Two legs with varicose veins in a sitting position

Varicose veins are enlarged, gnarled veins that are no longer effective at circulating blood through the body. They have a bulging, cord-like appearance and can sometimes even cause symptoms. The more you know about this condition, the more you can know what path is right for you if you are living with varicose or spider veins.

What are Varicose Veins and Spider Veins?

Veins are the highways of the body, carrying blood pumped by the heart along a network of “roads” (arteries and veins) to bring oxygen to all the different parts of the body. The body’s natural movement helps pump blood back to the heart where it is sent out again in this continuous cycle.

Sometimes, however, the blood doesn’t make it back to the heart the way it should, but collects in veins instead. Over time, this collecting blood causes varicose and spider veins.

A woman holds a magnifying glass up to varicose veins.

All veins have valves that act like traffic signals, opening and closing to make sure blood is always flowing the correct direction. Varicose veins are veins with broken valves. In a varicose vein, blood flows backward and stays in the vein, causing the vein to expand, stretch, and become twisted—all of which prevents it from circulating blood effectively.

Spider veins are similar to varicose veins. The main differences are they are generally smaller with purple or red coloration and occur closer to the surface of the skin.


Overall symptoms vary from person to person, but varicose veins can almost always be identified by their blue or purple color and their twisting, bulging, or cord-like appearance. This condition occurs most often in the legs where the blood is farthest away from the heart.

Some patients are simply bothered by the way varicose veins look, while others experience itching, pain, and tiredness in their legs.

In the most extreme cases, patients suffer bleeding, vein hardening, and skin ulcers near the ankle. These symptoms indicate serious vascular disease, and if you are experiencing any of them, you should seek medical attention.

Risk Factors

The American Society for Vascular Surgery estimates that 20-25 million Americans have varicose veins, making them one of the most common vein diseases in the country. Many factors can lead to varicose veins and spider veins, including:


As the body ages, veins stretch, and valves weaken. Both of these issues can lead to veins becoming varicose.


Pregnant women experience a decrease in the flow of blood to their legs as their blood flow shifts to support the growing fetus. This change in blood flow can lead to enlarged veins in the legs, which have a higher chance of becoming varicose.


For various reasons–mostly related to natural hormonal differences–women are up to four times more likely to develop varicose veins than men.

Family History

Varicose veins tend to run in the family. If you have a relative with varicose veins, your own chances of developing them are higher.


Being overweight puts greater than normal strain on the cardiovascular system. Over time, this strain wears down veins and their valves, resulting in greater risk of varicose veins.


Sitting or standing for long periods of time on a regular basis can make it difficult for blood to circulate correctly, raising your risk of developing varicose veins over time.

A woman with varicose veins holds her leg in pain

Diagnosis and Self Referral

If you’re living with varicose or spider veins, you can refer yourself and meet with a specialist right away without consulting your general care provider. A painless ultrasound is usually performed as a way to further identify any problem veins. After diagnosis, the doctor should go over the different treatment options available for you, including EVLT or VenaSeal for varicose veins and sclerotherapy for spider veins.

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