What Are Bilateral Varicose Veins? Is It Normal?

Medically reviewed by Thomas Militano, MD, PhD, RPVI, on March 22 2025

If you've noticed bulging, twisted veins on both legs, you might wonder: Is this normal? Should I see a doctor? The answer is yes to both. Bilateral varicose veins (meaning both legs) are a common sign of venous insufficiency, a progressive condition where blood struggles to flow back to the heart correctly. According to the Cleveland Clinic, the complications of untreated varicose veins include painful open leg sores, skin discoloration, and blood clots.

But what causes bilateral varicose veins? How do they differ from unilateral varicose veins (meaning on one side only), and why do some people develop varicose veins in just one leg instead of both? Let’s take a closer look.

What Are Bilateral Varicose Veins?

Varicose veins occur when vein valves weaken, allowing blood to pool in the veins and causing them to enlarge, twist, and become visible under the skin. When these veins appear in both legs, they are called bilateral varicose veins.

While bilateral varicose veins may be concerning, they are common and treatable. Seeking help from a vein expert early can prevent them from worsening and leading to symptoms such as leg pain, swelling, heaviness, and skin changes.

Center for Vein Restoration (CVR): Expert Care for Varicose Veins

At Center for Vein Restoration (CVR), our vein specialists treat all types of vein problems, including bilateral varicose veins and unilateral varicose veins (affecting just one leg). CVR’s minimally invasive vein treatments can reduce discomfort, improve circulation, and restore your legs’ natural appearance.

Call CVR at 240-965-3915 to learn more, or schedule a consultation with a CVR vein doctor near you HERE.

How Do Bilateral Varicose Veins Differ From Unilateral Varicose Veins?

The key difference between bilateral varicose veins and unilateral varicose veins is which leg(s) are affected:

• Bilateral varicose veins affect both legs, usually due to widespread venous insufficiency or other systemic risk factors like genetics or pregnancy.
• Unilateral varicose veins appear in only one leg, often due to localized issues such as a past injury, a blood clot, or pressure on one leg's veins.

If left untreated, unilateral varicose veins can eventually affect both legs and lead to venous leg ulcers and deep vein thrombosis (DVT).

What Are the Risk Factors for Bilateral Varicose Veins?

There are several risks that contribute to varicose veins developing in both legs. Some of the most common risks include:

1. Chronic Venous Insufficiency (CVI)

Venous insufficiency is the leading cause of bilateral varicose veins. This condition occurs when vein valves fail, causing blood to flow backward and pool in the legs. According to the Cleveland Clinic, CVI is one of the most common vein disorders, affecting millions of Americans.

2. Genetics

Family history plays a significant role in whether or not you develop varicose veins. Research shows that if one of your parents has varicose veins, your risk is around 40 percent. If both parents have them, your risk jumps to 90 percent.

3. Prolonged Standing or Sitting

Long hours on your feet (nurses, teachers, retail workers) or sitting (office jobs, truck drivers) increase the risk of vein disease. When blood doesn’t circulate properly, it can lead to varicose veins in both legs.

4. Obesity and Excess Weight

Extra weight puts more pressure on the veins, making it harder for blood to flow upward against gravity. This strain weakens vein walls, leading to bilateral varicose veins.

5. Hormonal Changes

Women experience varicose veins more often than men due to hormonal changes from pregnancy, birth control, and menopause. According to Mayo Clinic, estrogen and progesterone weaken vein walls, increasing the risk of vein problems.

6. Aging

As we age, veins lose elasticity, and valves weaken, allowing blood to pool in the legs. The Cleveland Clinic reports that vein disease is most common in people over 50, with the risk going up the older we get.

7. Blood Clots or Deep Vein Thrombosis (DVT)

A history of DVT (deep vein thrombosis) can damage vein valves, leading to venous insufficiency and varicose veins in both legs.

Why Do Some People Get Varicose Veins in Only One Leg?

While bilateral varicose veins are common, some develop them in only one leg. This can be due to:

• Previous injury or trauma – Damage to veins in one leg can cause valve failure and localized varicose veins.
• Past blood clot (DVT) – A blood clot in one leg can lead to long-term vein damage, making that leg more prone to varicose veins.
• Pressure from external factors – Carrying heavy bags on one shoulder or crossing one leg over the other frequently can restrict circulation in that leg. While these habits alone are unlikely to cause varicose veins, they may worsen leg discomfort or make existing veins more noticeable by limiting blood flow in those predisposed to vein disease.
• Uneven circulation or vein structure – Some people naturally have differences in their vein anatomy, making one leg more susceptible.

If you have varicose veins on one or both legs, you should still seek care from a board-certified vein specialist for an evaluation and a personalized treatment plan.

Symptoms of Bilateral Varicose Veins

If you have bilateral varicose veins, you may notice:

• Leg swelling, especially at the end of the day
• Aching, heaviness, or cramping in both legs
• Itchy or irritated skin around the veins
• Skin discoloration (brownish or reddish patches)
• Restless legs, especially at night

These symptoms often worsen without treatment, but modern vein treatments can provide relief.

How Are Bilateral Varicose Veins Treated?

Center for Vein Restoration offers state-of-the-art, minimally invasive outpatient treatments for bilateral and unilateral varicose veins. Our vein doctors specialize in the following:

• Endovenous Laser Ablation (EVLA) – Uses laser energy to close faulty veins and reroute blood flow.
• Radiofrequency Ablation (RFA) – A minimally invasive procedure that heats and seals varicose veins.
• Sclerotherapy – Injects a safe solution into veins to make them close and fade over time.
• Microphlebectomy – Removes larger varicose veins through tiny incisions.
• Compression Therapy – Improves circulation with medical-grade compression stockings.

Center for Center Restoration (CVR) vein specialists will create a customized vein treatment plan based on your needs. To schedule a consultation with a CVR vein center near you, call 240-965-3915 or click on the link below.

Bilateral Varicose Vein Treatment: Safe and Effective as an Outpatient Procedure

A study published by ScienceDirect, “Can Bilateral Varicose Vein Surgery be Performed Safely in an Ambulatory Setting?” found that bilateral varicose vein surgery can be safely performed in an outpatient setting without increasing complications, pain or recovery time compared to unilateral surgery. Patients who had ambulatory bilateral surgery experienced shorter stays and high satisfaction rates, supporting the move toward minimally invasive, office-based treatments.

At Center for Vein Restoration, our vein specialists provide safe, effective outpatient treatments for bilateral varicose veins, ensuring quick recovery and minimal discomfort.

Call 240-965-3915 to speak to a Patient Services Representative to schedule an appointment. You can also schedule your consultation online at a CVR near you today.

CVR accepts many insurances, including Aetna, Amerigroup, Anthem, Blue Cross/Blue Shield, Cigna, MultiPlan, Medicaid, Medicare, and more.

When Should You See a Vein Doctor?

If you have bilateral varicose veins and experience pain, swelling, skin changes, or restless legs, it’s time to see a qualified vein specialist. Varicose veins can lead to leg ulcers, blood clots, and chronic discomfort without treatment.

At Center for Vein Restoration, we provide affordable vein care with highly trained vein specialists nationwide.

Call CVR at 240-965-3915 or book an appointment HERE.

Bilateral Varicose Veins: The Bottom Line

Bilateral varicose veins are common and treatable. Early treatment can prevent complications and improve your quality of life, whether you have varicose veins in both legs— or just one.

At Center for Vein Restoration, our compassionate vein specialists are dedicated to helping you find relief from pain and discomfort so you can feel like yourself again. You don’t have to live with aching, swollen legs or unsightly veins—safe, effective treatment is within reach. Take the first step toward healthier, more confident legs today!