Medically reviewed by: Luke Maj, MD
Twisted, rope-like, bulging, lumpy — even the description of varicose veins isn’t pretty. But are varicose veins dangerous, or are they just a cosmetic issue you can safely ignore? Here, a vein specialist at Water’s Edge Dermatology explains when to worry about varicose veins and why it’s smart to get an evaluation.
What causes varicose veins?
These enlarged veins appear when the valves in the veins don’t work properly. When the valves are in good condition, the veins do their job, which is to carry blood back to the heart. If the valves become weakened or damaged, blood pools in the veins, causing them to swell, bulge and turn purple or blue. Varicose veins can develop anywhere, but they most often develop in the legs. That’s because leg veins have to fight gravity to get blood all the way up to the heart.
Are varicose veins dangerous?
Varicose veins aren’t necessarily dangerous, but they can become dangerous. Here are some of the potential complications associated with varicose veins.
Deep vein thrombosis
People with varicose veins have an increased risk of developing blood clots in the deep veins of the legs, a condition called deep vein thrombosis, or DVT. In the worst-case scenario, a clot can break off and travel to the lungs. A clot that blocks blood flow to part of the lung, called a pulmonary embolism, can be fatal.
DVT requires immediate medical care. If you have leg swelling and calf pain, or your skin is red and warm to the touch, call your doctor right away.
A second possible complication is a clot that forms in the slow-flowing blood of a varicose vein and causes extensive redness and/or inflammation of the skin over the vein, as well as pain. The pain may be severe enough that even the light pressure of clothing is too much to bear.
If you have severe varicose veins and don’t get them treated, over time you may develop tough, thickened skin with brown discolorations.
Some people with severe varicose veins experience more serious complications, including leg ulcers, which can be extremely painful and hard to treat.
The role of chronic venous insufficiency
Varicose veins may be caused by a problem with the veins that should be treated.
“Many people don’t realize that varicose veins can result from an underlying condition called chronic venous insufficiency,” said Luke Maj, MD, an interventional radiologist and director of The Vein Center at Water’s Edge Dermatology. CVI develops due to dysfunctional valves, a blood clot in the leg or an injury to the vein.
“Chronic venous insufficiency often gets worse over time and can ultimately reduce your quality of life,” said Dr. Maj. Early treatment can help prevent leg ulcers and relieve heaviness, aching, leg cramps and other symptoms.
When to seek varicose vein treatment
Many people want to know how to get rid of varicose veins because they don’t like how they look, but treatment can also help you feel better and reduce the risk of complications.
“Leg pain or heaviness can cause people to stop exercising, which is bad for overall health and can exacerbate vein conditions,” said Dr. Maj. If your veins are painful, your legs ache or itch or you have leg swelling or sores, see a vein specialist for evaluation. If you experience a sudden increase in leg pain or swelling, see a doctor right away.
Doctors have a variety of ways to treat varicose veins, from compression therapy to minimally invasive procedures that close faulty veins or cause them to collapse.
“Treating varicose veins is much less invasive than it was in the past, when vein stripping was more common,” said Dr. Maj. Vein stripping requires anesthesia and a hospital stay. “Today, in most cases, patients can be treated in the office and resume their normal activities the same day.”
Minimally invasive procedures include laser treatment, radiofrequency ablation (which uses heat to close the vein), VenaSeal (in which a glue-like substance is inserted into the vein via a catheter) and sclerotherapy, in which an irritant solution is injected. Once varicose veins are closed, the blood will reroute through healthier veins.
Written by: Jessica Brown, a health and science writer/editor based in Nanuet, New York. She has written for Prevention magazine, jnj.com, BCRF.org, and many other outlets.