Patient Basics: Varicose Veins

Varicose veins are swollen, twisted veins that bulge under the skin, most often on the legs. They form when tiny valves inside the veins stop working well, so blood pools instead of flowing back up to the heart. About 1 in 4 adults has them. They are usually harmless, but they can ache, and simple office treatments can close them off.

Key points

• Age, pregnancy, family history, extra weight and long hours of standing all raise the risk.
• Symptoms include aching, heavy or swollen legs that feel better when you raise them.
• Walking, raising your legs and wearing compression stockings ease symptoms.
• No pill makes varicose veins go away. Procedures that seal or remove the vein work well.
• Sudden pain and swelling in one leg can be a blood clot and needs urgent care.

What causes varicose veins

Leg veins carry blood up to the heart against gravity. One-way valves inside them stop blood from sliding back down. When the vein walls stretch or the valves weaken, blood leaks backward and collects. The vein swells, twists and becomes visible. Doctors call this backward flow venous reflux.

You’re more likely to get varicose veins if you:

• Are older, since valves wear out with age
• Are female. Hormones in pregnancy, around periods and with menopause relax vein walls
• Are or have been pregnant. More blood volume and pressure from the growing uterus strain leg veins
• Have a parent or sibling with varicose veins
• Have overweight or obesity
• Stand or sit for long stretches at work
• Had a blood clot in a leg vein in the past

Spider veins are a smaller relative. They are thin red, blue or purple lines close to the skin’s surface, often on the thighs, ankles or face. They rarely cause symptoms.

Varicose vein symptoms

• Dark blue or purple veins that look like bulging cords
• Aching, heavy or tired legs, often worse by evening
• Throbbing, burning or night cramps in the legs
• Swelling around the ankles
• Itching over the veins

Over years, poor blood flow can change the skin near the ankle. It may turn brown, become thick and hard, or develop a rash. In some people an open sore (venous ulcer) forms that is slow to heal.

How they’re diagnosed

A doctor looks at your legs while you stand. If you have symptoms or are thinking about treatment, you’ll usually have a duplex ultrasound. This painless scan shows which veins have leaky valves and checks for blood clots.

Treatment for varicose veins

Self-care

• Move. Walking works the calf muscles, which squeeze blood up the legs.
• Raise your legs above heart level for 15 minutes a few times a day.
• Take breaks from standing or sitting. Flex your ankles often on long trips.
• Wear compression stockings. They squeeze most at the ankle and less higher up, which helps blood flow up. Ask your doctor what strength to use, and put them on in the morning.
• Keep a healthy weight and protect the skin with moisturizer.

Medicines

No medicine dissolves varicose veins. Pain relievers such as acetaminophen or ibuprofen can ease aching. Some supplements, such as horse chestnut seed extract and diosmin, may ease swelling and heaviness a little, but they don’t shrink the veins. Talk to your doctor before trying them, especially if you take a blood thinner.

Procedures

Most are done in a clinic with numbing medicine, and you walk out the same day.

• Heat ablation. Using ultrasound to guide it, the doctor slides a thin tube into the faulty vein and seals it with laser or radiofrequency heat. Blood reroutes through healthy veins.
• Vein glue. A medical adhesive closes the vein without heat.
• Sclerotherapy. A liquid or foam is injected into smaller veins. It scars them shut, and they fade over weeks. It’s also the main treatment for spider veins.
• Phlebectomy. Bulging veins near the surface are pulled out through tiny nicks in the skin.
• Surgery. Tying off and removing a vein (stripping) is now done far less often.

Health plans often pay for treatment when veins cause symptoms or skin changes, usually after a trial of compression stockings. Treatment for looks alone is usually not covered.

Possible problems

• Superficial thrombophlebitis. A clot in a vein near the skin makes a hard, red, tender cord. Warm packs and pain relievers usually help, but see a doctor, since clots can spread to deeper veins.
• Bleeding. A vein near the surface can bleed a lot after a small knock. Lie down, raise the leg and press firmly on it.
• Deep vein thrombosis (DVT). Varicose veins raise the risk of a clot in a deep leg vein.
• Skin ulcers near the ankle

When to see a doctor

• Veins that ache, throb or swell enough to bother you
• Skin changes, a rash or a sore near the ankle
• A hard, red, painful lump along a vein

Get emergency care for sudden pain and swelling in one leg, chest pain or sudden shortness of breath, or a bleeding vein that won’t stop with firm pressure. Call 911.

Common questions about varicose veins

Is there a medicine or pill for varicose veins?

No pill gets rid of varicose veins. Pain relievers can ease aching, and some supplements may help heaviness and swelling a little. To close or remove the veins, you need a procedure such as heat ablation, vein glue or sclerotherapy, along with compression and exercise.

Are varicose veins dangerous?

Usually not. For most people they cause aching or are a cosmetic worry. Some people develop skin changes, ulcers, bleeding or blood clots, especially after many years. See a doctor if you have pain, swelling or skin changes.

Will varicose veins go away on their own?

Not usually. Veins that appear during pregnancy often shrink within months after the baby is born. Other varicose veins tend to stay or slowly get bigger. Exercise and compression help symptoms but don’t make the veins disappear.

Can varicose veins come back after treatment?

A treated vein rarely reopens, but new varicose veins can form over the years because the tendency remains. Staying active, keeping a healthy weight and wearing compression on long days can slow this down. Follow-up treatment is often quick.

Questions to ask your doctor

• Do I need an ultrasound of my leg veins?
• Which compression stockings should I wear, and for how long each day?
• Which procedure suits my veins, and how many sessions will I need?
• Will my health plan cover treatment?
• What can I do to keep new veins from forming?

Learn more

• Varicose veins (National Heart, Lung, and Blood Institute)
• Varicose veins (MedlinePlus, U.S. National Library of Medicine)

This guide is general information and doesn’t replace advice from your own doctor. Last updated October 2026.