Varicose veins, also known as varicoses or varicosities, occur when your veins become enlarged, dilated, and overfilled with blood. Varicose veins typically appear swollen and raised, and have a bluish-purple or red color. They are often painful.

The condition is very common, especially in women. Around 25 percent of all adults have varicose veins. In most cases, varicose veins appear on the lower legs.

Varicose veins occur when veins aren’t functioning properly. Veins have one-way valves that prevent blood from flowing backward. When these valves fail, blood begins to collect in the veins rather than continuing toward your heart. The veins then enlarge. Varicose veins often affect the legs. The veins there are the farthest from your heart, and gravity makes it harder for the blood to flow upward.

Some potential causes for varicose veins include:

• pregnancy
• menopause
• age over 50
• standing for long periods of time
• obesity
• family history of varicose veins

The primary symptoms of varicose veins are highly visible, misshapen veins, usually on your legs. You may also have pain, swelling, heaviness, and achiness over or around the enlarged veins.

In some cases, you can develop swelling and discoloration. In severe cases, the veins can bleed significantly, and ulcers can form.

Your doctor will likely examine your legs and visible veins while you’re sitting or standing to diagnose varicose veins. They may ask you about any pain or symptoms you’re having.

Your doctor may also want to do an ultrasound to check your blood flow. This is a noninvasive test that uses high-frequency sound waves. It allows your doctor to see how blood is flowing in your veins.

Depending on the location, a venogram may be done to further assess your veins. During this test, your doctor injects a special dye into your legs and takes X-rays of the area. The dye appears on the X-rays, giving your doctor a better view of how your blood is flowing.

Tests such as ultrasounds or venograms help ensure that another disorder like a blood clot or a blockage isn’t causing the pain and swelling in your legs.

In general, doctors are conservative when treating varicose veins. You’ll probably be advised to make changes to your lifestyle, instead of trying more aggressive treatments.

Lifestyle changes

The following changes may help prevent varicose veins from forming or becoming worse:

• Avoid standing for extended periods of time.
• Lose weight or maintain a healthy weight.
• Exercise to improve your circulation.
• Use compression socks or stockings.

If you already have varicose veins, you should take these steps to prevent new varicose veins. You should also elevate your legs whenever you’re resting or sleeping.

Compression

Your doctor may advise you to wear special compression socks or stockings. These place enough pressure on your legs so that blood can flow more easily to your heart. They also decrease swelling.

The level of compression varies, but most types of compression stockings are available in drugstores or medical supply stores.

Surgery

If lifestyle changes aren’t working, or if your varicose veins are causing a lot of pain or damaging your overall health, your doctor might try an invasive procedure.

Vein ligation and stripping is a surgical treatment that requires anesthesia. During the procedure, your surgeon makes cuts in your skin, cuts the varicose vein, and removes it through the incisions. Although updated variations of vein-stripping surgeries have been developed, they are less commonly performed because newer, less invasive options are available.

Other treatment options

Currently, a wide variety of minimally invasive treatment options for varicose veins are available. These include:

• sclerotherapy, using a liquid or foam chemical injection to block off a larger vein
• microsclerotherapy, using a liquid chemical injection to block off smaller veins
• laser surgery, using light energy to block off a vein
• endovenous ablation therapy, using heat and radiofrequency waves to block off a vein
• endoscopic vein surgery, using a small lighted scope inserted through a small incision to block off a vein

You should always talk to your doctor about your treatment options and the risks before choosing a method. The method recommended can depend on your symptoms, size, and location of the varicose vein.