Varicose Vein Symptoms

Varicose Vein Symptoms

Recognising varicose vein symptoms as early as possible is essential for effective treatment. After all, it’s about dealing with a chronic condition that gradually gets worse with the years, if left unchecked. According to one study, 28.6% of patients with visible varicose veins without swelling or any other symptoms progressed to more advanced stages of the disease within 6.6 years. [1]

In this article, we’ll go through a detailed overview of everything you need to know about varicose vein symptoms including their causes, potential complications, recommended diagnostic approaches, and available treatments.

We’ll even cover a few case studies from our patients here at Doctor Vein to give you an example of just how massive the improvement can be with the right treatment strategy!

Starting With the Basics: What Are Varicose Veins?

Varicose veins are enlarged, twisted veins. They can appear in any part of your body but typically affect the legs and feet, where blood tends to pool. Varicose veins are the most common visible sign of chronic venous disease (CVD), a complex condition that develops as a result of several factors:

  • Age
  • Genetic predisposition
  • Gender (women are more likely to be affected by the condition)
  • Long periods of standing or sitting, with little movement
  • Excess weight
  • Pregnancy
  • Height (tall people are more prone to varicose veins)

The primary cause of chronic venous disease in general and varicose veins specifically is the malfunctioning of the one-way venous valves. These tiny structures ensure the unidirectional flow of venous blood from the extremities to the heart, never the other way around. When the venous valves start malfunctioning, blood tends to leak back and pool in the leg veins, pressing on their walls and deforming them from the inside. 

That’s why varicose vein symptoms get worse with time. When the venous valves start leaking, more and more blood pools in the deformed vessels. As a result, the valves perform even worse, and the cycle reinforces itself. The sooner you recognise that you’re dealing with varicose vein symptoms and reach out for help, the more effective the treatment will be.

So what are the most common varicose vein symptoms? Let’s explore them in detail.

The Five Most Common Varicose Vein Symptoms

Visible bulging veins

This one is hard to miss, as it’s a hallmark of the condition. Varicose veins appear as enlarged, bulging, twisted vessels just beneath the skin. 

Usually, other symptoms are also present at this point, but that’s not always the case. Some people notice they have varicose veins without experiencing any other symptoms at all. Note that the absence of other symptoms doesn’t mean the condition doesn’t need professional help. If left unchecked, it will manifest all the varicose vein symptoms that we cover further in this list.

A common misconception is that visible varicose veins are a normal and unavoidable part of aging. That’s not true! Even though age is a confirmed risk factor for the condition, remember that there’s nothing normal about it. All varicose vein symptoms, including visible bulging veins, can be alleviated or even cured for good with the right treatment strategy. 

Aching or pain

People with varicose veins often report aching or pain, ranging from mild discomfort to intense sensations that could lead to poor sleep. One common trait of this ache is that it’s usually less troublesome in the morning and gets worse throughout the day, as blood accumulates in the legs due to the force of gravity. Nighttime muscle cramps are also more frequent in patients with varicose veins. [2]

Keep in mind that the pain caused by varicose veins tends to get more severe as the condition progresses. Don’t wait until the ache gets unbearable.


When the venous valves start malfunctioning and blood pools in the extremities, the pressure inside the veins gradually increases. After a while, this pressure forces the liquid part of the blood to ‘leak’ through the walls of the vessels. As it fills the adjacent tissues, you may notice growing swelling and discomfort, especially around the lower legs and ankles.

Swelling is one of the most troublesome varicose vein symptoms, and many people resort to diuretics (water pills) to reduce the swelling. Keep in mind that this may bring only superficial short-term relief without actually helping the root cause of the issue. [3] Instead of relying on water pills, consider reaching out for help from a professional phlebologist (vein doctor).

Leg fatigue

The growing discomfort, swelling, and pain caused by varicose veins quickly lead to leg fatigue. As a result, even mild physical activity becomes extremely unpleasant. Eventually, simple tasks like going shopping or enjoying an evening walk turn into real challenges. This can be very discouraging and may significantly reduce anyone’s quality of life.

Itching or burning sensations

Chronic venous insufficiency in the lower legs can damage the local nerves. This can lead to a wide range of unpleasant sensations including itching, burning, tingling, and numbness. Finding an effective treatment strategy is essential to reduce the intensity of these alarming varicose vein symptoms.

When Is It a Good Time to Start Worrying About Varicose Veins?

When it comes to varicose vein symptoms, the sooner you reach out for professional help, the more effective the treatment will be. Remember that chronic venous disease never resolves on its own. If left untreated, it will unavoidably progress into some of the following complications.

Skin changes and discolouration

Chronic venous insufficiency eventually leads to visual changes in the appearance of the skin. As blood continues to pool in the legs, part of it leaks into the adjacent tissue and skin. The red blood cells break down and cause local pigmentation, which may range from tan to reddish-brown.

Blood clots (thrombosis)

The blood that builds up in the enlarged varicose veins can form clots (thrombi). These clots further impair circulation, decrease the delivery of oxygen and nutrients, and lead to local inflammation.


As the skin changes and discolouration progresses, venous ulcers may appear. They are caused by the increasing venous pressure inside the varicose veins, reduced blood supply, and local skin changes. Approximately 20% of patients with chronic venous insufficiency develop venous ulcers. [4]

Keep in mind that there’s no point in waiting until any of these complications appear. As soon as you notice any varicose vein symptoms, contact a phlebologist for a personalised treatment strategy. It’s always easier (and cheaper!) to prevent venous complications than to treat them.

Diagnostic Methods

Even though the development of chronic venous disease and varicose veins has its peculiarities in every individual, the underlying mechanism is universal. The primary culprit is the malfunctioning of the venous valves, which results in venous reflux (backward flow ‘leaking’ through the valves) and progressive pooling of blood in the legs. That’s what causes all varicose vein symptoms, one way or another.

So, what are the most common diagnostic methods to confirm or rule out this process?

Physical examination

Your doctor will examine your legs and look for signs and symptoms of venous insufficiency. This can include any of the following:

  • Enlarged, bulging veins
  • Skin changes (discolouration, dryness, local wounds)
  • Local swelling
  • Cold legs and feet

Of course, this is just the start of the diagnostic process. To determine the severity of the condition, additional tests will be necessary.

Ultrasound imaging

Ultrasound imaging is a quick, painless, and extremely informative procedure when it comes to diagnosing varicose vein symptoms. Using an ultrasound machine, your phlebologist will be able to check the direction of blood flowing in your veins, evaluate the function of the venous valves, and even identify blood clots in some cases.

With these diagnostic methods, your doctor will get a detailed understanding of your condition and offer you the best treatment strategies. Many of them are non-invasive, meaning they won’t require full-blown surgery! Let’s go through a few of the most common strategies.

Treatment Options

Your phlebologist will offer you a personalised treatment plan depending on several factors:

  • The severity of your varicose vein symptoms
  • The affected part of your body
  • Your personal preferences
  • The effectiveness of previous treatments, if any
  • Other individual factors (like family history, age, and data from physical examination).

Some of the most effective and modern strategies include laser treatments, sclerotherapy, and vein glue. If you need more information, you can find an in-depth overview of each approach on our Treatments page.

When to See a Phlebologist?

Ideally, we recommend booking a consultation with a vein doctor (phlebologist) as soon as you suspect that you’re dealing with varicose vein symptoms or signs of venous issues in general. After all, the sooner you get professional advice, the more effective and comfortable your treatment will be. 

For example, in the initial stages of chronic venous disease, patients can expect dramatic improvements after adopting a few lifestyle modifications like dietary changes, regular physical activity, and maybe wearing compression stockings. [5] It’s as simple as that!

However, as the condition progresses, it may require more serious treatment. In other words, the sooner you reach out for professional help, the better.

If you notice any of the following red flags, please reach out for help immediately, as the process may be entering its advanced stages:

  • Persistent skin changes like darkening, drying, cracks, or ulcers
  • Local tingling, numbing, or itching
  • Significantly enlarged and bulging veins
  • Intense pain or burning

As with all varicose vein symptoms, don’t wait until they get too bad. Early diagnosis and treatment always bring the best and most comfortable results.

Patient Stories

Here at Doctor Vein, we can help you with all varicose vein symptoms. Here are a few stories from our patients!

varicose veins laser treatment before and after patient 1
Before treatment
varicose veins laser treatment before and after patient 1
After treatment

Have you ever postponed seeking medical help because you were afraid that the procedures and recovery would impair your performance at work? If yes, then this might be the perfect success story for you.

This gentleman struggled with varicose vein symptoms for many years, including bulging veins most visible on his right lower leg. He had put off treatment due to various work commitments, afraid that the recovery process could set him off the track. After examination and diagnosis, the patient received two treatments: endovenous laser ablation and phlebectomy. 

The chosen strategy was a big success, as you can see in the image above (the pictures were taken 6 weeks apart). And guess what? The patient didn’t miss any work at all!

Most people don’t know this, but modern treatments for varicose vein symptoms and other issues related to venous insufficiency bring minimal downtime and discomfort, rarely impairing work performance.

varicose vein symptoms before treatment - patient 2
Before treatment
varicose vein symptoms after treatment - patient 2
After treatment

Here at Doctor Vein, we have extensive experience in helping patients who tried getting help for their varicose vein symptoms but aren’t quite satisfied with the relief they got.

That’s the story of the patient above. Her work involved long periods of standing, and that’s a major risk factor for developing venous issues. As you can see in the Before part of the image, multiple surgeries weren’t enough to bring her substantial relief. She reached out to us for a more advanced and modern treatment. After endovenous laser ablation and phlebectomy, we achieved the results on the right. The patient was thrilled about the improvement.

Varicose vein symptoms can have an awful impact on your quality of life. But don’t get discouraged! There are modern treatment strategies for any situation, and most of them come with little to no discomfort or downtime. 

Book a consultation with our team today. We’ll answer all your questions and develop a personalised treatment plan to bring you the best relief as soon as possible.

Scientific References

  1. National Clinical Guideline Centre (UK). Varicose Veins in the Legs: The Diagnosis and Management of Varicose Veins. London: National Institute for Health and Care Excellence (NICE); July 2013.
  2. Hirai M. Prevalence and characteristics of muscle cramps in patients with varicose veins. Vasa. 2000;29(4):269-273. doi:10.1024/0301-1526.29.4.269
  3. Rathbun SW, Kirkpatrick AC. Treatment of chronic venous insufficiency. Curr Treat Options Cardiovasc Med. 2007;9(2):115-126. doi:10.1007/s11936-007-0005-6
  4. Singh A, Zahra F. Chronic Venous Insufficiency. In: StatPearls. Treasure Island (FL): StatPearls Publishing; April 27, 2023.
  5. National Clinical Guideline Centre (UK). Varicose Veins in the Legs: The Diagnosis and Management of Varicose Veins. London: National Institute for Health and Care Excellence (NICE); 2013 Jul. (NICE Clinical Guidelines, No. 168.) 8, Conservative Management.

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