Varicose veins

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. There are a number of different factors that may increase the likelihood of getting varicose veins, ranging from genes to environmental concerns (more on this in a bit). In terms of amelioration, a variety of activities may prevent them from becoming more noticeable. Pumped to learn more? Keep reading!

Before getting into varicose veins, it can be helpful to understand what veins do. 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 weak or damaged, 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 up to three in ten adults. Risk factors are thought to include genes and sex assigned at birth, as varicose veins run in families, and women typically outnumber men in developing them. It's 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. Smoking can also increase a person’s chances of developing varicose veins. Age and hormonal changes are factors, too. As the skin ages, it loses its elasticity and can't support the veins as firmly. 

In terms of prevention, it seems as though you're already taking many actions recommended 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, move, and take breaks from any prolonged position.
  • Maintain regular physical activity.
  • Avoid tight shoes or any other type of constrictive clothing on your legs such as leggings, garters, etc.
  • Eat a high-fiber, low-salt diet.
  • Elevate your legs.

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's 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 lower in the body to help blood flow upwards, against gravity. Research is mixed on whether or not compression stockings actually prevent varicose veins from developing or getting worse, but many people experience reduced discomfort, pain, and swelling as a result of wearing them. 

If you're 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. They may also be able to provide some guidance if you want to make cosmetic changes to reduce their appearance. However, as they're common for many folks, you may also consider what it would be like to accept them as a part of what makes you, you!

Last updated Apr 03, 2020
Originally published Oct 20, 1995

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