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Confident in Your Skin: When and How to Treat Varicose Veins

Contributor: Sherry Scovell, MD
7 minute read
Two women sit in chairs and read on the beach

When a condition affects the appearance of your skin, you might feel hyper-aware of it and lean toward covering up, especially in the summer months. Varicose veins are one such condition, but many people have them—as many as 25 to 40 million Americans.

Varicose veins are swollen, twisted veins that appear just under the skin, usually in the legs. They’re caused by high pressure when the valves (which open and close to keep your blood flowing toward your heart) or walls of your veins become weak or damaged. This may lead your veins to stretch and bulge.

“Varicose veins may cause bothersome symptoms, swelling, or even skin discoloration. And while treating tiny spider veins may be cosmetic, treating symptomatic varicose veins is not,” says Sherry Scovell, MD, a Mass General Brigham vascular surgeon. “Luckily, there are lifestyle changes you can make to help manage any symptoms or prevent them from getting worse. And there are many office-based treatments available to get rid of varicose veins and spider veins.”

Dr. Scovell, who cares for patients at Massachusetts General Hospital, explains when to seek treatment for varicose veins. She also discusses different lifestyle changes and medical treatments to help manage them, so you can feel comfortable and confident in your skin year-round.

What do varicose veins look like?

Close-up of varicose veins on the knee
Varicose veins usually appear blue, swollen and twisted beneath the skin’s surface.

Varicose veins are twisted, bulging, rope-like veins that appear just beneath the surface of your skin, usually in your legs, ankles, or feet. They often appear swollen and purple or blue in color.

Varicose veins are one type of venous disease that affect the veins. You may have heard of spider veins, which are similar and also commonly appear on the legs. There are some important differences between varicose veins and spider veins, and their treatments can vary.

Spider veins are web-like clusters of red, blue, or purple thin lines visible beneath the skin. They’re caused by damage to tiny veins, so they’re usually smaller and appear less swollen than varicose veins. Spider veins rarely cause health issues or pain, but if they cause discomfort, you can often treat them with home remedies, or there are injections to get rid of them.

If you’re unsure if you have varicose veins, talk to your primary care provider (PCP). They may want to examine you in person to determine if you have varicose veins and discuss whether you may need treatment.

When to worry about varicose veins

If the veins in your leg start to appear more noticeable and swollen, you may worry: Are varicose veins dangerous?

Dr. Scovell confirms that varicose veins usually aren’t dangerous, but they can cause leg pain, aching, heaviness, and throbbing. They can also lead to leg swelling, skin discoloration, and rarely, ulcers. Treating varicose veins and superficial vein insufficiency is a medical problem — not just cosmetic. They can worsen over time and lead to more serious health conditions.

“While usually harmless, varicose veins are often connected to a hidden superficial vein where the valves aren't working, leading the blood to flow backwards and pool in the veins,” Dr. Scovell explains. “There’s also a connection between patients with varicose veins and superficial vein thrombosis, which is when there is inflammation, redness, and pain in a vein near the skin’s surface due to a superficial blood clot. This needs treatment with a blood thinner and would be a reason to be evaluated by your physician.”

Your provider may recommend treatment if your veins are uncomfortable or cause your leg to swell. You may experience:

  • A heavy or aching feeling in your legs
  • Itchiness or a burning discomfort around the veins
  • Pain or soreness, especially behind your knees
  • Swelling
  • Leg cramps at night

Varicose veins can cause bleeding or ulcers (open sores) over time, which can lead to infection. This is serious and requires treatment. Call your provider right away if you notice a sore or bleeding from your varicose veins.

Varicose veins are very common, but minimally invasive treatments are available, if needed. If your veins are starting to affect your quality of life, talk to your provider. We want to help you feel comfortable and at ease in your own skin.

Sherry Scovell, MD
Vascular Surgeon
Mass General Brigham

How to get rid of varicose veins

Your provider may recommend lifestyle changes or treatment to prevent your veins from getting worse and developing more serious health issues, like chronic venous insufficiency.

Treatment for varicose veins aims to help relieve your symptoms and improve blood flow in your legs. Your provider discusses different treatment options with you to decide if lifestyle changes, medical treatment, or a combination are right for you.

Varicose veins natural treatment and lifestyle changes

Depending on your symptoms, your provider may recommend lifestyle changes to help relieve symptoms or reduce the appearance of your varicose veins. They may recommend that you:

  • Avoid long periods of standing or sitting. Try to elevate your feet while sitting to lower the pressure in your veins. If you have to sit or stand for long periods of time, switch positions or get up and move around frequently, if possible.
  • Elevate your legs. Putting your legs up on the couch (straight out from the hip) or lying down with your feet elevated for a few minutes several times a day helps lower the pressure in your veins.
  • Exercise more often. Activities like walking or strength training help contract the muscles in your legs and help move the blood back up to your heart. Be sure to talk to your provider before starting any exercise regimen.
  • Quit smoking. Smoking damages your veins and can increase your risk of developing blood clots.
  • Manage your weight with lifestyle changes. Having overweight or obesity increases the pressure in your veins and puts more strain on them. Talk to your provider if you’ve tried lifestyle changes and want help losing weight. They may recommend medication.
  • Wear compression stockings to improve blood flow. Your provider can prescribe them, or you can buy them over the counter.

Varicose veins medical treatment

Minimally invasive treatments and surgical procedures reduce the symptoms and appearance of your varicose veins. You may seek medical treatment if your varicose veins cause discomfort, or you may want to get rid of them for cosmetic reasons.

Varicose veins treatment options include:

  • Sclerotherapy. Providers often use this treatment to get rid of small varicose veins or spider veins. A provider injects a foam or liquid into the vein, which creates irritation and scarring on the inside of the vein and causes it to close. Your body absorbs the visible vein naturally, causing it to fade.
  • Endovenous ablation is one of the most common treatments for large varicose veins. After numbing the area so you don’t feel pain, a physician inserts a thin, flexible tube called a catheter into the affected vein. They use heat, laser energy, or a glue-like substance to close the vein, which redirects your blood flow to healthier veins.
  • Phlebectomy. Your physician or surgeon may recommend this procedure if your varicose veins are too large for sclerotherapy, or don’t go away after minimally invasive treatments. They also may perform this treatment at the same time as ablation. During a phlebectomy, a physician numbs the area and makes a small poke over your varicose vein. They then use a hook-like device to gently remove it.

“Varicose veins are very common, but minimally invasive treatments are available, if needed,” says Dr. Scovell. “If your veins are starting to affect your quality of life, talk to your provider. We want to help you feel comfortable and at ease in your own skin.”

Learn more about treatment for vein conditions

Learn about Mass General Brigham Heart and Vascular services

Heart & Vascular Care
Sherry Scovell, MD

Contributor

Sherry Scovell, MD
Vascular Surgeon