Varicose veins are incredibly common — especially among adult women — and they are also distinct in appearance: Blue, purple-tinted twists and turns underneath the skin, which usually take shape on the legs. For some people, varicose veins are merely a cosmetic issue (that can easily and quickly be fixed, thanks to advancing technologies and approvals by the Food and Drug Administration). While for others, the presence of these swollen, enlarged veins can bring on a host of painful side effects.
Here, we asked a handful of experts to explain everything about varicose veins, including what they are in the first place, why they form, and the potential risk factors that contribute to their development. If you’re an adult of any age — but especially if you’ve ever taken oral contraceptives — this is what you need to know about varicose veins.
What are varicose veins?
In simple terms, varicose veins are veins that become enlarged, twisted, and pooled with blood (which gives them their distinct bluish, purple-colored appearance). Technically speaking, “varicose veins are a condition where the deeper, large veins of the legs stop working normally and cause the vein to back up with blood, [thereby] becoming stretched out and dilated,” explains George Skandamis, a board-certified dermatologist in Ohio.
The result of this backlog is swelling of the veins, which causes them to become visible on the surface of the skin. Varicose veins are often diagnosable simply by their appearance, although your doctor may use an ultrasound to confirm that the valves aren’t working properly.
Varicose veins can range in severity from thin, threadlike veins (spider veins) to “deeper vessels called reticular veins which appear as medium-sized bluish veins under the skin,” explains Laura Haygood, a board-certified dermatologist in Tyler, Texas. “The largest deep connecting varicose veins are not usually visible unless special ultrasound devices are used. ” Varicose veins are most commonly found on the lower leg and inner thighs, as well as the shins, calves, and ankles (we’ll explain why).
For some people, varicose veins are purely a cosmetic issue. For others, however, varicose veins can cause potentially debilitating physical symptoms like pain, aching, cramping, and restless legs. They might also cause the skin to become irritated or itchy, and some research suggests these symptoms can potentially worsen in warmer weather.
What causes varicose veins to form?
To understand what causes veins to become varicosed, it helps to first understand the body’s venous system. Our veins, when functioning properly, operate as one-way streets: Moving blood from our peripheries (legs, arms, everywhere else) back to the heart.
Healthy veins “have little trap-door valves that don’t allow blood to go backward,” Skandamis explains. “When the vein is overworked from having to push blood up the body against gravity, the valves seals become leaky and blood is allowed to go backward, leading to the vein becoming enlarged.”
This explains why varicose veins almost always occur on the legs — because when we’re standing or sitting, our veins have to work against gravity to do their job. “As gravity pulls everything down, veins tend to accumulate blood and it becomes harder for blood to travel upwards back towards the heart,” says Danny Del Campo, a board-certified dermatologist in Chicago. “As time goes on, this backup of pressure leads to collapse of valves in the veins.”
Varicose veins often develop as part of the aging process, after years of “increased venous pressure caused by standing or sitting in one position for prolonged periods,” explains Haygood.
Other potential risk factors for developing varicose veins include, “family history, pregnancy, lack of exercise, and weight gain,” she says.
Who is most susceptible to developing varicose veins?
Everyone, but especially those who are pregnant and/or have had more than one child, are at a higher risk for developing varicose veins than the general public. In fact, varicose veins affect nearly twice as many women as men, and spider veins may be an issue for half of all women, according to the U.S. Department of Health & Human Services Office on Women’s Health. Why?