Varicose Veins

Varicose veins are superficial veins that have become enlarged and twisted. When the shape of the vessels widens to change the pressure, the veins can be seen on the shin. It is harmless and usually painless. Some may experience weight, pressure, and itching. You can reduce the symptoms by walking, using support socks and keeping your legs raised when resting.


Blood circulation ensures that all the tissues in the body get oxygenated and nutritious blood. Arteries, capillaries and veins are three types of vessels with different functions in the circulatory system. The vein system consists of a superficial and a deeper network of vessels.


What are varicose veins? In the veins there are valves which prevent the blood from flowing backward. The work of the muscles in the legs acts as a pumping mechanism and helps the flow of blood back to the heart. As they widen, they turn and begin to bulge.


Signs of varicose veins are mainly seen in your legs as bluish bulges. These are most clearly visible on the shin, back of the knees and hips. The superficial blood vessels present in the skin can also form small cobweb-like patterns, which is a milder form of the varicose vein, without any symptoms.


Heredity is a known risk factor for developing varicose veins.


Pregnancy increases the risk due to hormone changes, increased weight and blood volume.


Circulation from the legs is dependent on movement, therefore standing for long periods or being sedentary can increase the risk of developing varicose veins.
Varicose veins are also associated with being overweight, due to the increased pressure.


If you have a blood clot in the leg, the valves may be damaged, which increases the risk of varicose veins later.


Varicose veins are more common in the elderly as the vein valves deteriorate and the elasticity of the vessels also deteriorates with age.


You can have varicose veins without any symptoms. The symptoms vary, but common symptoms of varicose veins in the legs are:


  • Aching, heavy legs.
  • Appearance of spider veins (telangiectasia) in the affected leg.
  • Ankle swelling, especially in the evening.
  • A brownish-yellow shiny skin discoloration near the affected veins.
  • Redness, dryness, and itchiness of areas of skin, termed stasis dermatitis or venous eczema, because of waste products building up in the leg.
  • Cramps may develop, especially when making sudden movements or standing up.
  • Minor injuries to the area may bleed more than normal or take a long time to heal.
  • In some cases, the skin above the ankle may shrink (lipodermatosclerosis) because the fat underneath the skin becomes hard.
  • Restless legs syndrome appears to be a common overlapping clinical syndrome in people with varicose veins and other chronic venous insufficiencies.
  • Whitened, irregular scar-like patches can appear at the ankles. This is known as atrophie blanche.


Symptoms may increase after prolonged stasis. At the end of the day, it may feel worse. Some may feel burning in their legs. 


You can also get skin changes called pigmentation, which can look like bruises on the legs.


A less usual symptom – more common in the elderly – is thinner and more fragile skin, which more easily leads to injuries. Watch out for signs:


  • eczema
  • leg ulcers

Prevention and protection

Self-care in the form of walking, wearing support stockings and having the legs raised while resting, are good preventative measures. Other important measures include:


  • weight loss in case of obesity
  • stop smoking
  • regular physical activity according to ability
  • use of compression socks or stockings.


Varicose veins are harmless and usually symptom-free.
If you have eczema problems, treatment is needed to avoid inflammation of the skin and ulceration. Leg ulcers at the ankle joints and shin also require long-term treatment by healthcare professionals.


The doctor will perform a physical examination to see the extent of the varicose veins and to determine if there are any other circulatory or skin problems. It is important to distinguish whether the problem is linked to arteries or veins.


Varicose veins can be removed by a laser, radio wave treatment, injection with a type of foaming agent and surgery. Varicose veins that are medically painless are not treated. In case of cosmetic discomfort you need to contact a private healthcare provider yourself.

When to consult a doctor

If your symptoms worsen despite self-care, you should contact your health care provider for advice. Skin changes, eczema, and ulceration are signs of a worsening condition.

How Appotek can help

You can contact us at APPOTEK for help with varicose veins. A nurse or physician makes an individual assessment based on your symptoms. You can then be referred for further care. In the case of varicose veins, a physical examination is required.


Vadym Diadiun, Doctor of Medicine, M.D.