Are varicose veins dangerous?

Most varicose veins are benign but can lead to complications such as superficial thrombophlebitis, venous eczema, lipodermatosclerosis, or venous ulcers if left untreated. See a doctor if you notice skin changes or pain.

At what age do varicose veins appear?

Varicose veins can appear as early as your twenties, but they become more common after age 40. Hormonal factors (pregnancy, menopause) explain why women are more affected. Heredity plays a major role.

Can varicose veins be cured without surgery?

Compression therapy and lifestyle measures slow progression but do not cure established varicose veins. Current minimally invasive techniques (endovenous laser, radiofrequency ablation, sclerotherapy) can treat most varicose veins without traditional surgery, on an outpatient basis.

How much does varicose vein treatment cost?

The cost of varicose vein treatment varies by country, technique (surgery, laser, radiofrequency), and healthcare system. In many countries, treatment is partially or fully covered by insurance when medically indicated. Check with your insurer and treating physician for specifics.

Do you need to wear compression stockings after treatment?

Yes, compression stockings are generally recommended for 2 to 6 weeks after treatment. The exact duration depends on the technique used and your surgeon's recommendations.

Varicose Veins: Causes, Symptoms, and Complete Treatment Guide

Everything you need to know about varicose veins: causes, symptoms, treatments (surgery, laser, sclerotherapy) and prevention. Physician-reviewed guide.

Definition: What Is a Varicose Vein?

A varicose vein is an abnormally dilated, tortuous, and visible superficial vein under the skin. It results from a malfunction of the venous valves — small flaps that prevent blood from flowing backward in the legs.

When these valves no longer function properly, blood pools in the veins: this is venous insufficiency. Over time, pressure increases, the vein dilates, and becomes varicose.

Key figure: An estimated 23% of adults worldwide are affected by varicose veins, with prevalence increasing with age. Studies suggest that up to 30 to 40% of the population in Western countries will develop some form of chronic venous disease during their lifetime.

Causes and Risk Factors

Primary Causes

The venous insufficiency that causes varicose veins has two main origins:

Heredity — This is the number one risk factor. If your parents have varicose veins, you have a 60 to 80% probability of developing them.
Valvular incompetence — Venous valves weaken naturally with age.

Aggravating Factors

Prolonged standing: at-risk occupations (nurses, retail workers, chefs, hairdressers)
Sedentary lifestyle: lack of activity reduces venous return
Overweight and obesity: abdominal pressure impedes venous drainage
Pregnancy: hormones soften venous walls, blood volume increases
Heat: vasodilation promotes venous pooling
Age: venous walls lose their elasticity

Symptoms: How to Recognize Varicose Veins

Early Symptoms

Heavy legs, especially at the end of the day
Ankle swelling that worsens in the evening and resolves by morning
Restless legs or tingling sensations
Nighttime calf cramps

Advanced Symptoms

Visible veins — bluish, tortuous, bulging under the skin
Pain along the course of the varicose veins
Skin changes: eczema, brown discoloration (hemosiderin staining)
Venous ulcer: chronic wound near the ankle, the most severe complication

CEAP Classification

Physicians use the CEAP classification to assess severity:

C0: no visible signs
C1: telangiectasias (spider veins) and reticular veins
C2: varicose veins (dilated veins > 3 mm)
C3: edema
C4: skin changes (eczema, pigmentation)
C5: healed ulcer
C6: active ulcer

Varicose Vein Treatments

1. Conservative Measures

Compression stockings: class 2 (15-20 mmHg) to class 3 (20-36 mmHg)
Physical activity: walking, swimming, cycling
Leg elevation at the end of the day
Avoid prolonged standing and heat exposure

2. Sclerotherapy

Injection of a sclerosing agent into the diseased vein, causing it to close. Indicated for spider veins and small varicose veins. Performed in the office, without anesthesia.

3. Endovenous Laser Ablation (EVLA)

A laser fiber is introduced into the vein under ultrasound guidance. Thermal energy closes the vein from the inside. Reference technique for great and small saphenous vein varicosities. Outpatient procedure, rapid return to activity. See our complete guide to endovenous laser treatment for more details.

4. Radiofrequency Ablation

Same principle as laser but using radiofrequency energy. Equivalent results, sometimes with less post-procedural discomfort.

5. Traditional Surgery (Stripping)

Removal of the saphenous vein by stripping. A historical technique still used in certain complex cases, but largely replaced by endovenous methods.

Prevention

Varicose veins are not always preventable (genetic factors), but you can slow their appearance:

Walk at least 30 minutes a day
Wear compression stockings if you have risk factors
Avoid prolonged sitting or standing (take breaks)
Elevate your legs in the evening
Maintain a healthy weight
Cool water on the legs after a hot shower
Avoid direct heat sources on the legs

When to See a Doctor

See a doctor if:

Your legs are regularly heavy and swollen
Veins are appearing and growing larger
The skin around your ankles is changing color
A varicose vein becomes red, warm, and painful (suspicion of thrombophlebitis)
A wound near the ankle does not heal

Read also:

Sources: European Society for Vascular Surgery (ESVS) 2022 Guidelines on Management of Chronic Venous Disease, American Venous Forum (AVF), Society for Vascular Surgery (SVS) clinical practice guidelines.

Medical disclaimer: This article is for informational and educational purposes only. It does not constitute medical advice, a diagnosis, or a prescription. The information presented cannot replace a consultation with a qualified healthcare professional. If you have doubts about your health or experience symptoms described in this article, consult your doctor or call emergency services (911 in the US, 999 in the UK, 112 in the EU) in case of emergency. Petit Veinard assumes no liability for the use of this information for self-diagnosis or self-medication.