Unattractive dark blue or purple bulges on your calves of the inside of your legs are a sign that you have varicose veins. They’re fairly common, though experts don’t agree on how many people are affected: according to the NHS, up to three in 10 adults have varicose veins, while others think the number is lower. What we do know, however, is that they’re more common in women than men (the Circulation Foundation charity suggests up to 50 percent of women may have varicose veins (ii)). It’s also thought that varicose veins run in families – though in some cases, there may not be any medical or genetic reason why they develop.
Meanwhile, in addition to not looking very attractive, sometimes larger varicose veins can also cause other symptoms, including discomfort, aches, cramps, itching, dry skin and swollen ankles and feet.
How leg veins work
The veins in the leg have a difficult job to do in transporting blood back up to the heart, defying gravity. There are deep leg veins that aren’t visible on the surface of the skin – these pass through the muscles, which squeeze the deep veins while your legs move – and veins that run under the skin, called superficial veins. Then there are lots of smaller veins running from the superficial veins and into the deep veins.
As well as the muscles squeezing the deep veins and helping the blood to push through them, there are valves inside all three types of veins that stop the blood from flowing back down towards the ankles. However, if a valve in a superficial vein becomes weakened or damaged, blood can flow backwards and cause extra pressure on the vein, stretching it and making it wider and, in time, swollen. This can lead to the development of varicose veins, as well as much smaller thread veins and spider veins.
Thankfully the majority of people who have varicose veins don’t go on to develop any related complications. However, in a small number of cases, the following may develop several years after varicose veins appear:
Phlebitis (thrombophlebitis) is inflammation of vein caused by blood clots (thrombosis) in the vein. Blood clots in superficial veins can also go on to cause a serious complication called deep vein thrombosis, which causes pain and swelling in the leg.
Varicose eczema can also develop, making your skin dry, red and flaky. You can read more about eczema treatment and support here.
Venous leg ulcers can also form if the pressure in the veins of your lower leg make your skin thick and swollen.
Lipodermatosclerosis usually affects the calves, causing areas of thickened, red skin.
Oedema – or swelling – can also develop in your lower leg or foot.
Why do you get varicose veins?
While some people may develop varicose veins for no obvious reason, there are several risk factors that may affect your chances, including the following:
Women are thought to be more likely to have varicose veins than men because of the female hormones they produce. This can relax the walls of your veins and make leakage more likely.
During pregnancy, there may also be extra pressure on your veins caused by the additional amount of blood needed to support the foetus, while the flow of blood from your legs to your pelvis may be reduced, both of which can enlarge the veins in your legs. Higher levels of pregnancy hormones may also affect your blood vessels, making them relax more than normal. And as your uterus grows, it puts extra pressure on the veins in your pelvic area too. Thankfully, while many women develop varicose veins during pregnancy, most find that things improve once they’ve had their baby because there’s less pressure on their veins (ii).
Loss of elasticity in the veins, which can cause veins to stretch and become weaker, is a natural consequence of ageing. The valves in your leg veins may also become weaker due to general wear and tear, causing little blood pools instead of making sure your blood flows back up towards your heart. Both of these things are common as you get older.
If you are carrying more weight than you should be, it puts extra pressure on your veins and valves, and makes them work harder to send blood to your heart. However, experts believe being overweight is only a risk factor for women, as men don’t seem to be affected (iii).
If you stand or sit for prolonged periods of time, it may affect your risk of developing varicose veins. Many people believe an occupation where you have to stand around a lot increases your risk of developing varicose veins, but there is little evidence to suggest this is true. It does make sense, however, as standing still for long periods of time could mean your blood may not circulate as easily as it should.
Having a family history
If others in your family have varicose veins, your chance of developing them is also higher than normal.
Occasionally, an underlying medical condition could cause varicose veins to develop, such as an injury to or thrombosis in a deep leg vein, a swelling or tumour in the pelvis or a blood vessel abnormality.
Can varicose veins be prevented?
There may not be a way to prevent varicose veins completely, but there are several things you can do to help stop them getting worse or to prevent or delay new ones forming.
Put your feet up
Try to keep your legs raised when you’re resting whenever you can, as it can reduce the pressure in your veins and improve blood flow. Most importantly, avoid crossing your legs at the knees or ankles when sitting down, as it puts extra pressure on your veins. If possible, raise your legs above the level of your heart (sleep with pillows under your ankles, for instance).
Avoiding sitting or standing for prolonged periods can help to keep your blood flowing. If you have to sit or stand a lot at work, try to take regular breaks and take a walk to get your legs moving to help the blood move through your veins. Also make sure you’re moderately active for at least 150 minutes each week, as staying fit can help tone your muscles, boost your circulation and help you to lose weight (shedding excess pounds can also help to improve your circulation and reduce the pressure on your veins). Choose activities that really work your leg muscles, including brisk walking, jogging, cycling, dancing and swimming.
Consider ditching your skinny jeans, as clothes that are tight around your waist, upper thighs and legs can make varicose veins worse. However, you could try wearing support tights, especially if you know you’re going to be standing for a long period of time. Support tights create gentle pressure, supporting your leg muscles and improving your blood flow.
Wearing high heels for long periods of time can cause a problem because your calf muscles don’t contract as much as when you’re wearing flats, which leads to reduced blood flow in your legs. Instead, try wearing heels less often, and you may find your circulation improves.
Eat more fibre
If you suffer frequently from constipation it can increase the pressure on the circulation in your abdomen, which also affects the blood flow in your legs. Eating more foods that are high in fibre can help prevent chronic constipation: make sure your diet includes plenty of fruit and veg and switch to wholegrain varieties of bread, rice and pasta. Cutting down on salt may also help, as eating too much can cause oedema (water retention), causing swelling in your legs, feet and ankles. You can find more advice on how to prevent constipation here.
Experts believe smoking may contribute to the development of varicose veins, so giving up may help. If you’re having problems quitting, there are many products available that could help you to conquer your cravings, such as gum, lozenges and patches.
Treatments for varicose veins
In many cases, varicose veins don’t need to be treated and treatment is seldom offered by the NHS for cosmetic reasons. But if you are also experiencing pain and discomfort, your GP may recommend one of the following:
This treatment uses high-frequently radio waves to heat the walls of varicose veins. The radio waves are directed into the vein through a small tube inserted via a small incision made just above or below the knee. The vein is heated until it collapses and sealed shut. The procedure is carried out under local anaesthetic.
Endovenous laser ablation
Endovenous laser ablation is similar to radiofrequency ablation, but instead of high-frequency radio waves, a tiny laser is passed through the tube and into the vein, where it heats up and kills the vein, then seals it closed. Again, it’s performed under local anaesthetic, which means you’ll be awake during the procedure.
In this procedure, a chemical called sodium tetradecyl sulphate is injected into the vein, which damages the lining of the vein and causes the blood in the vein to clot. Foam sclerotherapy is a new type of sclerotherapy that uses sodium tetradecyl sulphate in a foam rather than liquid format, which means it can treat larger veins than standard sclerotherapy. With both procedures, the chemical is guided into the vein using an ultrasound scan. Both are also carried out under local anaesthetic. Sclerotherapy is only usually offered to people who aren’t suitable for either of the ablation therapies. There are also more side effects associated with it than with the ablation therapies, including temporary clots in the treated veins (superficial thrombophlebitis), deep vein thrombosis (where a blood clot forms in a deep vein), skin discolouration, skin ulceration and temporary visual disturbances.
These are only officially recommended for varicose veins when other treatments aren’t suitable, though your GP may offer you compression stockings if you’re pregnant, which you can use until your baby is born.
There are two different compression strengths: class 1 (light compression) and class 2 (medium compression). They are thought to help relieve the pressure in the leg veins, and may ease the discomfort caused by varicose veins. Compression tights are also available in pharmacies, but you can’t get them on the NHS.
Varicose vein surgery
Surgery to remove varicose veins may also be offered if you’re not suitable for ablation or sclerotherapy. Called ligation and stripping, the technique involves typing and removing the affected veins, and is performed under general anaesthetic. The downside to varicose vein surgery is that it can be painful and cause bruising and bleeding. Rare complications can also include nerve damage or deep vein thrombosis.
Natural remedies for varicose veins
If you’re not eligible for varicose vein treatment on the NHS – or if you prefer to take a more natural approach – there are some alternative remedies you can try:
The root of this shrub-like evergreen plant is commonly found in woods and bushes, particularly in the south of England. It’s often used to treat varicose veins and leg swelling, as it contains chemicals that are thought to constrict blood vessels. In Germany, Butcher’s broom has been officially approved as a supportive therapy for chronic venous insufficiency. This means your leg veins cannot pump blood back to your heart, leading blood to pool in the veins and causing varicose veins. Studies suggest Butcher’s broom reduces leg swelling significantly in people with chronic venous insufficiency (i).
German researchers have also investigated horse chestnut extract extensively, and it is one of the most popular single-herb products sold in the country. Horse chestnut is most often used as a treatment for venous insufficiency. That’s because the seeds of the horse chestnut tree contain chemicals called saponins, including a compound called aescin. There is some evidence to suggest that aescin may help seal leaking capillaries and improve the elasticity of veins, which may help to reduce swelling and inflammation (vi). A review of trials looking at the use of horse chestnut seed extract for chronic venous insufficiency also concludes that it’s a safe short-term treatment, with one of the trials suggesting horse chestnut may be as effective as using compression stockings (vii).
These antioxidant compounds – including their derivatives anthocyanins – give fruits such as blueberries, cranberries, raspberries, blackberries and red grapes, as well as vegetables such as red cabbage, red onions and aubergines their deep, rich, red colour. Available in supplement form, anthocyanidins are thought to help seal up leaky blood vessels by repairing collagen in blood vessel walls and capillaries. One study suggests they may have an anti-angiogenic effect, which means they may reduce the unwanted blood vessel growth that’s thought to lead to varicose veins (viii).
This bioflavonoid is also a plant pigment found in fruits and vegetables, with buckwheat being the main source for supplements. You can also find rutin in apples and elderflowers. It’s often used to treat varicose veins and bruising as it’s thought to help strengthen blood vessels and capillaries. It contains a group of chemicals called oxerutins, which have been shown in numerous studies to be helpful for varicose veins, improving aching, swelling and tiredness in the legs (ix).
It can be uncomfortable to have varicose veins, but by following the tips above you should be able to alleviate some of the effects. To find more advice on how to manage common health conditions, visit our health library.
Available online: https://www.circulationfoundation.org.uk/help-advice/veins
Available online: https://patient.info/heart-health/varicose-veins-leaflet
Vanscheidt. W, Jost. V, Wolna. P, et al. Efficacy and safety of a Butcher's broom preparation (Ruscus aculeatus L. extract) compared to placebo in patients suffering from chronic venous insufficiency. Arzneimittelforschung. 2002;52(4):243-250. Available online: https://pubmed.ncbi.nlm.nih.gov/12040966-efficacy-and-safety-of-a-butchers-broom-preparation-ruscus-aculeatus-l-extract-compared-to-placebo-in-patients-suffering-from-chronic-venous-insufficiency/
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Petruzzellis. V, Troccoli. T, Candiani. C, et al. Oxerutins (Venoruton): efficacy in chronic venous insufficiency—a double-blind, randomized, controlled study. Angiology. 2002;53:257-263. Available online: https://pubmed.ncbi.nlm.nih.gov/12025912-oxerutins-venoruton-efficacy-in-chronic-venous-insufficiency-a-double-blind-randomized-controlled-study/
Incandela. L, Belcaro. G, Renton. S, et al. HR (Paroven, Venoruton; 0-(beta-hydroxyethyl)-rutosides) in venous hypertensive microangiopathy: A prospective, placebo-controlled, randomized trial. J Cardiovasc Pharmacol Ther. 2002;7(Suppl 1):S7-S10.
Aziz Z. et al., A Systematic Review of the Efficacy and Tolerability of Hydroxyethylrutosides for Improvement of the Signs and Symptoms of Chronic Venous Insufficiency. J Clin Pharm Ther. 40 (2): 177-85. Available online: https://pubmed.ncbi.nlm.nih.gov/25630350-a-systematic-review-of-the-efficacy-and-tolerability-of-hydroxyethylrutosides-for-improvement-of-the-signs-and-symptoms-of-chronic-venous-insufficiency/
Incandela L. et al., (Paroven, Venoruton; 0-(beta-hydroxyethyl)-rutosides) in venous hypertensive microangiopathy: A prospective, placebo-controlled, randomized trial. J Cardiovasc Pharmacol Ther. 2002;7(Suppl 1):S7-S10. Available online: https://pubmed.ncbi.nlm.nih.gov/12011966-hr-paroven-venoruton-0-beta-hydroxyethyl-rutosides-in-venous-hypertensive-microangiopathy-a-prospective-placebo-controlled-randomized-trial/
Discalimer: The information presented by Nature's Best is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications.
Christine Morgan has been a freelance health and wellbeing journalist for almost 20 years, having written for numerous publications including the Daily Mirror, S Magazine, Top Sante, Healthy, Woman & Home, Zest, Allergy, Healthy Times and Pregnancy & Birth; she has also edited several titles such as Women’ Health, Shine’s Real Health & Beauty and All About Health.