What Causes Varicose Veins?

One of the most common questions we get is “What causes varicose veins?”. Varicose veins are extremely common. In fact, millions of people in the U.S. alone will experience them in their lifetime. For some, these blue, bulging veins may be mainly a cosmetic nuisance. For others, varicose veins can have a variety of negative effects, such as pain, swelling, or more serious health issues like blood clots. Read on for a closer look at varicose veins, their causes, and what you can do about them.

What are varicose veins?

Varicose veins appear as bluish, rope-like cords bulging from beneath the skin’s surface. They’re one of two types of abnormal veins: spider veins and varicose veins.

Spider Veins

Spider veins are thin purple or blue veins that are located just below the surface of the skin. They tend to be more of a cosmetic concern and are mostly asymptotic.

Varicose Veins

Varicose veins are larger than spider veins and protrude from the skin. They also have much more severe symptoms than spider veins.

Causes of varicose veins

The circulatory system is responsible for the circulation of blood throughout the body. Arteries carry blood away from the heart, and veins carry blood back to the heart. In order to help blood move through your body, veins use small, one-way valves that open to push blood in the direction it needs to go – up towards the heart – and close to prevent blood from flowing backward. Sometimes, these valves become damaged or stop working, making it difficult – or even impossible – for blood to flow properly, causing some blood to flow backward and become trapped and pool within the vein. This is called venous reflux, or venous insufficiency. When this happens, the buildup of blood causes the vein to stretch and enlarge, leaving you with varicose veins.

Where do varicose veins occur?

While varicose veins can occur anywhere in the body, they most commonly form in the feet, ankles, and legs thanks to gravity. Valves in those low areas have to work harder than valves in more elevated areas of the body in order to transmit blood to the heart.

Risk factors

There are a lot of factors that can affect a person’s likelihood of developing varicose veins. These include:


As we get older, our bodies experience more wear and tear – and our veins are not excluded from that. As the valves in our veins become older and more worn, they may weaken and stop functioning as they should. When this happens, blood can gather and even flow backward, causing bulging varicose veins.


Your sex can also be a determining factor in your likelihood of experiencing varicose veins, with women experiencing them more often than men. Approximately one in three women and one in five men experience problems with varicose veins.

Weight gain and obesity

Veins are already under pressure due to gravity. When greater body weight is added to this, veins – especially those lower to the ground like in the legs and feet – are put under even more pressure, causing the valves to weaken. Additionally, if there’s too much salt in your diet, it can cause your body to retain water, resulting in added pressure on the veins.


As with any weight gain, the weight added during pregnancy causes more pressure on the veins in the legs and feet. Additionally, your body can experience an increase of blood during pregnancy, causing veins in your legs to enlarge. Changes in estrogen and progesterone hormone levels can also cause the walls of veins to relax, leading to varicose veins.

Prolonged sitting or standing

Blood doesn’t as easily flow through the body when you’re sitting or standing versus when you’re moving around. If you have a sedentary lifestyle or your job requires you to sit or stand for long periods of time, you may be at greater risk of developing varicose veins.


If your family has a history of varicose veins, you’re more likely to experience them for yourself.

What about diabetes? While diabetes doesn’t cause varicose veins, it can negatively affect the circulatory system and make existing venous insufficiency worse.


It’s important to note that while some symptoms of varicose veins are visible, there are non-visible signs as well. Visible symptoms include veins that appear large, swollen and ropey. Other symptoms can include fatigue, pain, heaviness, throbbing and intense swelling. You may also experience restless legs, night cramps, and itching and burning sensations. It’s possible to experience non-visible symptoms with or without visible varicose veins.

Treatment options

It’s important to consult a vein specialist if you have symptoms of venous insufficiency, such as pain, swelling, restless legs, or any of the symptoms mentioned earlier. Even if you only have what appear to be cosmetic spider veins, a vein specialist will be able to determine if there’s an underlying condition you may not be aware of. Remember, it’s easier to treat abnormal veins before they become large and twisted.

If you’re nervous about not having all of your veins post-treatment, don’t be! Varicose veins are dysfunctional, and leaving them as-is rather than treating them can actually make your symptoms worse. Your body has enough remaining healthy veins to pick up the slack, and blood flow can actually improve when you treat the veins that aren’t working correctly!

What to expect

While vein surgeries in the past were much more invasive, today’s treatments are less so, as well as more effective, have faster recovery times, and can be safely performed in a convenient outpatient center rather than a hospital.

When you arrive at the treatment center, you’ll likely undergo a diagnostic procedure called a duplex ultrasound. Painless and noninvasive, this procedure uses ultrasound imaging to allow specialists to get a better look at your veins, including how blood is moving plus the pathway and size of your varicose veins. The ultrasound is medically reviewed and enables doctors to recommend treatment plans for their patients.


There are multiple procedures that treat varicose veins. These include:

VNUS ClosureFast (RFA)

In this minimally invasive, non-surgical procedure, a small catheter is inserted into the varicose vein to direct radiofrequency energy into the vein walls. This makes the affected vein seal itself shut.

Endovenous Laser Treatment (EVLT)

This is another minimally invasive procedure. A small laser fiber is inserted into the diseased vein and directs laser energy into the vein wall. This causes the vein walls to shrink and collapse.

VenaSeal™ Closure

This safe and effective procedure uses a medical adhesive to close the vein. The procedure is virtually pain-free and doesn’t require an anesthetic.

Ambulatory Phlebectomy

This procedure is used on large veins that are close to the skin. The skin is numbed, an incision about 1 mm in size in made, and the diseased veins are removed from the body.


Using a small needle, a chemical solution is injected into the vein. The solution irritates the damaged vein and causes it to collapse. This procedure is typically used to treat spider veins and varicose veins in the legs.

Most insurance plans don’t require a referral, but a patient may need to have a primary care physician of record. Medicare and other insurance providers commonly cover procedures that are medically necessary, excluding VenaSeal™ Closure.


While there are no well-defined methods for preventing varicose veins, there are measures you can take to reduce your risk of developing abnormal veins as well as alleviate symptoms and slow varicose veins’ progression. One step is to avoid putting excess pressure on the veins’ valves by maintaining a healthy weight by eating nutritious meals and getting plenty of exercise. It’s also best to limit the amount of time you sit or stand; however, if your job requires sitting or standing for extended periods of time, try switching the positions you’re in or taking breaks to walk around. Wearing compression stockings – which help your leg muscles move blood upwards – can also be beneficial.

Are varicose veins dangerous?

While varicose veins can sometimes seem like an annoying cosmetic issue, they can turn problematic if they begin causing you pain or discomfort. If you have underlying venous disease, the backflow and pooling of blood can create a condition that gets worse as time goes on.


When left untreated, varicose veins can cause multiple complications. For example, the buildup of blood puts pressure on the tissues surrounding the vein, which can lead to skin discoloration and ulcers in the lower calves and ankles. Thrombophlebitis – more commonly known as blood clots – can form due to the stagnant blood flow. Since varicose veins have thinner walls and protrude from the surface of the skin, they can spontaneously rupture, causing bleeding or bruising. Leaving varicose veins untreated can also lead to the development of additional varicose and spider veins. With varicose veins’ ability to cause ongoing issues if left untreated, it’s important to consult a doctor if you notice any.

Whether your concerns about varicose veins are for medical or cosmetic reasons, talking to a vein specialist is an important step in ensuring you get the care you deserve. At the Columbus Vein Center, we specialize in the latest technologies and procedures to make your legs look and feel great. We work under the direction of two board-certified Interventional Radiologists fellowship-trained in vascular procedures, and our medical staff members have years of experience treating vein problems. Call or email us today to schedule a consultation!