What are Varicose Veins and Can They Be Prevented?

Many people blame their varicose veins on getting older, standing too long, or simply bad luck. But research tells a different story. The first large-scale genetic study of varicose veins, published in PLOS Genetics with support from the National Institutes of Health, found that the condition affects roughly 30 percent of adults in developed countries and that heredity plays a central role in who develops them. 

If one parent has varicose veins, your risk of developing them is about 40 percent. If both parents have them, your risk can reach 90 percent. 

Does that mean your fate is sealed if your parents, or their parents, had visible varicose veins? No, because varicose veins are also preventable, influenced by lifestyle choices, and are highly treatable using minimally invasive outpatient procedures. But understanding what causes them and what puts you at risk is the first step toward protecting your vein health for the long term.

We consulted Center for Vein Restoration (CVR) vein expert, Ralph Delius, MD, FACS, lead physician at CVR vein clinics in Tanasbourne, Oregon, for more information on what varicose veins are, why they develop, and what you can do to lower your risk.

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What Causes Varicose Veins?

To understand what causes varicose veins, it helps to know how healthy veins work. Your leg veins have a demanding job: they push blood upward against gravity and back to your heart with every heartbeat. To make this happen, veins rely on tiny one-way valves that open and close in sequence to keep blood moving in the right direction.

When those valves weaken or stop working correctly, blood flows backward and pools in the lower legs instead of continuing upward. The National Heart, Lung, and Blood Institute (NHLBI) explains that this causes pressure to build inside the vein walls, eventually stretching and weakening them. The result is the bulging, twisted appearance of varicose veins. This valve failure is called venous reflux, and it is the root mechanism behind vein disease and CVI.

It is worth noting that not all varicose veins are visible on the surface. Some develop deeper in the leg tissue and can only be detected using duplex ultrasound, the same imaging technology CVR's vein specialists use to assess blood flow and design a personalized treatment plan.

Who Is at Risk for Varicose Veins?

Several factors can increase your chances of developing varicose veins and vein problems. Some are within your control. Others are not.

As mentioned earlier, genetics is among the strongest risk factors.  Additional risk factors include:

• Age. Vein valves naturally become less efficient over time.
• Pregnancy. Increased blood volume, hormonal shifts that relax the walls of blood vessels, and the growing uterus pressing on major pelvic veins all raise pressure in the leg veins. In many cases, varicose veins that appear during pregnancy improve on their own after delivery.
• Obesity. Extra body weight continuously adds pressure on leg veins and strains valve function.
• Prolonged sitting or standing. Jobs and daily routines that keep you stationary for long stretches slow blood flow and increase venous pressure.
• History of deep vein thrombosis (DVT). Previous blood clots can scar and damage the vein valves, raising the risk of venous reflux.

What Happens If Varicose Veins Go Untreated?

Vein disease does not stay the same over time. Without treatment, the pressure inside damaged veins continues to build, and what starts as a cosmetic nuisance can gradually progress into pain, swelling, skin changes, and more serious complications. The National Library of Medicine (NIH) characterizes CVI as a progressive condition that tends to worsen without treatment. Untreated varicose veins can lead to worsening leg pain and swelling, skin changes and discoloration, spontaneous bleeding, slow-healing venous leg ulcers, and dangerous blood clots. Early evaluation by a vein specialist makes a meaningful difference in outcomes.

Not Sure If Your Leg Symptoms Are Related to Vein Disease?

Aching, swelling, heaviness, and visible veins are all reasons to take a closer look. CVR's Vein Quiz takes just a few minutes and can help you understand whether your symptoms point to an underlying vein problem ⬇️

Take the Free Vein Quiz at centerforvein.com

Can Varicose Veins Be Prevented?

This is one of the most common questions people have, and the honest answer is: not entirely, especially if your family history puts you at high risk. When genetics is the primary driver, varicose veins may develop regardless of how well you take care of yourself.

That said, there is a real difference between preventing varicose veins and preventing them from getting worse. 

Healthy habits supported by Mayo Clinic can meaningfully delay the onset, slow progression, and reduce the severity of vein problems when they do appear:

• Stay active. Walking, cycling, and other low-impact activities strengthen the calf muscles, which act as natural pumps to help move blood up through the leg veins. Aim for at least 30 minutes most days.
• Maintain a healthy weight. Keeping weight in a healthy range reduces continuous pressure on leg veins.
• Avoid long periods of sitting or standing. If your job requires it, take regular breaks to move around and change your position every 30 to 60 minutes.
• Elevate your legs. Raising your legs above heart level for a few minutes each day helps blood drain from the lower legs and relieve venous pressure.
• Wear compression stockings. Especially helpful during long travel or extended periods of standing, compression stockings apply gentle graduated pressure that supports blood flow toward the heart.
• Limit prolonged soaking in hot water. Hot tubs and long, hot baths can dilate blood vessels, temporarily worsening vein symptoms.

Already Seeing Vein Symptoms? It's Time to Get Evaluated.

Lifestyle changes can slow the progression of vein disease, but they can't repair damaged valves or treat existing varicose veins. A CVR board-certified vein doctor can assess your vein health, identify the root cause of your symptoms, and build a personalized treatment plan.

How Are Varicose Veins Treated Today?

Modern varicose vein treatment looks nothing like the vein stripping procedures of the past. Today, all varicose vein and spider vein treatments are minimally invasive, performed right in the office, and typically take less than an hour. No hospital stay, no general anesthesia, and most patients return to normal activities the same day.

CVR's board-certified vein doctors offer the full range of outpatient vein treatment options, matched to each patient's specific condition after a thorough duplex ultrasound evaluation:

• Radiofrequency ablation (RFA): Uses controlled heat energy to close the diseased vein from the inside. Research published in NIH PubMed Central reports success rates of 97 to 99 percent for RFA in treating venous insufficiency.
• Endovenous laser ablation: A similar heat-based approach using laser energy to seal off the affected vein.
• VenaSeal: A medical-grade adhesive that closes the diseased vein without heat or needles, offering a comfortable in-office option with minimal downtime.
• Varithena: A foam injectable that collapses and seals varicose veins, effective for a range of vein sizes.
• Sclerotherapy: A solution is injected directly into spider veins and smaller varicose veins, causing them to fade over several weeks.
• Ambulatory phlebectomy: Larger surface varicose veins are removed through tiny, stitch-less openings in the skin in a simple in-office procedure.

Most varicose vein treatments are covered by major insurance plans, including Medicare and Medicaid, when symptoms are medically documented.

Frequently Asked Questions

1. What is the difference between varicose veins and spider veins?
   Both are forms of chronic venous disease. Varicose veins are larger, raised, and visible as twisted or rope-like bulges under the skin, usually on the thighs, calves, or back of the knees. Spider veins are smaller, flat, and appear as fine red, blue, or purple web-like patterns on the skin's surface. Both can indicate underlying venous insufficiency.
2. Can varicose veins come back after treatment?
   Treated veins do not return. However, because vein disease is a progressive condition, new varicose veins can develop over time in other areas. That is why CVR's vein doctors monitor patients closely with follow-up ultrasounds after treatment. Modern procedures like radiofrequency ablation have reported long-term success rates above 90 percent, even at five-year follow-up, according to research cited in NIH PubMed Central.
3. Should I see a vein doctor even if my varicose veins don't hurt?
   Yes. Pain is not the only signal that vein disease needs attention. Skin changes, persistent swelling, or visibly worsening veins are all reasons to get evaluated. Many patients with significant venous insufficiency have little or no pain until the condition advances. A vein specialist can assess the health of your veins with a painless duplex ultrasound and identify any problems before they become more serious.
4. Does sitting cross-legged make varicose veins worse?
   The evidence does not support a strong link between crossing your legs and worsening varicose veins. However, sitting for long periods in any position can slow circulation in the legs and raise venous pressure over time. If your legs feel heavy or uncomfortable, standing up, walking, or stretching regularly throughout the day is a simple way to improve blood flow.
5. What is the first step if I think I have vein disease?
   Take CVR's free Vein Quiz to better understand your symptoms, then schedule a consultation at your nearest CVR location. A board-certified vein specialist will perform a physical exam and duplex ultrasound to evaluate your vein health and explain your options. CVR accepts most major insurance plans, including Medicare and Medicaid.
6. Does insurance cover varicose vein treatment?
   In many cases, yes. When varicose veins cause medical symptoms such as leg pain, swelling, or skin changes, treatment is generally covered by major insurance plans, including Medicare and Medicaid. Contact your nearest CVR location to verify your coverage before your appointment.