What are the symptoms of varicose veins?

Varicose vein disease has a spectrum of presentations and complications. People with venous disease or problem varicose veins may present with:

  1. Abnormal veins alone – visible spider veins, reticular veins and/or varicose veins
  2. Abnormal veins plus symptoms – swelling in the leg or venous ulcers (breakdown in skin around the lower leg or ankle region)
  3. Symptoms alone – no visible abnormal veins

Abnormal veins can range from small thread-like veins called spider veins (or telangiectasia), to slightly larger blue veins or reticular veins, to large and bulging varicose veins. Varicose veins can affect any part of the leg or pelvic area.

Common varicose vein symptoms are localised pain, fatigue, heaviness, aching, burning, throbbing, cramping and restless legs. The presence of a skin rash, small blue veins on the feet, skin discoloration and ulcers usually indicate advancing vein problems. Severe varicose veins can lead to eczema, inflammation or even ulceration of the lower legs.

Moderate Varicose Veins

Varicose veins are large, dilated, ropey veins that bulge above the skin surface, and are usually blue or green in colour. They no longer serve the primary function of veins, which is to return blood to the heart. Varicose veins can occur alone or with many of the physical manifestations of chronic venous disease. Many patients do not realise they have a complication of venous disease until they see a phlebologist (vein doctor).

Pelvic, Vulval and Pregnancy-Related Varicose Veins

Pregnancy-related varicose veins often appear in the vulval or gluteal region and can extend down the inner thigh and lower leg. The extra pressure a growing baby places on the veins around the ovaries, uterus, and vagina can cause venous insufficiency. Pregnancy-related varicose veins can appear during or following pregnancy.

Severe Varicose Veins / Chronic Venous Disease

Patients with severe venous disease may have signs such as venous eczema (venous dermatitis), swelling in the leg (oedema), discolouration of the skin (hyperpigmentation), thickening of the skin of the lower leg or ankle (lipodermatosclerosis), and localised or extensive break downs of the skin barrier, particularly around the ankle region (venous ulceration). As well as this, patients can experience heaviness, aching and tiredness in the legs. If left untreated, these symptoms are likely to become worse with advancing age.

Spider Veins and Reticular Veins

Spider veins are the tiny red or blue veins that can appear anywhere on the body, but more often on the legs, ankles, face, chest, or abdomen. Spider veins are extremely common. They may appear to be short, seemingly unconnected lines, each about the width of a large hair, or they may resemble a spider web or a tree with branches. In medical terms spider veins are called telangiectasias, and usually occur in association with larger dilated blood vessels (often blue / green in colour) called reticular veins. Often dilated blood vessels cause aching especially with prolonged standing.

Periorbital Veins

Periorbital veins (POV) are often a cause of cosmetic concern for patients. POVs are superficial veins which start at the bridge of the nose and stretch below or above the eye to join venous branches on the lateral forehead and scalp. Under normal circumstances, periorbital veins are barely visible to the human eye.

Lipoedema & Varicose Veins

Lipoedema is a chronic progressive condition characterised by the abnormal and excessive accumulation of the fatty tissue, generally in the lower legs and thighs. Other areas frequently affected by lipoedema include the buttocks, thighs, lower legs and ankles. Varicose vein disease is often present in conjunction with lipoedema and associated mild lymphedema.