Varicose veins typically are only of cosmetic concern. However, a wide range of symptoms, of varying severity, have been reported. Potential symptoms include:
- Visible, raised, twisted bluish-purple veins
- Aching pain
- Heaviness in the legs
- Enhanced pain following long periods of sitting or standing
- Itching
- Bleeding of the varicose veins
- Red skin discoloration associated with pain
- Eczema
- Superficial thrombophlebitis (inflammation of superficial veins due to a blood clot along with a reddening of the skin)
- Bleeding
- Loss of subcutaneous tissue
- Lipodermatosclerosis (inflammation of fat under the epidermis of the lower extremities)
- Venous ulcers
Severe cases also serve as risk factors for thrombotic disorders, which can also have other deleterious effects on mental and physical health.
There are four risk factors for varicose veins. They are as follows:
Hormonal/Sex
Women are more likely to develop varicose veins than men, suggesting that hormones may influence the likelihood of developing varicose veins. Varicose veins are also more common in women during pregnancy and in women taking contraceptives with estrogen.
Lifestyle
- Prolonged standing or sitting can cause compression of the blood vessels and reduce blood flow. Thus, it is vital to alternate between standing and sitting throughout the day.
- Smoking
Acquired
- Pregnancy: During pregnancy, the body contains more blood. In order to support the fetus, blood circulation is also slowed between the legs and the pelvis. This increase in blood and reduction in flow can result in varicose veins. Additionally, hormones released during pregnancy can increase the risk of developing varicose veins or worsen existing veins. The veins typically disappear from 3 months to a year after delivery.
- Deep vein thrombosis
- Age: As one age, veins lose their elasticity. The valves that work to prevent blood backflow become weaker allowing blood to pool in the veins. This pooling causes the veins to become enlarged and varicose. The veins appear blue because the blood in the veins does not have oxygen.
- Obesity and diabetes
Hereditary
- Family history: Patients with family members that have varicose veins are more likely to develop varicose veins. Between 42% to 85% of patients with varicose veins report having family members with varicose veins compared to 14% to 22% of people with without family members with varicose veins. One report found that individuals had a 90% chance of developing varicose veins if both parents have varicose veins.
- Tall height
- Congenital Syndromes
Varicose veins are linked to several disorders and genetic mutations such as:
- Klippel-Trenaunay syndrome
- Lymphoedema-distichiasis
- Chuvash polycythemia
- Severe congenital neutropenia type 4
- Ehlers-Danlos syndrome
- Notch3 mutation in pedigree of CADASIL (Cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy)
- Clonal trisomies
- Mutations in the Thrombomodulin gene
- Mutations in the Desmuslin gene
Klippel-Trenaunay syndrome (KTS) is defined by the presence of misshapen cutaneous capillaries, varicose veins and an increase in bone and tissue cell size. The disorder arises when there is a mutation that causes two distinct cell types in one person. Some mutations include chromosome translocation and mutations in the EII3K and VG5Q genes. Varicose veins occur in 76% to 100% of cases.
Lymphoedema Distichiasis (LD) syndrome is a type of lymphedema, which is swelling in an arm or leg. In addition to varicose veins, the syndrome is defined by the presence of congenital heart defects, vertebral abnormalities, cysts and a cleft palate. The disease results from mutations in the FOXC2 gene, a gene involved in the development of endothelial and smooth muscle cells in blood vessels.
Chuvash polycythemia is a disorder caused by a mutation in the von Hippel-Lindau gene. Chuvash polycythemia is characterized by a high level of red blood cells, hematocrit, and hemoglobin (erythrocytosis). A study found that 74% of individuals with a mutation in the von Hippel-Lindau gene have varicose veins.
Severe congenital neutropenia type 4 is a disorder that causes individuals to be more susceptible to infection. This condition results in a low level of white blood cells called neutrophils, as well as varicose veins and leg ulcers. The disorder is the result of a mutation in the G6PC3 gene.
Ehlers-Danlos syndrome is a disorder that affects the skin, joints and blood vessel walls. Symptoms include overly flexible joints; stretchy, fragile skin; and stretchy blood vessels and varicose veins. This disease results from mutations in type V collagen.
Cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy or CADASIL is a common form of hereditary stroke disorder. It is the results of a mutation in the Notch 3 gene on chromosome 19, and may cause varicose veins.
