Varicose veins are enlarged, twisted veins that often appear as blue or purple clusters, usually in the legs or pelvic area. They form when vein walls weaken and valves fail, causing blood to pool and veins to bulge. Sometimes, they’re surrounded by spider veins, which are small red capillaries visible just beneath the skin. While not always serious, varicose veins can lead to discomfort, swelling and aching.

It’s important to know that varicose veins can be more than a cosmetic issue. They signal inefficiencies in the circulatory system, which can place added strain on the heart as it works harder to maintain healthy blood flow. Over time, this can contribute to more serious cardiovascular issues.

Identifying varicose veins early is therefore important to prevent complications such as blood clots, skin ulcers and chronic venous insufficiency. Prompt treatment not only helps reduce discomfort but also supports healthy circulation, easing the workload on the heart and lowering the risk of future cardiovascular problems.

What Are the Types of Varicose Veins?

Varicose veins can develop in several forms, affecting different parts of the venous system and varying in size, appearance and severity. The most common types include:

Trunk Varicose Veins

These are the large, swollen and visible veins that typically bulge beneath the skin’s surface. Most often found in the branches of the large saphenous veins (which are superficial veins in the leg) and sometimes the abdomen or chest or running into the arms from these areas, trunk varicose veins are bluish or purple and can be twisted in appearance.

Reticular Varicose Veins

These are smaller than trunk veins and appear as flat blue, purple or green networks beneath the skin. They are often found on the backs of the knees, inner thighs and ankles. While they usually don’t bulge, they can cause discomfort.

Telangiectasia (Spider Veins)

These are the smallest type of varicose vein. They appear just below the surface of the skin as red, purple or blue webs and do not cause swelling or bulging. While they can develop anywhere, spider veins are most often found on the legs and can also occur on the face. Typically, they are harmless and cosmetic in nature but in some cases can be an early sign of an underlying issue, such as chronic venous insufficiency.

Pelvic Varicose Veins

These form around the pelvic region and are often linked to pelvic congestion syndrome, a condition that mainly affects women caused by enlarged veins in the pelvis that lead to persistent discomfort. Pelvic varicose veins aren’t always visible externally but can cause chronic pelvic pain. This type of varicose vein is frequently found in women who have had multiple pregnancies.

Perforator Varicose Veins

These occur when valves in the perforator veins, which are found in the legs, lead to visible bulging and aching in the surrounding areas. Over time, untreated perforator vein issues can contribute to more serious problems like skin discoloration or ulcers. Because they allow high-pressure blood to leak into superficial veins, they can also increase the risk of chronic venous insufficiency and non-healing wounds.

What Are the Causes and Risk Factors of Varicose Veins?

Varicose veins result from weakened vein walls and malfunctioning valves, which leads to blood pooling instead of flowing efficiently back to the heart. Several causes and risk factors contribute to their development, including:

• Aging – Veins naturally weaken over time, reducing blood flow efficiency.
• Being overweight – Extra weight adds pressure on leg veins, making them more prone to damage.
• Prolonged sitting or standing – Certain occupational demands, such as sitting in one position for long periods, restrict circulation and increase pressure in the veins.
• Hormonal changes – Shifts during pregnancy or menopause can reduce vein elasticity and impact valve function.
• Use of hormonal birth control – These can alter blood flow and interfere with normal vein valve performance.
• History of blood clots – Previous blood clots can weaken or scar vein walls and impair blood circulation.
• Liver disease, heart failure or fluid in the abdomen – These conditions increase pressure in the veins, making them more likely to swell.
• Prior groin or abdominal surgery – Such procedures may disrupt blood flow and impact the nearby veins.
• Smoking – This habit damages blood vessels and weakens overall circulatory health.
• Lack of physical activity – A sedentary lifestyle limits muscle support for veins, reducing circulation and vein strength.
• Chronic health conditions – Health issues such as diabetes and high blood pressure can impair circulation.

In addition, having a family history of varicose veins increases your risk of developing them. Hereditary factors can affect the strength of vein walls and the function of vein valves, making them more susceptible to weakening or malfunctioning. As a result, if your parents or siblings have varicose veins, you could be more prone to them as well.

What Are the Symptoms and Warning Signs of Varicose Veins?

Varicose vein symptoms can range from asymptomatic and mild to severe depending on how advanced the condition is. In asymptomatic cases, individuals don’t experience any noticeable symptoms. Mild cases involve visible veins with occasional aching or leg fatigue, while moderate cases often bring persistent swelling, discomfort and itchiness. In more severe cases, individuals experience skin changes, open sores (ulcers) and a higher risk of blood clots.

You should contact your healthcare provider immediately if you notice any of the following warning signs:

• Worsening leg pain or swelling
• Skin discoloration or ulcers near the ankles
• Bleeding from a varicose vein
• A hard or tender vein, which could indicate a clot
• Sudden, severe leg swelling
• Fainting or lightheadedness
• Chest pain or shortness of breath, as these may be signs of a serious vascular issue or pulmonary embolism

Diagnosis & Tests for Varicose Veins

Because the symptoms of varicose veins can resemble those of other conditions, such as chronic venous insufficiency, lymphedema or deep vein thrombosis, an accurate diagnosis is vital. As the first step, your physician will review your medical history and ask about leg discomfort, swelling, lifestyle factors and any family history of vein issues. Your doctor will also inspect your legs while both standing and sitting to assess for visible signs of varicose veins.

If additional tests are needed, your physician might recommend:

• Doppler ultrasound – A non-invasive test that uses sound waves to evaluate blood flow in both surface and deep veins.
• Echocardiogram (ECHO) – Assesses heart function to check for any underlying cardiovascular issues, typically only if a doctor suspects a heart condition is contributing to vein problems.
• Electrocardiogram (ECG/EKG) – Measures the heart’s electrical activity, especially if symptoms suggest circulation-related complications.
• Blood tests – Can detect clotting issues, inflammation or other contributing medical conditions.
• MRI or CT scan – Used in complex cases to get detailed images of blood vessels and rule out deep vein conditions.

These tests are important for understanding the extent of vein damage, evaluating blood flow and identifying any related heart or vascular issues.

How Do You Treat Varicose Veins?

Varicose veins are treatable through a combination of approaches, including lifestyle adjustments and medical procedures. While there is no cure, treatment can relieve discomfort, reduce complications and improve the appearance of affected veins.

Lifestyle Changes

Conservative management begins with daily habits that support vein health. Doctors often recommend:

• Wearing compression stockings – Improves blood flow and reduces swelling.
• Eating a heart-healthy diet – Supports weight management and reduces vein pressure.
• Regular physical activity – Promotes circulation and strengthens leg muscles.
• Elevating your legs – Helps reduce pressure on veins, especially after prolonged standing.
• Taking frequent breaks – Prevents blood from pooling in the lower extremities
• Quitting smoking – Supports vascular and overall heart health.
• Managing stress – Helps regulate blood pressure and circulation.

Surgical and Procedural Interventions

If lifestyle changes and compression therapy don’t offer enough relief, your physician may also recommend:

• Laser therapy – Uses light energy to close off small varicose veins. This procedure is typically done in-office and allows you to return to normal activities quickly.
• Radiofrequency ablation – A minimally invasive procedure that closes damaged veins using heat delivered through a catheter. This treatment can improve circulation and reduce symptoms with minimal discomfort and downtime.
• Sclerotherapy – Involves injecting a solution into the vein to collapse and fade it. It is often used for smaller varicose veins and spider veins. It can require multiple sessions for the best results.
• Vein stripping or phlebectomy – In rare, severe cases, surgical removal of veins is necessary. This procedure is usually considered when other treatments have not been effective and symptoms are significantly impacting daily life.

Medications

Although medications are not typically the first line of treatment for varicose veins, they can be used to manage symptoms or reduce the likelihood of complications. Common options include:

• Anticoagulants – Help prevent blood clots, especially in patients at risk for deep vein thrombosis.
• Over-the-counter pain relievers – Reduce swelling and associated pain in affected areas.
• Venoactive medications – Used in combination with other therapies to support vein tone and circulation.

What Are the Complications and Long-Term Effects of Varicose Veins?

Although varicose veins are often seen as a cosmetic concern, they can lead to serious complications if left untreated. The most severe is deep vein thrombosis (DVT). While rare, it can develop when a blood clot forms in a deep vein in the leg, blocking normal blood flow. If the clot breaks free, it can move to the lungs and cause a pulmonary embolism, a life-threatening medical emergency that requires immediate care.

Other potential complications and long-term effects of varicose veins include:

• Leg swelling and skin discoloration
• Painful and recurring leg ulcers, especially near the ankles
• Infections due to skin breakdown around affected veins
• Bleeding from surface veins
• Skin changes, such as hardening or thickening
• Superficial thrombophlebitis, which causes painful inflammation and clotting in veins near the skin’s surface

How Do You Prevent and Reduce Your Risk of Varicose Veins?

In addition to lifestyle changes like staying active, limiting prolonged standing or sitting and wearing compression stockings, regular monitoring plays a key role in preventing varicose veins. Routine check-ups with your healthcare provider or a vascular specialist can help detect early signs of vein dysfunction before symptoms become more severe. The process includes:

• Routine imaging to monitor vein health
• Adjustment of compression therapy based on progress
• Rehabilitation or support programs for recovery after a vein procedure

This is especially important for individuals with a family history of varicose veins or other risk factors. Paying close attention to changes in your legs, such as swelling, aching or skin discoloration, can lead to earlier treatment and better outcomes. Staying proactive with your vascular health helps reduce the risk of complications and supports long-term vein function.

Living with Varicose Veins

While factors like age, genetics, pregnancy, a sedentary lifestyle and excess weight can increase your risk of developing varicose veins, taking proactive steps can help improve their appearance and prevent further progression. To reduce discomfort and support vein health, incorporate small, healthy habits into your routine, such as:

• Wearing loose, comfortable clothing to avoid restricting blood flow.
• Elevating your legs above heart level several times a day and overnight to relieve pressure and aid circulation.
• Engaging in low-impact exercises like walking, swimming or cycling, which strengthen leg muscles and promote blood flow back to the heart
• Maintaining a balanced diet and healthy weight to reduce unnecessary strain on your veins.
• Keeping your skin clean and well-hydrated to support overall skin and vein health.
• Avoiding heat exposure from hot baths, saunas or prolonged sun exposure, which can worsen symptoms.
• Maintaining movement during long trips by taking walking breaks or doing leg exercises to lower the risk of venous thrombosis.

Varicose veins can also affect how you feel about your body or limit your activities, leading to stress or lowered self-esteem. Coping strategies such as mindfulness, therapy and staying informed about treatment options can help you manage these emotional effects.

The TGH Difference for Varicose Veins

Varicose veins are a common yet manageable condition that can impact both comfort and long-term vascular health. With early detection, lifestyle changes, medical therapies and minimally invasive procedures, most individuals can effectively control symptoms and prevent complications.

If you’re experiencing symptoms or concerned about your vein health, consulting a healthcare provider is the first step toward relief. A vascular specialist can assess your condition and recommend a personalized treatment plan that fits your needs and lifestyle.

At Tampa General Hospital, our Heart & Vascular Institute is recognized for delivering world-class care and innovation in vascular health. TGH is ranked among U.S. News & World Report’s Best Hospitals for Heart & Vascular Care for 2025–26 and was named one of America’s Best Specialized Hospitals for Cardiac Care in 2025 by Newsweek. Our team of experienced vascular specialists uses the latest diagnostic tools and treatment techniques to help patients achieve lasting relief and better health outcomes.

We also rely on a compassionate, patient-centered approach to care, ensuring you feel informed and supported at every stage of your treatment. Our team takes the time to listen to your concerns, explain your options clearly and work with you to create a care plan that aligns with your health goals and daily life.

Take control of your vein health and contact a vascular specialist at TGH today. Call (813) 844-3900 or email us at heart-vascular@tgh.org to request an appointment with a member of our team.