Updated:
by
Fernando F. Illescas, MD, CM, DVIR, FRCPC
Medically reviewed by Fernando F. Illescas, MD, CM, DVIR, FRCPC
Summer is peak season for a lot of things: road trips, travel, outdoor events — and, for millions of Americans, worsening vein symptoms. The leg swelling, heaviness, and achy fatigue that set in by afternoon are not simply signs that you overdid it in the heat. They may be signals that your veins need medical attention.
Fernando F. Illescas, MD, CM, DABR, FRCP(C), an accomplished interventional radiologist and vein physician at Center for Vein Restoration (CVR) in Springfield, Massachusetts, recently sat down with Channel 22 News program Mass Appeal to explain what happens inside your legs when temperatures rise, and when it is time to stop the wait-and-see approach and see a vein specialist.
Watch the full interview HERE
Most people understand that the heart pumps blood through the arteries to deliver oxygen throughout the body. But the second half of that equation, returning blood to the heart through the veins, is where things can get complicated, especially in warm weather.
To get blood from your ankles back up to your heart, your veins rely on a series of one-way valves. These valves open to allow blood to flow upward and close to prevent it from flowing back down. It is an elegant engineering solution to a real challenge: fighting gravity every minute of every day.
When temperatures rise, your body responds by sending more blood toward the surface of the skin. This is how you cool down. Heat escapes through the skin as blood circulates close to it. But that process causes the veins to dilate and fill with more blood. For veins with healthy, functioning valves, this is manageable. For veins with weakened or damaged valves, the added volume leads to more pooling, higher pressure, and more symptoms.
"The veins become more noticeable, and with people who have failing valves, it may cause symptoms such as heaviness, tiredness, throbbing pain, and, more commonly, swelling."
–Dr. Fernando Illescas
According to the Society for Vascular Surgery, as many as 40 million Americans live with varicose veins. Many of them experience their worst symptoms during the summer months, not because heat causes vein disease, but because it amplifies what is already there.
Varicose vein symptoms that are barely manageable in March can become hard to ignore by July. If your legs feel heavier, more swollen, or more painful than they did last summer, that change is worth evaluating. Find a CVR vein specialist near you at centerforvein.com, or call 240-249-8250, or schedule at one of the 130+ CVR vein clinics nationwide using the link below⬇️
Bulging or visible veins are the symptom most people associate with vein disease, but they are only part of the picture. In fact, they may be the least significant part.
Dr. Illescas described the veins you can see as just "the tip of the iceberg."
What ultrasound reveals, which are the deeper veins beneath the skin that are feeding those surface veins, is often the more clinically meaningful finding. This is why a vein consultation at CVR begins with a diagnostic ultrasound, not just a visual examination. Seeing the veins beneath the skin allows a physician to understand what is actually driving the symptoms and what, if anything, should be treated.
Vein disease that goes untreated can progress. Chronic venous insufficiency, a condition in which vein valves consistently fail to return blood efficiently, can lead to skin changes, persistent swelling, and, in more serious cases, venous ulcers. The symptoms patients often dismiss as "just tired legs" can be the early warning signs of a condition worth addressing.
If your legs feel heavy, achy, or swollen regularly, particularly after prolonged standing or sitting, it is worth having that conversation with a Center for Vein Restoration vein specialist.
📍 Find a Center for Vein Restoration near you
📞 Speak to a CVR Patient Services Representative at 240-249-8250
📅Book an appointment online
Heat is the trigger, but it rarely acts alone. Several factors stack on top of each other to make summer particularly hard on your veins. Fortunately, most of them are things you can do something about.
Inactivity
Your leg muscles act as a secondary pump for your venous system. Every time the muscles in your calves and thighs contract, they squeeze the veins and push blood upward toward the heart. When you sit or stand still for extended periods, that pumping action stops — and blood has a harder time moving against gravity.
Whether you have a desk job, spend long hours on your feet without moving, or tend toward a more sedentary lifestyle, inactivity compounds the challenges your veins already face in the heat.
Dehydration
Hydration matters more than most people realize. When the body is dehydrated, blood becomes more viscous, and circulation slows. Dr. Illescas specifically highlighted hydration as a key strategy during New England's hot and humid summers. Drinking enough water throughout the day supports blood flow and reduces the strain on your venous system.
Prolonged Travel
This is where vein symptoms can cross from uncomfortable to genuinely dangerous. The Centers for Disease Control and Prevention (CDC) notes that anyone traveling for four hours or more, whether by plane, car, bus, or train, faces an elevated risk of blood clots. Sitting still in a confined space for extended periods significantly slows circulation in the legs, and for people with existing vein issues, that risk is compounded.
Dr. Illescas recommends walking the aisle of the plane when possible, taking breaks on long car trips, and performing simple calf raises or ankle movements while seated. He also recommends that his patients wear at least knee-high compression stockings during air travel. Research consistently supports this practice: a Cochrane Review of nine randomized trials published in PubMed Central found that compression stockings significantly reduced the occurrence of asymptomatic deep vein thrombosis (DVT) in airline passengers on flights of five hours or more.
If you notice leg pain, swelling, redness, or warmth after travel, seek medical attention promptly. These can be signs of DVT, which requires immediate evaluation. CVR offers a DVT rule-out service for same-day or next-day diagnosis and treatment plans. Call our hotline number at 877-SCAN-DVT (877-722-6388)
If you are planning summer travel and have known vein issues, it is worth scheduling a consultation before your trip so you can travel with a plan.
An increasing number of patients arriving at vein consultations are surprised by veins they seem to have "developed" after losing weight on GLP-1 medications like semaglutide (Ozempic, Wegovy) or tirzepatide (Mounjaro, Zepbound).
Dr. Illescas addressed this directly: Those veins were not new; they had simply been concealed beneath a layer of subcutaneous fat. As that fat layer diminishes, the veins become visible. Patients who lose significant weight through GLP-1 medications often find that, along with wanting to feel and look better, they also want those veins addressed.
The important distinction is that losing weight is generally beneficial for vein health. Excess weight increases pressure on the venous system and is a recognized risk factor for vein disease. GLP-1-related weight loss does not cause varicose veins; it reveals ones that were already present.
Dr. Illescas put it simply: if you see veins in your legs, whether bulging or otherwise, treat that as a cue to come in for an evaluation. You do not need to wait until symptoms are severe or daily life is significantly disrupted.
Reasons to schedule a consultation include:
At a CVR consultation, a physician will perform a diagnostic ultrasound to evaluate the veins beneath the surface, review the findings with you, and discuss treatment options — or confirm that no treatment is currently needed. There is no guesswork involved.
Summer does not have to mean suffering through symptoms. Heat and activity affect everyone's circulation, but for people with underlying vein disease, the impact can be significant and cumulative. The good news is that vein disease is treatable, and the earlier it is addressed, the better the outcomes tend to be.
Dr. Illescas practices in Springfield, Massachusetts, and is one of more than 100 highly qualified physicians practicing across CVR's network of 130+ locations in 23 states. CVR's interventional radiologists, vascular surgeons, and vein specialists are trained to evaluate and treat the full range of venous conditions using minimally invasive, in-office procedures.
📞To speak to a knowledgeable Patient Services Representative, call 240-249-8250.
📅To schedule a consultation with Dr. Illescas in Springfield, MA, CLICK HERE
📅To schedule a consultation at any of Center for Vein Restoration’s 130+ vein clinics nationwide, CLICK HERE
Q: Why do my legs feel worse in the summer?
A: Heat causes the veins to dilate and fill with more blood, which increases pressure and makes symptoms like heaviness, swelling, and aching more pronounced — especially in people with venous insufficiency or weakened vein valves.
Q: Is leg swelling in summer always related to veins?
A: Not always. Dehydration, prolonged heat exposure, and inactivity can cause temporary swelling in otherwise healthy people. But persistent or recurrent swelling, especially when accompanied by heaviness, pain, or visible veins, warrants evaluation by a vein specialist.
Does losing weight help varicose veins? Weight loss reduces pressure on the venous system and can improve symptoms. However, it does not eliminate varicose veins. If veins become more visible after weight loss, it likely means they were already present but previously concealed by fat tissue.
Q: Are compression stockings really necessary for travel?
A: For people with vein disease or known risk factors for blood clots, compression stockings during travel of four or more hours are strongly recommended. Multiple clinical studies support their use for reducing DVT risk and leg swelling during extended travel.
Q: How do I know if I need vein treatment?
A: A diagnostic ultrasound is the definitive way to understand the extent of vein disease beneath the skin. CVR physicians evaluate your imaging, walk you through the findings, and discuss whether treatment is recommended — or whether monitoring is the right approach for now. Call 240-249-8250 or visit centerforvein.com to find a location near you.
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