7 symptoms of varicose veins you shouldn’t ignore

By Dr. Javairiah Fatima, Vascular Surgery, Danbury Hospital, part of Northwell Health.

Varicose veins are swollen, twisted veins that often look blue or purple. They usually show up on your legs and can be easy to spot. These veins form when tiny valves inside them stop working properly, causing blood to pool. While some people think varicose veins are just a cosmetic issue, they can sometimes signal more serious health problems. Knowing the symptoms can help you catch issues early and get the right care.

Navigate this article:

1. What are varicose and spider veins?
2. Symptoms you shouldn’t ignore
3. Causes and risk factors
4. When to see a doctor
5. Prevention tips
6. Treatment options
7. The bottom line

What are varicose and spider veins?

Varicose veins are large, bulging veins that often appear just under the skin, especially on the legs. They may look like twisted ropes and can cause discomfort or pain. 

Spider veins are smaller and closer to the skin’s surface. They’re usually red or blue and may look like a spider’s web. Unlike varicose veins, spider veins rarely hurt, but they can still be a sign of poor circulation.

7 symptoms you shouldn’t ignore

Varicose veins aren’t just a cosmetic issue — they can cause real discomfort and may point to more serious problems. 

Here are the symptoms to watch for:

1. Aching or heavy legs: Your legs might feel tired, sore or heavy, especially after standing or sitting for a long time. This is one of the most common signs.
2. Swelling in the lower legs or ankles: If your ankles or calves look puffy by the end of the day, it could be due to poor blood flow caused by varicose veins.
3. Itching or burning: You might feel itchy or notice a burning sensation around the veins. This can be a sign of irritation or inflammation.
4. Skin changes: Look out for dark patches, redness or dry, flaky skin near the veins. These changes can mean the skin isn’t getting enough oxygen.
5. Slow-healing sores: Sores or ulcers near your ankles that take a long time to heal could be a sign of advanced vein disease and need medical attention.
6. Bleeding: Sometimes, varicose veins can bleed if bumped or scratched. Even a small injury can cause a lot of bleeding, so don’t ignore it.
7. Hard or painful veins: If a vein feels hard, warm or painful to the touch, it might be a blood clot. This condition is called superficial thrombophlebitis and should be checked by a doctor.

Causes and risk factors

Varicose veins happen when the tiny valves inside your veins stop working the way they should. These valves usually help blood flow back to your heart. When they weaken or get damaged, blood can pool in the veins, making them swell and twist.

Here are some common reasons why varicose veins develop:

1. Family history: If your parents or grandparents had varicose veins, you’re more likely to get them too.
2. Getting older: As you age, your veins can lose strength and flexibility. This makes it harder for blood to flow properly.
3. Hormones: Changes in hormones — especially during pregnancy, menopause or while taking birth control — can relax vein walls and lead to varicose veins. That’s why women are more likely to get them.
4. Being overweight: Extra weight puts more pressure on your veins, especially in your legs.
5. Lack of movement: Standing or sitting for long periods can slow down blood flow. This makes it harder for your veins to push blood back to your heart.
6. Pregnancy: During pregnancy, your body makes more blood to support the baby. This can enlarge veins and increase pressure, especially in the legs.

When to see a doctor

Not all varicose veins need medical treatment, but some signs mean it’s time to check in with a healthcare provider. If you notice any of the following, don’t wait:

1. Severe or constant leg pain that doesn’t go away.
2. Swelling that gets worse or doesn’t improve with rest.
3. Skin changes, like dark patches, rashes or thickened skin near the veins.
4. Sores or ulcers near your ankles that are slow to heal.
5. Bleeding from a vein, even from a small bump.
6. Hard, warm or tender veins, which could be a sign of a blood clot.

These symptoms may point to a more serious condition like chronic venous insufficiency or superficial thrombophlebitis. Getting help early can prevent complications and improve your comfort.

Prevention tips

You can’t always stop varicose veins from forming, especially if they run in your family. But there are smart habits that can help lower your chances or keep them from getting worse:

Stay active

Exercise helps your blood flow better. Walking, swimming and biking are great ways to keep your legs strong and your veins healthy.

Keep a healthy weight

Extra weight puts pressure on your veins. Eating balanced meals and staying active can help you manage your weight.

Elevate your legs

When you’re resting, try to raise your legs above your heart. This helps blood flow back toward your heart and reduces swelling.

Avoid long sitting or standing

If your job keeps you on your feet or sitting for hours, take breaks to move around. Stretch your legs or walk for a few minutes every hour.

Wear compression stockings (if recommended)

These special socks gently squeeze your legs to help blood move more easily. Your doctor can tell you if they’re right for you.

Choose comfortable clothing

Avoid tight clothes around your waist, legs or groin. They can make it harder for blood to flow properly.

Treatment options

If varicose veins are causing pain or other problems, there are several ways to treat them. Some treatments are simple and can be done at home, while others may need a doctor’s help.

1. Compression stockings
   These special socks gently squeeze your legs to help blood move more easily. They can reduce swelling and discomfort. You can buy them at most drugstores, but your doctor might recommend a specific type.
2. Sclerotherapy
   This is a common treatment for small varicose and spider veins. A doctor injects a solution into the vein, which makes it close up and fade over time.
3. Laser therapy
   Laser treatments use strong bursts of light to close off smaller veins. It’s a quick procedure and doesn’t require any cuts or needles.
4. Minimally invasive procedures
   For larger veins, doctors may use heat (radiofrequency or laser) through a small tube to seal the vein shut. These treatments are usually done in a clinic and don’t take long to recover from.
5. Surgery (vein stripping or ligation)
   In more serious cases, a doctor may remove the damaged vein through small cuts. This is usually only needed if other treatments haven’t worked.

The bottom line: Varicose veins may seem like a small issue, but they can lead to bigger health problems if ignored. Knowing the symptoms, and what they might mean, can help you take action early. Whether it’s making simple lifestyle changes or talking to a doctor about treatment, there are steps you can take to feel better and protect your vein health.