You notice a blue knot or a fine web on your lower leg—and you want to understand what's cosmetic and what's already a diagnosis. Varicose veins are enlarged, tortuous veins under the skin, most often in the legs: very common and usually not dangerous. But the mechanism is specific, and in some people it leads to complications that aren't immediately obvious.
What Happens to Veins and Valves
Veins return blood to the heart—that is, from bottom to top, against gravity. Valves keep this movement going: they work like locks, letting blood flow in the right direction and closing to prevent it from flowing back. If the vein wall is weak and the valve leaflets don't close tightly, backflow occurs, blood flows downward and pools in the legs. Pressure in the vessel increases, the lumen stretches—and the cycle continues: the wider the vein, the worse the valve seals its lumen. An additional pump is the leg muscles: during movement they push blood upward, so immobility slows this flow.
What Varicose Veins Look Like and How Vascular Webs Differ
Varicose veins are visible through the skin: enlarged, tortuous, lumpy to the touch, sometimes bulging. Most often they are in the legs, but they can occur in other areas of the body—hemorrhoids are also a type of varicose vein. Vascular webs, or spider veins, are small vessels of red, blue, or purple color; they are usually harmless.
Myth: a web on the thigh is the first stage of varicose veins. Fact: these are different phenomena. Varicose veins are enlarged and tortuous veins that without treatment can slowly worsen over years; webs usually do not behave this way.
Who Is at Risk
Risk increases when several factors coincide:
- age—the older the person, the higher the likelihood;
- female sex;
- obesity and lack of physical activity;
- heredity—congenital weakness of connective tissue and vein wall;
- pregnancy—the enlarged uterus presses on pelvic veins and impedes outflow.
An occupational factor also plays a role: prolonged standing still in cooks and salespeople. It is not decisive—rather, it adds to the predisposition. A trigger can also be deep vein thrombosis or compression of pelvic veins by a tumor: outflow is impeded, pressure in superficial veins increases.
What Symptoms Accompany It
Many people live with varicose veins without complaints. When symptoms are present, they are usually: pain or aching discomfort, a feeling of heaviness in the legs, swelling of the lower legs and feet. The skin over the veins may itch, change color, become dry and scaly. The pattern is simple: it worsens after prolonged standing, eases when lying down with legs elevated; pain is more often bothersome in the evening. Without treatment, the picture may worsen, but usually slowly—over several years.
How It Is Examined
Often a physical examination is sufficient: the doctor looks at the veins, palpates them, asks about symptoms. If there are complaints or complications, the patient is referred to a specialist who performs duplex ultrasound—a scan that shows blood flow in the veins. This study confirms the diagnosis and helps plan further steps. Not every case requires intervention: the decision depends on symptoms and complications.
Complications and Warning Signs
The skin over enlarged veins thins, dries, is easily injured, and eventually becomes pigmented—brown spots appear. Due to impaired tissue nutrition, trophic ulcers form: wounds resembling eczema that heal poorly. Inflammation of a vein with thrombus formation is thrombophlebitis. Bleeding from an injured vein can also occur. In people with varicose veins, a D-dimer test may be elevated due to chronic low-grade thrombosis in enlarged veins.
See a doctor routinely if: pain, itching, or swelling in the legs; a wound on the leg has not healed within 2 weeks; veins are worsening. Bleeding from a varicose vein is not a routine visit but an urgent appeal to a family doctor.
Varicose veins alone are not a reason to call an ambulance; 103/112—if bleeding from a vein is life-threatening or there is loss of consciousness
Reference material does not replace consultation: numbers and mechanisms help understand the picture, but assessment and further steps are determined by a doctor during an examination.
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This content is for reference and does not replace a doctor's consultation. Medical disclaimer