Dear Alice,

I am thirty-years-old, and have noticed that the veins in my upper legs have become very prominent, giving my legs a rippled and pretty unattractive appearance. Is this an age-related phenomena, or is there something I could do — i.e., nutrition or exercise-wise — that could ameliorate this? I eat well, run fifteen miles a week, lift weights, etc. What's the problem?



Dear Methuselah,

What you're describing sounds like the beginnings of varicose veins, or enlarged veins that appear twisted and bulging. Spider veins are similar to varicose veins, but smaller. Spider veins are often red or blue, and can look like tree branches or spiderwebs with their short, jagged lines. They can be found on the legs and face and can cover either a very small or very large area of skin.

Veins collect blood and pump it upwards to the heart by contractions of the leg muscles, while valves in the veins prevent blood from draining back down the leg under the force of gravity. However, if valves become defective, blood accumulates in the superficial veins. This leads to the swollen and distorted look of varicose veins.

Varicose veins are extremely common. In fact, varicose veins affect about half of people 50 years and older. Risk factors are thought to include genes and gender, as varicose veins run in families, and women outnumber men, 4 to 1. It is believed that prolonged standing or inactivity can cause varicose veins in people genetically predisposed to them. Strain in the abdominal region, from repeated heavy lifting, pregnancy, or constipation, can also be a cause. Age and hormonal changes are also factors. As the skin ages, it loses its elasticity and cannot support the veins as firmly. Smoking can also increase a person’s chances of developing varicose veins.

In terms of prevention, you're in a good place to keep the veins from becoming more prominent. These tips may help prevent further varicose development:

  • Avoid standing or sitting for long periods in the same position. Try to get up and take breaks.
  • Have correct posture.
  • Walk for exercise. This may help control a mild case of varicose veins.
  • Wear compression stockings. These are slightly thicker than regular pantyhose, and feel extremely supportive (plus they cover up those veins!).
  • Avoid tight shoes, or any other type of constrictive clothing on your legs such as leggings, garters, etc.

Usually varicose and spider veins are only of cosmetic concern. However, in more serious cases, skin can discolor and the surrounding area can become very uncomfortable and even painful. In such cases, certain medical procedures can remove or close off the affected vein to improve the symptoms. A few common procedures include:

  • Surface laser treatment: high energy lasers are used to close off the vein.
  • Sclerotherapy: Liquid chemicals are injected into the vein to collapse it.
  • Vein litigation and stripping: Incisions are made at the ends of the vein in order to close it off and remove it.  

When considering any surgical procedure, it is always good to consider differences in possible scarring, recovery time, and any possible risks. If surgical procedures are unnecessary or undesirable, your health care provider may recommend that you wear compression stockings. These can improve blood circulation by putting pressure on the veins. The most helpful ones are those with gradient pressure that provides different amounts of pressure depending on where it is needed the most.

If you are experiencing pain from your varicose veins, or would like to learn more about prevention and treatment, you may want to speak with your health care provider.


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