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.
- 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.
If you’re affected by the signs of any of these complications, see your GP as soon as possible.
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:
Being female: 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.
- Being pregnant: During pregnancy, there may also be extra pressure on your veins caused by the additional amount of blood needed to support the fetus, 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.
- Getting older: 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.
- Being overweight: 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.
- 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).
- Keep active: 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.
- Loosen up: 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.
- Limit heels: 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.
- Quit smoking: 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.
Natural remedies for varicose veins
In many cases, varicose veins don’t need to be treated. But if you are also experiencing pain and discomfort, your GP may recommend different treatments.
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:
- Horse chestnut: German researchers have also investigated horse chestnut extract extensively, and it is currently the third most common single-herb product sold in the country after ginkgo and St John’s Wort. 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 (ii).
- Anthocyanidins: 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, they 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 (iii).
- Rutin: This bioflavonoid is also a plant pigment found in fruits and vegetables, with buckwheat being the main source for supplements. You can also find it 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 (iv).
(i) 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.Lucker P, Jost V, Wolna P, et al. Efficacy and safety of ruscus extract compared to placebo in patients suffering from chronic venous insufficiency [abstract]. Phytomedicine. 2000;7(suppl 2):P-155.
(ii) Sirtori CR. Aescin: pharmacology, pharmacokinetics and therapeutic profile. Pharmacol Res. 2001;44:183-193.
(iii) Bagchi D, Sen CK, Bagchi M, Atalay M. Anti-angiogenic, antioxidant and anti-carcinogenic properties of a novel anthocyanin-rich berry extract formula. Biochemistry (Mosc). 2004 Jan;69(1):75-80.
(iv) 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. 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 CardiovascPharmacolTher. 2002;7(Suppl 1):S7-S10.