Amanda S. Cooper, MD

Varicose veins occur when the valves that help efficiently return blood through the veins, from the limbs back to the heart, begin to weaken and fail. This condition is called venous reflux, and it causes blood to pool in your lower legs, causing the veins to get larger. There are several factors that may cause varicose veins including weight gain, pregnancy, age, occupations requiring prolonged standing, or heredity.

A patient can have symptoms with or without visible evidence of varicose veins. Varicose veins are large veins that lie close to the skin’s surface with a knotty, ropy, or bulging appearance.

There are two types of abnormal veins. Thin red or blue veins that sit on the surface of the skin are referred to as spider veins. On the other hand, true varicose veins are often swollen, bulging veins that have a rope-like appearance.

Unlike varicose veins, spider veins usually do not have physical symptoms. Most people choose to get rid of them simply because they are unsightly. Spider veins are shaped liked tiny cobwebs or roadmaps and are located close to the surface of the skin. They can be either red or blue and can appear on the head, chest, arms, neck, or legs.

If you have an underlying venous disease (e.g., venous reflux), the backflow of blood may lead to pooling in the lower legs, creating a condition that only progresses with time. If left untreated, you may develop additional varicose and spider veins, swelling, and in some cases venous ulcers in the lower calf and ankle.

There is no clear method for preventing varicose veins. Some actions, however, may help alleviate the symptoms and slow the progression of varicose veins, such as routine exercise, maintaining a normal weight, avoiding long periods of sitting or standing, and wearing compression stockings.

People with a family history of varicose veins, along with occupations requiring prolonged standing, increasing age, obesity, or women who have been pregnant have a higher risk of developing varicose veins.