Varicose veins usually won't go away on their own. But if they are causing you problems, treatments can help your legs look and feel much better. Some treatments have side effects, so you need to consider the pros and cons when deciding what's right for you.

Veins are the tubes (or blood vessels) that carry blood to your heart. Other tubes called arteries carry blood away from your heart and around your body.

Blood enters your veins once it has delivered oxygen and food to cells in your body. The blood in your veins looks blue through your skin because it doesn't have oxygen in it.

Veins are stretchy. Usually, they expand and tighten to let different amounts of blood pass through them. The wall of a vein has a smooth inner lining.

You have three sets of veins in your legs: deep veins, surface veins and connecting veins.

Once your blood has delivered oxygen and food to the cells in your legs, it collects in your surface veins. The blood then flows into the deep veins through the connecting veins and goes back to your heart.

 

 

 

 

 

Source:
Green D.
Sclerotherapy treatment insights.
Dermatologic Clinics. 1998; 16: 195-211.

 

 

 

 

 

¹

Deep veins are the largest. You can't see them because they run deep within and between the muscles inside your legs.

Surface veins are just under your skin. You can probably see them, especially when your legs get hot (for example, when the weather's warm or you have just gotten out of the bathtub). These are the veins that may become varicose. You have two main surface veins in each leg. One runs the full length of your inside leg from your ankle to your

 

 

 

 

 

groin
Your groin is the top, inside part of your thighs.

 

 

 

 

 

groin. The other surface vein runs up the back of your leg from your ankle to just past your knee. Doctors call both these veins saphenous veins. Blood flows from these veins into deep veins.

Connecting veins join surface veins to the deep veins. They are small veins, and there are lots of them. Doctors sometimes call them perforating veins.

Most veins have a system of valves that help push blood back up to your heart. This is because, except for when you are lying down, the blood from the lower half of your body has to flow back toward your heart against gravity.

One-way valves in the walls of your veins make sure blood flows only toward your heart. When blood flows through a valve, the valve closes to keep the blood from flowing backward.

The muscles in your legs also help pump blood up toward your heart. When you stand, walk or make other movements, your muscles tighten and squeeze blood in the veins upward, against gravity.

You get varicose veins when the valves that normally keep blood flowing up through your legs don't work properly. This means that blood flows back down the vein instead of getting pushed up toward your heart. Blood then pools in your vein, which makes the vein bulge.

Doctors don't really know why your valves stop working properly. It may start with a weakness in the valve or a weakness in the wall of your vein. If the wall is weak, your vein overstretches. This means the valve can't close properly.

 

 

 

 

 

Source:
London NJ, Nash R.
ABC of arterial and venous disease: varicose veins.
BMJ. 2000; 320: 1391-1394.

 

 

 

 

 

²

 

 

 

 

 

Source:
Tran NT.
Epidemiology, pathophysiology, and natural history of chronic venous disease.
Seminars in Vascular Surgery. 2002; 15: 5-12.

 

 

 

 

 

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Source:
Creager MA, Dzau VJ.
Vascular diseases of extremities: varicose veins.
In: Braunwald E, Hauser SL, Fauci AS, et al. (editors). Harrison's principles of internal medicine. 15th edition. McGraw Hill, New York, U.S.A.; 2001.

 

 

 

 

 

⁴

 

 

 

 

 

Source:
Sunthareswaran R.
Diseases of the veins and lymphatics: varicose veins.
In: Mosby's crash course: cardiovascular system. Mosby, London, UK; 1998.

 

 

 

 

 

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The most common places where valves in veins stop working are:

Varicose veins affect your surface veins. This is why you can see them through your skin. The surface veins usually affected are the two main ones, called saphenous veins (see above). Varicose veins often appear on the backs of the calves, or on the inside of your leg, anywhere from your groin to your ankle.

Varicose veins appear mainly on your legs. But you can have similar problems with bulging veins in and around your anus, where they form

 

 

 

 

 

hemorrhoids
Hemorrhoids are swollen veins in the anus. Sometimes you can see or feel them and sometimes they are inside the anus. Hemorrhoids can hurt and bleed. They usually happen when you strain a lot to pass a stool.

 

 

 

 

 

hemorrhoids. Men may also get varicose veins in their scrotum. This is the pouch that hangs behind the penis and holds the testicles. Doctors call varicose veins in the scrotum a varicocele.

Varicose veins don't look nice, but:

There are lots of veins taking blood from the surface of your legs to the deeper veins. So if one vein doesn't work properly, there are lots of other veins that can bring the blood back to your heart.

 

 

 

 

 

Source:
London NJ, Nash R.
ABC of arterial and venous disease: varicose veins.
BMJ. 2000; 320: 1391-1394.

 

 

 

 

 

²

A small number of people get varicose veins as a result of problems in their deep veins. See More serious problems in your veins.

Certain things make it more likely that you'll have varicose veins. These are called risk factors.

You may be more likely to have varicose veins if you're overweight, or if you're a woman and you are pregnant. Your family history also may be important, but researchers aren't sure. To learn more, see Are you at risk of varicose veins?

Keep in mind that even if you have a risk factor, that doesn't mean you will get varicose veins.

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