Varicose veins
Varicose veins are a common problem, especially for women. In the UK nearly one in three women will 
develop varicose veins, whereas for men the risk is one in six.
The heart pumps blood through the arteries to all parts of the body. Blood travels through smaller and smaller vessels until reaching the capillary network, where it delivers oxygen and nutrients and collects wastes and carbon dioxide. It then travels back to the heart through veins. Arteries have thick, elastic muscular walls which helps to conserve the blood pressure ensuring the blood can reach all areas. The veins have very thin walls which cannot contract to move blood through them. Larger veins contain one-way valves which prevent backflow of blood and depend on movement of surrounding muscles to keep the blood flowing against gravity.
If a vein section around a valve, or the valve itself becomes weakened or damaged, the leaflets of the valve may not meet properly and blood can leak and flow backwards, away from the heart, causing a build up of blood. Once this occurs at one valve there is extra pressure on the vein, which may widen and cause more leaky valves. The resulting imperfect return of blood back to the heart is known as chronic venous insufficiency.
Chronic venous insufficiency (sometimes known as chronic venous disease) can cause varicose veins. When the blood starts to collect in the veins it can cause them to become abnormally enlarged, thick and twisted and they may protrude under the skin. These visible, bulging veins are called varicose veins. The thickened and twisted parts of the veins are called varicosities.
Although varicose veins are more common in the legs, varicosities can occur anywhere in the body, for example piles (haemorrhoids) are a type of varicosity.
Varicose vein causes
Varicose veins tend to be inherited, if your parents have varicose veins you are more likely to develop them. This may be related to too few valves or defective valves.
Varicose veins are also more common with aging, this is because as we age our veins become weaker and more susceptible to damage that results in varicosities. Most elderly people have some degree of varicosity.
The leaking of the venous valves that leads to varicosities may be due to a vein disease such as thrombophlebitis, or to increased pressure within the veins such as can occur during pregnancy. Hormonal factors during pregnancy also increase the risk of developing varicosities, increasing with the number of pregnancies. However, sometimes there is no apparent cause for varicosities.
Being overweight may increase the risk of varicosities developing, and it is often suggested that the risk may be greater for people with jobs that involve lots of time on their feet as standing and walking put extra pressure on the leg veins, though this has not been proven.
Varicose vein symptoms
Most people with varicose veins do not have symptoms or complications, but some people are concerned by the appearance of the varicosities.
Larger varicose veins may cause symptoms such as heaviness, aching or tiredness in the legs after standing for long periods. A creeping sensation or itchiness of the skin. Sore or painful legs, or night-time cramps due to poor circulation. Swollen legs or ankles due to an accumulation of fluid.
Restless legs syndrome is often associated with varicose veins and other chronic venous insufficiency.
Varicose vein complications
If varicose veins are severe, the resulting higher pressure in the varicose veins causes changes in the surrounding small blood vessels leading to poor circulation to the area. The skin over the varicosity can become sore, red, dry, itchy and thin, this is known variously as stasis dermatitis, stasis eczema, varicose eczema or venous eczema and is caused by the poor circulation to the skin. The skin may have a shiny and brownish-blue discolouration around the affected veins. Damage to the affected skin can lead to skin loss and development of a skin ulcer, especially near the ankle, usually called a venous ulcer or varicose ulcer.
Other possible complications include inflammation of the vein, called thrombophlebitis, and in rare cases, a long-standing venous ulcer may turn malignant.
Varicose vein prevention
A balanced diet can help strengthen your veins. Eating plenty of fruit and vegetables that contain antioxidants helps to keep blood vessels healthy.
To prevent varicose veins from developing or getting worse, regular exercise such as walking may be beneficial as this helps vein function.
Maintaining a healthy weight or losing excess weight may help by keeping pressure in the leg veins down. After standing for long periods raise legs higher than your chest. Do not cross legs while sitting down.
If varicose veins are causing symptoms such as discomfort your doctor may suggest lightweight compression stockings. Using these may help to ease the discomfort, however they will not remove the varicose veins.
Self-help for varicose veins
Apply distilled witch hazel or horsechestnut cream topically to the area around a varicose vein. Both of these herbal remedies have a long tradition of use for varicose veins and haemorrhoids.
Marigold cream may be a good moisturising cream for dry skin around varicose veins because it is both healing and soothing.
Modern research confirms that several herbal remedies can help treat chronic venous insufficiency, safely and effectively. If you would like to try a herbal approach for prevention or management of varicose veins or chronic venous insufficiency consult a local qualified herbalist.
A herbalist will prepare an individually prescribed combination of herbal medicine specifically for you. They may choose from herbal medicines such as horsechestnut, ginkgo, butcher's broom, yarrow or gotu kola. Herbal remedies can help to strengthen veins, improve circulation and reduce inflammation and swelling.
Research on varicose veins and chronic venous insufficiency
Pathogenesis of primary varicose veins; abstract
Varicose veins and chronic venous insufficiency; abstract
Effect of progesterone and pregnancy on the development of varicose veins; abstract
Risk factors related to the failure of venous leg ulcers to heal with compression treatment; abstract
The epidemiology of chronic venous insufficiency and varicose veins; abstract
Minimally invasive techniques in the treatment of saphenous varicose veins; abstract
Treatment of varicose veins; abstract
Research on herbal remedies
Treatment of patients with venous insufficiency with fresh plant horse chestnut seed extract: a review of 5 clinical studies; abstract
Clinical efficacy of horsechestnut seed extract in the treatment of venous ulceration; abstract
Increase in circulating endothelial cells in patients with primary chronic venous insufficiency: protective effect of Ginkor Fort in a randomised double-blind, placebo-controlled clinical trial; abstract
[Treatment with Ginkor Fort in varicose veins]; abstract
Haemorrhoids and varicose veins: a review of treatment options; abstract
Effects of Centella asiatica extract on mucopolysaccharide metabolism in subjects with varicose veins; abstract
From medical herbalism to phytotherapy in dermatology: back to the future; abstract
Using horsechestnut seed extract in the treatment of venous leg ulcers: a cost-benefit analysis; abstract
Titrated extract of Centella asiatica (TECA) in the treatment of venous insufficiency of the lower limbs; abstract
[Activity of Centella asiatica in venous insufficiency]; abstract
Efficacy and safety of a Butcher's broom preparation (Ruscus aculeatus L. extract) compared to placebo in patients suffering from chronic venous insufficiency; abstract
Horse chestnut seed extract for chronic venous insufficiency; abstract
More information on varicose veins
Medline Plus - Varicose veins
Patient UK Information sheet - Varicose veins
NHS Choices - Health A-Z - Varicose veins
BUPA factsheet - Varicose veins
The Merck Manuals online medical library - Varicose veins