Due to how common they are, the term "varicose veins" is almost always associated with the visible, bulging veins in the legs. However, varicose veins can occur elsewhere in the body, though less frequently. Two other known types include esophageal varices and testicular varicoceles.

Varicose veins in the legs are the most common. Studies have shown that early signs and characteristics of these venous conditions can be detected in over one-third of the population aged 18 to 64. Leg varicose veins are significantly more common in women (20–25% of the population) compared to men (10–15%). A number of treatment options are available. Surgery can often be avoided in favor of alternatives like laser or radiofrequency endovenous ablation via catheter, foam sclerotherapy, or glue closure. Another option is echotherapy—a non-invasive thermal treatment using therapeutic ultrasound.

Chronic venous insufficiency can be asymptomatic, especially in the early stages. As the condition progresses, symptoms such as visible varicose or spider veins may appear. Pain, swelling, edema, skin changes, and—at more advanced stages—leg ulcers may also develop. Varicose veins result from damaged valves that reduce the vein’s ability to return blood to the heart against gravity. This causes blood to accumulate, eventually leading to stretched vein walls that become visible under the skin. Visible varicose veins usually represent only part of the affected segment and the overall extent of venous insufficiency. Although visible, twisted, swollen veins often cause cosmetic concerns, they may not require immediate treatment if they don’t cause physical discomfort. If the condition worsens and begins affecting daily life—causing pain, irritated skin, or sleep disturbances—it’s important to consult a doctor to explore treatment options.

Venous insufficiency is a common chronic condition of the lower limbs (also called chronic venous insufficiency, or CVI), characterized by malfunctioning valves inside the veins. These valves are supposed to help blood move upward toward the heart against gravity. When they don’t close properly, blood can partially flow backward. This causes blood pooling in the legs, which further damages the veins and leads to symptomatic disease.

Spider veins are typically treated for cosmetic reasons, as they pose little medical concern. Treatments are often not reimbursed. Varicose veins, on the other hand, may require medical intervention when they become painful or bothersome and are more commonly covered by healthcare. Traditional treatment options include thermal endovenous ablation via laser or radiofrequency using a catheter, sclerotherapy (foam injection), or surgical vein removal (stripping). More recently, echotherapy has emerged as a treatment using focused ultrasound. It is completely non-invasive, unlike surgery or endovascular techniques that require catheter insertion into the vein.

The visible part of a varicose vein is generally just one portion of the segment affected by venous insufficiency. Deeper veins may also be involved. These are known as hidden or invisible varicose veins. Venous malfunction often begins with faulty valves that no longer prevent reflux. In a healthy person, these valves close completely to stop blood from flowing backward. When they become leaky, blood can partially flow back down—this is referred to as venous reflux.

Telangiectasias or spider veins are very superficial vein lesions that appear on the face or legs. The affected venules are tiny blood vessels in the dermis—the most superficial layer of the skin—that dilate into a web-like pattern and take on a red to purplish color. While different from varicose veins, telangiectasias can still signal underlying venous insufficiency. One study showed a significant association between the presence of telangiectasias and the severity of varicose veins. However, spider veins are much more common, and having them does not necessarily mean that venous insufficiency will develop.

Varicose veins are veins that have gradually lost their ability to return blood to the heart against the force of gravity. This dysfunction can lead to blood pooling in the veins and, over time, to stretching of the vein walls: the enlargement of the vein then becomes visibly apparent under the skin. Varicose veins are often twisted, swollen, and visible, and they are typically a cosmetic concern for the individual. If they do not cause discomfort or pain, there is usually no medical need for immediate treatment. However, symptoms may develop as the condition progresses, commonly including skin irritation or dryness, pain, or sleep disturbances due to itching… At that point, it is essential to consult a medical specialist to explore different treatment options.

For individuals with venous insufficiency or chronic venous disease, the following activities are especially recommended: Running or Walking: Strengthens leg muscles and supports venous function. Swimming: Gentle on the legs and veins, water pressure relieves discomfort. Cooler water temperatures help veins constrict slightly. Cycling: Helps pump blood from the legs. Best done on flat terrain to avoid pressure spikes. Maintaining correct posture—pedaling with the sole of the foot and keeping a straight spine—helps prevent pelvic or hip vein congestion.

Some doctors suggest a potential link between certain sports—especially competitive sports—and the formation of varicose veins. However, current research does not offer clear evidence to confirm this hypothesis. In general, exercise is considered beneficial for venous health. It stimulates circulation, prevents blood pooling in the legs, and helps blood return to the heart—reducing vein wall pressure.

The connection between venous disease and prolonged standing is well documented. Even in jobs requiring regular standing, preventive measures can and should be taken: Take breaks or rotate tasks when possible Use compression stockings to support upward blood flow Incorporate regular stretching or small exercises to encourage circulation and reduce pressure

Work environments that require long periods of standing have been studied for their impact on varicose vein risk. One Danish study followed 1.6 million workers over 3 years to evaluate whether job conditions were correlated with initial hospitalization for leg varicose veins. Results showed that men who stood for long hours had a 1.85x higher risk than other men. Among women, the risk was even higher—2.63x compared to women in other professions.

Excess weight generally increases abdominal pressure, which in turn raises pressure in the leg veins—promoting the onset and progression of chronic venous disease. Another effect is the disruption of blood flow between deep and superficial veins in the legs. Fat and fibrous tissue around the veins may impair circulation, lead to blood pooling (stasis), and contribute to varicose vein formation.

Evidence shows a stronger link between obesity and venous disease in women than in men. One study found that an increase in Body Mass Index (BMI) significantly correlates with a higher risk of varicose veins in postmenopausal women.

The causes of chronic venous disease and varicose vein formation are multifactorial. However, certain risk factors are consistently recognized: sex, age, number of pregnancies, family history, and excess weight or obesity. Studies have shown that especially in women, obesity and low physical activity levels are more common among patients with varicose veins than those without signs of venous insufficiency. Research also suggests that the disease tends to be more clinically severe in overweight or obese individuals.

Contraceptives are not considered a primary cause of varicose veins but can exacerbate existing conditions or predispositions. Women with a higher risk of venous disease—such as smokers, obese individuals, or those with a family history of venous insufficiency—should discuss the use of contraceptives with a healthcare provider.

Birth control pills typically contain hormones such as estrogen and progestin. These prevent ovulation through mechanisms similar to pregnancy. Elevated estrogen levels have been linked to an increased risk of blood clots, which can lead to deep vein thrombosis or, in severe cases, pulmonary embolism. Another hormonal effect is reduced blood flow. While helpful during childbirth to limit bleeding, it may increase the risk of clots and varicose veins when caused by the pill. Additionally, estrogen may relax vein walls, impairing blood flow. Combined with water retention (another side effect), this can increase blood volume and vein pressure—contributing to varicose vein development.

Some women are more prone to developing varicose veins during pregnancy, and there's no way to completely prevent their appearance. However, certain strategies can help minimize the risk: Wearing elastic compression stockings Doing light leg exercises (approved by a physician) Taking regular breaks during prolonged sitting or standing Avoiding crossing legs while seated Wearing flat shoes instead of heels Elevating the legs periodically Reducing sodium intake to prevent vein swelling

Signs of varicose veins are observed in around one-third of women after their first pregnancy, and about 50% after multiple pregnancies. Although the exact causes and mechanisms are not fully understood, pregnancy is considered a major factor. Hormonal changes during pregnancy alter vein tone, and the increasing pressure from the growing uterus hampers venous return. Together, these factors can significantly enlarge vein walls. If a minor existing insufficiency is present, pregnancy can lead to a substantial progression of the condition. Another cause is the increase in blood volume during pregnancy. This often leads to reduced blood flow from the legs to the groin, which increases venous pressure and can damage vein valves.

Most researchers and physicians believe genetics plays a notable role in the development of chronic venous diseases (CVD) and varicose veins. A family history of venous insufficiency or varicose veins is often considered a significant risk factor. However, understanding the exact genetic component has proven challenging. Despite several studies, small sample sizes and limited reproducibility have left many questions unanswered. Large-scale, collaborative studies are needed to better understand the genetic influence.

There is no definitive explanation for why women appear more prone to varicose veins than men. However, pregnancy may play a role. Pregnancy and childbirth are known risk factors for varicose veins. While the incidence of varicose veins is similar among young men and women, the prevalence increases more significantly among women with age. Signs of varicose veins are observed in about one-third of women after their first pregnancy. After multiple pregnancies, that number increases to approximately 50%.

It has been shown that venous insufficiency cosmetically affects half the population, with visible varicose veins being more common among women (20–25%) than men (10–15%).

Extensive research has shown that varicose veins tend to occur more frequently in women than in men. One study found that the prevalence of varicose veins was 29% among women and 10% among men, increasing with age in both groups. Interestingly, risk factors also appear to differ between the sexes: in women, obesity and elevated systolic blood pressure are more strongly associated with varicose veins, while in men, these factors seem less relevant. In contrast, smoking appears to be a more significant risk factor for men. Common risk factors for both genders include prolonged standing at work and low levels of physical activity.

In the early stages, varicose veins are generally harmless and often don’t require treatment. However, if they go untreated despite worsening symptoms and discomfort, they can lead to serious venous leg ulcers. Therefore, it is advisable to consult a doctor once varicose veins begin to cause pain or discomfort, to discuss treatment options and prevent the development of potentially dangerous leg ulcers.

The formation and progression of varicose veins are influenced by multiple factors, including gender, age, prolonged standing, obesity, pregnancy, and family history. To reduce your risk of developing varicose veins, it's important to eliminate as many risk factors as possible. This includes maintaining or achieving a healthy weight, exercising regularly, and avoiding prolonged standing to support proper circulation. Additionally, if there is a family history of venous disease, preventive measures such as wearing compression stockings may be appropriate and should be discussed with a healthcare provider.

There are several causes of heavy legs: Nervousness, and Restless Legs Syndrome (RLS) Restless Legs Syndrome is a condition that typically arises before or during sleep. It is often described as a sensation of pain, trembling, or numbness. The cause remains unclear, but relief is often found simply by moving the legs. Overtraining Syndrome It’s not uncommon for certain training routines or exercises to cause discomfort in the legs. However, athletes may suffer from overtraining syndrome when they push themselves too hard without giving their body adequate time to recover. Exercising intensely every day can prevent muscles from repairing and lead to weak, heavy legs. This problem is most commonly seen in cyclists and runners. Peripheral Arterial Disease (PAD) Peripheral arterial disease is a cardiovascular condition affecting the veins and arteries. It is caused by a buildup of fatty deposits (plaque) in the artery walls, narrowing them. Over time, the arteries may become so narrow that blood flow is restricted, leading to reduced circulation. Since this often occurs in the legs, it results in sensations of tired, painful, and heavy legs. Common risk factors for PAD include smoking, diabetes, high cholesterol, and high blood pressure.

If you have varicose veins, you can consult a phlebologist, an angiologist, or a vascular surgeon. These specialists have the diagnostic tools to accurately assess your condition. They will first ask about your symptoms, medical history, and potential risk factors before recommending treatment.

Exercise Exercise can help prevent varicose veins or alleviate symptoms of existing venous disease. Experts agree that physical activity benefits vein health by stimulating and improving blood circulation. It helps prevent blood from pooling in the legs and supports its return to the heart. In cases of chronic venous insufficiency, gentle leg movement is especially beneficial. Recommended sports include jogging, swimming, cycling, cross-country skiing, and dancing, when done moderately. Compression stockings Compression stockings can assist the leg muscles and veins in pushing blood upward. A 2018 study showed that knee-high compression stockings with a pressure level of 18 to 21 mmHg could relieve pain symptoms in patients within a week. It is important to note that compression stockings only work when worn regularly—they do not treat the underlying cause of the disease but help alleviate symptoms. Loose clothing Very tight pants can restrict blood flow and worsen venous disease symptoms. Choosing looser clothing helps promote better circulation. Flat shoes are also preferable to high heels. Diet A diet high in sodium can promote water retention, which may aggravate symptoms. That’s why it's advisable to avoid foods rich in salt or sodium and instead opt for a diet high in potassium. Potassium-rich foods can help reduce water retention and are therefore more suitable. Recommended foods include almonds, pistachios, lentils, potatoes, leafy green vegetables, and certain fish like tuna and salmon.