I have varicose veins – should I worry and what can I do about them?

What Causes Varicose Veins?

Arteries carry blood away from the heart, and veins bring it back. But that's a tougher job in the legs, where blood has to travel upward, Dr Faisal said. So your body relies on a two-part system: As you move around, your calf muscles squeeze the veins in your legs and push blood upward, while one-way valves keep that blood from travelling back down, said Dr Isabella Kuo, a vascular surgeon at University of California Irvine Medical Center.

Varicose veins form when these valves weaken or don't close properly. Blood pools in the legs and pressure builds, causing the veins to enlarge. Family history is the strongest risk factor for varicose veins, Dr Faisal said, but ageing, excess weight and jobs that require long stretches of sitting or standing also increase the odds. Women are more likely to develop varicose veins too, and while the reasons are not fully clear, hormone replacement therapy and pregnancy probably play a role, Dr Kuo said.

Because many of these risk factors are beyond a person's control, there is not much people can do to prevent varicose veins. But staying active, maintaining a healthy weight and taking breaks from long sedentary periods can help reduce strain.

Are Varicose Veins Dangerous?

If varicose veins aren't painful or bothersome, it's perfectly fine to ignore them, said Dr Angela Kokkosis, director of the centre for vein care at Stony Brook Medicine. However, many cases are symptomatic and worth getting checked out. For example, as blood pools in the veins, it can cause pain, tenderness and a feeling of heaviness in the legs. If the pressure stays elevated, fluid and red blood cells can seep into nearby tissue, Kokkosis said, causing swelling; itchy, dry skin; and discoloration. In rare cases, varicose veins can lead to ulcers, particularly without treatment, Dr Faisal said. Varicose veins are also tied to a higher risk of deep vein thrombosis, a potentially dangerous blood clot. So, sudden swelling or pain in just one leg – especially after a long sedentary stretch, like a trans-Atlantic flight – deserves prompt attention.

What Can You Do About Varicose Veins?

Varicose veins can't be cured, but doctors recommend starting with some simple changes to help slow their progression. The goal is to help blood move back up the legs, Dr Kokkosis said. Taking a short walk or flexing your feet at your desk – at least every hour – can help keep your calf muscles engaged. When sitting or lying down, doctors also recommend elevating your legs for about 15 minutes at a time. Wearing compression stockings during the day can help as well. They apply external pressure to the legs, thus helping counteract gravity and reduce blood pooling. Compression stockings are one of the best tools for symptom relief, Dr Faisal said, but can be uncomfortable, especially in hot weather. But there are ways to make them more manageable. Most people don't need the strongest, thigh-high versions; knee-high stockings with moderate compression typically work well, he added. And if you have trouble wearing them every day, at least do so on days when you'll be sitting or standing for long stretches, Dr Kokkosis said.