Varicose veins

They are as common as they are unpopular: varicose veins. These mostly superficial, visible and tortuous veins are more than just a minor blemish. But how do varicose veins develop, what are the warning signs and, above all, why should you do something about these thick veins as early as possible?

  • Typical signs of varicose veins are heavy, swollen legs and unsightly, superficially dilated veins.

  • Venous thrombosis and inflammation can be the result of untreated varicose veins.

  • Varicose veins are easy to treat – often with gentle methods.

Krampfadern
Medically reviewed by:

Medically reviewed by:

Dr. Peter Herndlhofer

Varicose veins: Simply explained!

Varicose veins are abnormally dilated veins in which the blood flows in the wrong direction. In technical jargon, they are also called “varicose veins“.

A short recap: veins are blood vessels that carry blood back to the heart. There is only one problem in the legs – gravity. The heart and leg muscles have to work hard to keep the blood flowing: Every heartbeat, every muscle movement pumps blood upwards.

And because that alone is not enough, we have venous valves that function like non-return valves. They normally only allow the blood to flow upwards and prevent it from flowing back.

Sometimes, however, this system reaches its limits, and then a real vicious circle begins. Because as soon as a vein expands too far, the venous valves can no longer close properly. This causes even more blood to pool in the vein and overfill it. Initially, this is still reversible, but over the years the delicate venous valves break down. The vein bulges under the constant strain and becomes a varicose vein that meanders over the leg in a curved or tangled shape.

Varicose veins: Often just the tip of the iceberg

But did you know? Varicose veins are only visible when veins directly under the skin are affected. In addition to these superficial veins, we also have veins that run deeper in the tissue. These veins can also weaken and expand too much. And this is sometimes more dangerous, precisely because you can’t see it!

Sometimes “hidden” varicose veins deep down are the actual cause of dilated veins on the surface. And there is almost always venous insufficiency long before a thick, crooked varicose vein clearly draws attention to itself.

Varicose veins: recognizing symptoms

Visible varicose veins often only develop with advanced venous insufficiency. It is therefore important to also look out for more subtle signs. The following symptoms may indicate varicose veins or venous insufficiency:

  • Spider veins: precursors of varicose veins?

    Do thin, net-like blue-reddish veins shimmer through the skin on your legs? Spider veins are often an aesthetic blemish, but in rare cases they can also be an indication of venous insufficiency and a consequence of varicose veins. They are sometimes mistakenly referred to as mini varicose veins or as a preliminary stage of varicose veins, but they are usually the result of such vein problems.

    If they bother you visually Spider veins can be easily removed. It is only important to have the leg veins examined by ultrasound beforehand if there are more than a few spider veins.

  • Water retention and heavy legs

    If veins are permanently overfilled with blood, a little fluid always leaks through the overloaded vein walls into the tissue. The result: water retention, also known as oedema. There are many causes of oedema, but one of the most common is venous insufficiency.

    Do your legs feel heavy, especially in the evening, in the heat or after standing for a long time? Do your calves become noticeably thicker? Can you press a dent in the skin with your finger? If so, this may be an indication of venous insufficiency.

  • Pain in the legs

    Painful legs can have very different causes, and conversely, not every varicose vein is painful. Nevertheless, dull or throbbing pain, which worsens in the heat or when standing, can be possible symptoms of varicose veins, as can cramps in the calves at night.

  • Skin changes

    When blood and tissue fluid build up in the leg, the skin receives too few nutrients and waste products accumulate. This can cause itching or visible skin changes on the calves or in the ankle area: The skin becomes thin, scaly, may turn brownish in color or show pinpoint hemorrhages. In extreme cases, an open ulcer may even develop. All these changes happen gradually over many years, not suddenly. Taken together, they are an indication of advanced venous disease.

Varicose veins: Causes

But why do varicose veins actually develop? As you already know, leg veins work hard all their lives, carrying blood upwards against the force of gravity. You can’t blame them if some of them give out in the course of your life.

Whether this happens sooner or later – or not at all – depends on various factors:

  • Predisposition: Varicose veins run in families – you have little control over this.
  • Age: Just as your skin ages, veins also become weaker over time and lose their elasticity, which promotes varicose veins.
  • Lack of exercise: An active musculature promotes blood circulation in the legs, so our sedentary lifestyle is not very vein-friendly. Occupations that involve a lot of standing are also unfavorable.
  • Overweight: Even if the reasons are not fully understood: Studies show that too many kilos on the scales also increase the risk of venous disease and varicose veins.

Unfortunately, many of these risk factors cannot simply be eliminated. This is precisely why varicose veins and venous disease are so common.

Varicose veins during pregnancy

Another risk factor is pregnancy – baby bumps, stretch marks and varicose veins often go hand in hand. For various reasons: Firstly, significantly more blood circulates in the body during pregnancy, which increases the pressure in the veins. The hormones released also soften the blood vessels. Towards the end of pregnancy, the baby can also directly obstruct the blood flow.

The good news is that varicose veins that first appear during pregnancy often disappear on their own.

Varicose veins: When to see a doctor?

Varicose veins are often dismissed as a purely cosmetic problem. But they are not: varicose veins should be treated, as they can lead to secondary diseases. Some of these are serious, such as thrombosis, phlebitis, venous bleeding or leg ulcers.

Even if you currently have no symptoms: For the sake of your health, you should have visible varicose veins checked by a doctor. A visit to the doctor is also worthwhile if there are warning signs such as frequently swollen legs. As already mentioned, not every vein weakness is clearly recognizable as a varicose vein.

Important: Diseased veins can also affect other vessels. Early treatment can prevent such domino effects. You can find out more about the treatment options, which are usually gentle and minimally invasive, in our guide to treating varicose veins.

Any questions? Our FAQ section has the answers!

There is little that can be done to prevent genetic or age-related connective tissue weakness. But what is within your control: You can maintain a normal weight and incorporate regular exercise into your daily routine. Anything that challenges your calf muscles is good. If you have to sit a lot, frequently elevating your legs will also relieve the pressure on your veins.

Unlike spider veins, varicose veins are unfortunately never a purely cosmetic problem. If left untreated, they can lead to unpleasant and sometimes dangerous secondary diseases: From water retention and skin problems to venous thrombosis or open skin ulcers. To avoid this, you should have varicose veins treated early.

Treacherously, varicose veins often cause no pain at all. However, feelings of pressure and tightness or dull, throbbing pain can be an indication of varicose veins or venous insufficiency. The symptoms usually improve with movement or elevation of the legs.

The reason for varicose veins is venous insufficiency: the walls of the veins give way too much. As a result, the venous valves, which are supposed to direct the blood to the heart, can no longer close properly. The blood keeps flowing back downwards, causing the vein to expand increasingly. At some point, it remains permanently dilated.

This only applies to varicose veins that develop during pregnancy: they often disappear on their own after the birth. In all other cases, varicose veins unfortunately do not disappear on their own without treatment.

Active leg muscles support the work of the veins. Sports such as running, Nordic walking, swimming or even just a brisk walk therefore promote vein health. Unfortunately, as this does not cure existing venous insufficiency, sport does not automatically protect you from varicose veins.

More questions? Simply make a personal consultation appointment online.

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References

Last update: 25.02.2025

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