, pregnancy, and excess weight. 

Over time, increased pressure on the veins can lead to visible swelling, discomfort, and even complications if left untreated.

It’s helpful to differentiate two common vein concerns:

• Spider veins are small, web-like clusters closer to the surface of the skin and typically don’t cause discomfort.
• Varicose veins are larger, rope-like veins that bulge outward and can cause pain or swelling.

Several factors contribute to varicose vein development, including genetics, aging, weight, hormonal changes, lifestyle habits, and circulation pressure in the lower limbs.

How Varicose Veins Develop

Varicose veins don’t appear overnight; they progress gradually:

Vein valves weaken or become leaky

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Gravity keeps blood pooling in lower extremities

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Pressure builds within the vein

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The vein stretches, enlarges, and becomes visible

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Discomfort and leg heaviness may increase

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Over time, skin changes and complications can occur

Understanding this progression is important, because early detection makes a meaningful difference in long-term vein health.

Causes of Varicose Veins

Varicose veins develop due to a combination of factors, but the most common cause is weak or damaged vein valves that prevent blood from flowing efficiently back to the heart. This leads to blood pooling in the veins, causing them to stretch and bulge over time. 

Several factors can increase the risk of this occurring, including:

• Genetics: A family history of varicose veins increases the likelihood of developing them.
• Aging: As veins lose elasticity over time, their valves become weaker.
• Prolonged standing or sitting: Jobs or lifestyles involving long standing or sitting periods can put extra pressure on the veins.
• Pregnancy: Increased blood volume and hormonal changes during pregnancy can weaken vein walls and valves.
• Obesity: Excess weight that puts additional strain on veins, making it harder for blood to circulate properly.
• Lack of exercise: Regular movement helps maintain healthy circulation and vein strength.

Early Signs and Symptoms of Varicose Veins

Varicose veins often begin subtly before they become visible on the skin.

Common Early Warning Signs

• Aching or heaviness in the legs
• Swelling around the ankles or feet
• Tingling or burning sensations
• Mild skin discoloration
• Restlessness or nighttime leg cramps

When Symptoms Become More Noticeable

• Prominent blue, purple, or bulging veins
• Itching or skin irritation around the vein
• Hardening of the skin (lipodermatosclerosis) 
• Persistent swelling or inflammation

If you’re noticing these changes, a vein evaluation can help determine whether intervention is needed.

Are Varicose Veins Dangerous?

In many cases, varicose veins are not medically dangerous, but they can worsen over time and lead to complications if untreated.

Possible Complications

• Chronic venous insufficiency
• Skin ulcers (venous ulcers)
• Blood clots (superficial thrombophlebitis or DVT)
• Skin changes and hyperpigmentation
• Bleeding from surface veins

How Do Varicose Veins Impact Health?

While varicose veins are often seen as a cosmetic issue, they can also impact your overall health in several ways. If left untreated, they may lead to other complications.

Pain and Discomfort

Varicose veins can cause aching, throbbing, heaviness, and swelling in the legs, especially after long periods of standing or sitting.

Some people also experience cramping, burning, or itching around the affected veins.

Blood Clots

When blood pools in varicose veins, it can increase the risk of clot formation. 

A superficial clot (superficial thrombophlebitis) can cause localized redness and tenderness, while a deeper clot (deep vein thrombosis, or DVT) is more serious and requires immediate medical care.

Stasis Hyperpigmentation

Poor circulation from varicose veins can leak blood into surrounding tissues, causing dark brown or reddish skin discoloration, usually around the lower legs and ankles. This can also result in inflammation and skin damage over time.

Chronic Venous Insufficiency (CVI)

When varicose veins worsen, they can contribute to CVI, a long-term condition where the veins struggle to return blood to the heart. This can lead to persistent swelling, skin changes, and even venous ulcers, slow-healing wounds requiring medical treatment.

How Varicose Veins Are Diagnosed

Diagnosis typically begins with:

• A review of your symptoms
• A physical examination that assesses your health
• The physician conducting a visual assessment of your veins
• A duplex ultrasound, which evaluates blood flow and valve function

What to Expect During a Vein Evaluation

Your specialist will:

• Ask about your symptoms and history
• Examine affected areas
• Use imaging to assess valve performance and blood flow

Treatment Options for Varicose Veins

Treatment depends on severity, discomfort, and your overall vascular health. Today’s medical options are swift, effective, and minimally invasive.

Conservative (At-Home) Treatments

• Wearing compression stockings: These special medical-grade socks apply gentle pressure to the legs to improve circulation and help prevent blood from pooling in the veins.
• Elevating the legs: Raising your legs above heart level encourages blood to flow upward toward the heart, reducing swelling and discomfort.
• Avoiding long periods of sitting or standing still: Moving regularly throughout the day helps maintain healthy circulation and reduces pressure on the veins.
• Increasing exercise and activity: Activities like walking, cycling, or swimming strengthen the calf muscles that help pump blood back toward the heart.
• Weight management: Maintaining a healthy weight reduces strain on the veins and improves overall blood flow.

Minimally Invasive Medical Treatments

• Endovenous laser therapy (EVLT): EVLT uses a tiny laser fiber inserted into the vein to gently heat and close the affected vein from the inside.
• Radiofrequency ablation (RFA): RFA uses controlled heat energy to seal off the damaged vein, allowing blood to naturally reroute through healthier veins.
• Sclerotherapy: A safe chemical solution is injected into the vein, causing it to collapse and fade over time.
• Microphlebectomy: Tiny punctures in the skin allow the removal of bulging surface veins without the need for full surgery and with minimal scarring.
• VenaSeal adhesive closure: This advanced treatment uses a medical-grade adhesive to close the vein instantly, typically without the need for post-procedure compression stockings.

How to Know Which Treatment Is Right for You

The right treatment option for you will depend on many things. A vein specialist will recommend options based on:

• Size and type of vein
• Symptom severity
• Ultrasound findings
• Lifestyle and health factors

How to Prevent Varicose Veins

Not all cases of varicose veins can be prevented. Prevention focuses on strengthening veins and improving circulation. You can reduce your risk by:

• Moving frequently and avoiding prolonged sitting or standing
• Exercising regularly
• Wearing compression socks if advised
• Elevating the legs when resting
• Avoiding tight clothing around the waist
• Eating a balanced diet and maintaining a healthy weight

When to See a Vein Specialist

You should consider an evaluation if:

• You experience leg pain, heaviness, or swelling
• Visible veins are causing discomfort
• Skin around your veins is irritated or discolored
• You have a history of blood clots or vein disease
• Symptoms are worsening over time
• Varicose veins are affecting your quality of life or confidence

Trust The Cardiovascular Center of Florida for Expert Vein Care in Florida

As a distinguished provider of cardiovascular care in Orlando, our cardiovascular specialists are here to guide you through any health worries or frustrations you may have, particularly varicose veins. 

If you or someone you know is struggling with varicose veins, request an appointment with the Cardiovascular Center of Florida today. We'll be here to support you every step of the way.