Frequently asked questions about varicose veins

Mr Sohail Choksy, our expert surgeon, answers some common questions about varicose veins. Read on to find out more about your condition.

What are varicose veins?

Varicose veins are enlarged and twisted veins that appear beneath the skin, usually affecting the legs. They are very common, and affect up to a third of the population.

Veins are the blood vessels that carry blood back to the heart. You can find them all over the body, including the legs. Veins contain valves, which keep the blood moving in the right direction. The valves are not working properly in varicose veins, which causes the blood to pool in your legs and the veins to swell up.

What are the symptoms of varicose veins?

Varicose veins most often cause an unsightly appearance to the legs. They can also cause other symptoms such as: aching/heaviness in the legs, itching or burning over the veins, swollen feet and ankles, cramps, and restless legs.

In more severe cases, the skin around the lower calf and ankle can start to be affected. You may notice dry, inflamed patches of skin known as venous eczema. It can also cause brown patches of skin staining, small thread veins (spider veins), or skin breakdown (leg ulcers). Sometimes, the varicose veins can develop a blood clot within them, which causes the vein to be hard, painful and inflamed – this is known as superficial thrombophlebitis.

What causes varicose veins?

Varicose veins are caused by the valves inside the veins not working. The exact cause is not fully understood, however there are a number of things which increase your chances of developing them.

Varicose veins often run in families. They can be worsened by professions which involve a lot of standing, such as nursing. They will often first appear, or get worse, during pregnancy. They are more common in women, and as you get older. Being overweight also increases the risk of developing varicose veins.

How can varicose veins be treated?

There are a number of treatment options for varicose veins. Depending on your specific symptoms, they may be treated with surgery or small injections. They can also be managed conservatively by wearing compression stockings to help improve the circulation. See our treatments page for more details.

Should I be worried about my varicose veins?

If you are content with the appearance and do not have any other significant symptoms or complications, you can leave them be. Should your symptoms get worse over time, you may want to get treatment for them.

What are thread veins? Are they different to varicose veins?

Thread veins (or spider veins) are different to varicose veins. These are very thin veins beneath the skin. They may be an early sign that the veins in your legs are not working properly, even if you do not have any visible varicose veins.

Thread veins are usually painless and do not cause any probems, but may appear unsightly. They can be treated with microsclerotherapy injections.

Spider Veins on Leg
Can varicose veins cause a DVT?

In the legs, there are two systems of veins: deep veins and superficial veins. The superficial veins join the deep veins at certain points in the body, including in the groin and at the back of the knee. Varicose veins affect the superficial veins. Blood clots in the deep veins are known as a deep vein thrombosis, or a DVT.

The vast majority of patients with varicose veins do not suffer with a DVT. However, several studies have shown that patients with varicose veins are at higher risk of DVT. We don’t know the exact reason why, but it is thought that it may be due to the inflammation causing a greater risk of developing blood clots (a “prothrombotic state”).

Varicose veins can also develop blood clots, known as superficial thrombophlebitis. This is less serious than a DVT, but you should still seek medical treatment. Very rarely, a large blood clot in the superficial varicose vein can extend into the deep veins, causing a DVT.