Varicose veins occur when superficial veins in the legs become swollen and twisted. Whilst unsightly, they rarely cause symptoms or serious health concerns.


There are several factors that can contribute to the development of varicose veins.

These include:

Age: As people get older, the valves in their veins can become weaker, making it harder for blood to flow properly.

Smoking: Smoking is generally bad for vein health and can increase the risk of developing varicose veins.

Genetics: Varicose veins often run in families, so if your parents or grandparents had them, you may be more likely to develop them as well.

Gender: Women are more likely to develop varicose veins than men, due in part to hormonal changes that can affect vein health.

Pregnancy: Pregnant women may develop varicose veins as a result of increased pressure on their veins, as well as hormonal changes.

Obesity: Being overweight or obese can put extra strain on the veins in the legs, increasing the risk of varicose veins.

Occupation: Jobs that require prolonged standing or sitting can increase the risk of varicose veins, as they can put pressure on the veins and make it harder for blood to flow.

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Types of Varicose Veins

Varicose veins can vary in size and severity, and there are several types:

Spider veins: These are small, thin veins that appear near the surface of the skin and may resemble spider webs or tree branches.

Reticular veins: These are larger than spider veins but smaller than varicose veins, and often appear blue or green in colour.

Varicose veins: These are large, swollen veins that are often twisted or bulging, and may cause discomfort or pain.

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The symptoms of varicose veins may include:

  • Unsightly swollen or bulging veins that can be red, blue or purple in colour
  • A heavy feeling in the legs, especially after standing or sitting for long periods
  • Throbbing or cramping in the legs
  • Itchy or irritated skin around the affected veins
  • Swelling or inflammation in the legs
  • Skin discoloration or other skin changes near the affected veins

In some cases, a blood clot can form in these superficial veins. This may result in localised inflammation (“superficial thrombophlebitis”) causing tender, warm swellings within the varicose vein. This is often concerning to patients but very rarely poses a serious health risk.

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If you are experiencing symptoms of varicose veins, your doctor should perform a physical exam to assess the severity of your condition.  Your doctor may also recommend an ultrasound or other imaging tests to get a closer look at the affected veins and to check for any underlying issues.

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The most common reason for seeking medical treatment is for cosmetic reasons due to the unsightly nature of the varicose veins. In some cases, varicose veins may be symptomatic, as described above, warranting investigation and treatment.

Conservative treatments and lifestyle modifications such as exercise, weight loss, avoiding long periods of standing, elevating legs wherever possible and the use of compression stockings may be recommended for mild cases. These treatments help improve blood flow and relieve symptoms, but do not treat the underlying problem.

Sclerotherapy is a minimally invasive procedure that involves injecting a solution into the affected vein to close it off. The vein eventually shrinks and disappears. This treatment is often used for smaller veins and may require multiple sessions.

Endovenous laser treatment (EVLT) is a minimally invasive procedure that uses laser energy to close off the affected vein. The procedure involves inserting a laser fibre into the vein and applying heat to seal it shut. This treatment is often used for larger veins and may require only one session.

Surgical treatments such as vein ligation and stripping may be recommended for severe cases of varicose veins. These procedures involve tying off or removing the affected vein. While effective, they are more invasive and require a longer recovery time.

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There are several steps you can take to prevent varicose veins or slow their progression. These include:

Maintaining a healthy weight: Excess weight puts pressure on the veins and can increase the risk of varicose veins.

Exercise regularly: Exercise helps improve blood flow and strengthen the muscles in your legs, which can help prevent varicose veins.

Wear compression stockings: Compression stockings help improve blood flow and relieve symptoms of varicose veins.

Avoid prolonged standing or sitting: Prolonged periods of standing or sitting can put pressure on the veins and increase the risk of varicose veins.

Elevate your legs: Elevating your legs above your heart can help improve blood flow and relieve symptoms of varicose veins. Be sure to check with your health practitioner before practicing this, as it may aggravate certain health conditions

Avoid tight clothing: Tight clothing, especially around the waist, groin, and legs, can restrict blood flow and increase the risk of varicose veins.

Quit smoking: Smoking can increase the risk of varicose veins by damaging the veins and reducing blood flow.

Varicose veins are a common condition that can cause discomfort and embarrassment. Fortunately, they are very rarely a serious health concern. Understanding the causes and risk factors of varicose veins can help you take steps to prevent or slow their progression. If you are experiencing symptoms of varicose veins, it is important to consult a healthcare professional for a diagnosis and to discuss treatment options.

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This referenced content has been reviewed by Dr Cilliers, who is a qualified medical doctor with extensive experience in the private healthcare sector of South Africa, particularly in the disciplines of emergency medicine, general practice, geriatrics, healthcare leadership, sub-acute care and physical rehabilitation.
  1. Mayo Clinic. Varicose veins. Accessed on August 30, 2022. https://www.mayoclinic.org/diseases-conditions/varicose-veins/symptoms-causes/syc-20350643
  2. American Society of Hematology. Varicose veins. Accessed on August 30, 2022. https://www.hematology.org/Patients/Blood-Disorders/Vein-Clots/Varicose-Veins.aspx
  3. National Heart, Lung, and Blood Institute. What are varicose veins? Accessed on August 30, 2022. https://www.nhlbi.nih.gov/health-topics/varicose-veins
  4. National Institute of Arthritis and Musculoskeletal and Skin Diseases. What are varicose veins? Accessed on August 30, 2022. https://www.niams.nih.gov/health-topics/varicose-veins

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