What are varicose veins and how can they be treated?

The human circulatory system is a closed-loop network with the heart at its center. Its main job is to pump blood through an extensive system of blood vessels, delivering oxygen and nutrients to cells and removing waste products from tissues.

The circulatory system includes:

• Veins, which carry blood back to the heart. Many of them contain valves that prevent the blood from flowing backward. Interestingly, about 75% of the blood in our body flows through the veins.

• Arteries, thick-walled vessels that transport blood away from the heart to organs and tissues, delivering oxygen and nutrients. Their flow matches the rhythm of the heartbeat, and the pressure in arteries is higher than in veins. Arteries connect to veins through tiny capillaries, forming a complete network.

Together with the lymphatic system, the circulatory system forms what’s known as the cardiovascular system. You can think of it like a network of pipes—some large, some tiny—all working together to keep your body functioning.

The veins of the lower limbs are divided into deep veins (located between muscles and connective tissue) and superficial veins (situated just beneath the skin). These two systems are connected by short, transverse vessels known as perforator veins. Unfortunately, venous vessels are also prone to various disorders—varicose veins among them. They form when the valves inside the veins can no longer perform their function and fail to prevent blood from pooling in the lower vessels. In some people, the valves are naturally weakened or faulty, causing blood to flow backward instead of toward the heart. This leads to the vein becoming overstretched, elongated, and widened.

This defect is what manifests visibly as varicose veins (which most commonly affect leg veins). The following types of varicose veins can be identified:

• Telangiectasias (Spider Veins) – A relatively common cosmetic issue. These are tiny dilated blood vessels (up to 1 mm in diameter) located in the skin, most often on the face, though they can also appear on the legs. They rarely cause any pain or physical discomfort.

• Reticular Varicose Veins – A network of small, twisted veins. These typically occur in women over the age of 20, most often behind the knee or on the outer side of the thigh and calf. Reticular veins are not usually painful or symptomatic, though you should consult a doctor if you notice pain, swelling, or bleeding from the veins.

• Trunk Varicose Veins (Main Trunk Veins) – When most people refer to “varicose veins,” they mean this type. They commonly appear along the inner surface of the leg (involving the great saphenous vein) or the back of the calf (involving the small saphenous vein). These veins are often associated with symptoms of chronic venous insufficiency, such as leg heaviness, swelling, and persistent pain.

There are several theories explaining the development of varicose veins, but most researchers agree that genetic predisposition is the leading cause. Inherited traits can influence the structure of vein walls (e.g., increased elasticity) or valve abnormalities (including an insufficient number of valves). So, if someone in your immediate family has varicose veins, there’s a high chance you may develop them too. Well-documented studies show that around 30–50% of people with one affected parent are likely to experience the condition themselves.

However, there are also several lifestyle and health-related factors that can increase the risk of developing varicose veins, such as:

• Prolonged standing (especially in certain professions)
• Lack of physical activity and sitting for long hours (especially with legs crossed)
• Pregnancy (due to hormonal changes, increased blood volume, and pressure from the growing uterus)
• Gender and ethnicity (women are up to 5 times more likely to be affected)
• Overweight and obesity
• Hormonal imbalances, as well as the use of oral contraceptives or hormone replacement therapy
• Wearing high-heeled shoes
• Heavy lifting
• Previous leg injuries or surgeries
• A diet low in fiber and vitamin C, and excessive use of substances like alcohol and tobacco
• Older age (although more and more young people are experiencing symptoms too)

Varicose veins are not just a cosmetic issue—they are a warning sign that something in your body isn’t functioning properly. That’s why it’s especially important not to ignore the symptoms.

Why? Because untreated varicose veins can lead to hard-to-heal leg ulcers and serious, potentially life-threatening complications, such as deep vein thrombosis (DVT). This condition can result in a pulmonary embolism, which poses a direct threat to a patient’s life. It is estimated that around half a million people die from pulmonary embolism each year in the European Union, including approximately 40,000 deaths annually in Poland. That’s why accurate diagnosis and timely, effective treatment are crucial in preventing serious complications related to varicose veins.

When a patient visits a specialist, they undergo a series of tests to determine the severity of the condition.

During a consultation with a vascular surgeon, the primary diagnostic tool is a Doppler ultrasound, which provides a precise assessment of the blood vessels, veins, and arteries. Other diagnostic methods may include varicography, phlebography, or liquid crystal thermography. During the appointment, the doctor discusses treatment options with the patient. The goals are to relieve symptoms, prevent complications, and improve the cosmetic appearance—especially important in the case of spider veins. Importantly, treatment for varicose veins and spider veins can be conservative, pharmacological, or surgical.

W pierwszym przypadku leczy się niewielkie zmiany, a pacjent musi przestrzegać ogólnych zaleceń, takich jak: stosowanie maści zmniejszających obrzęki, noszenie specjalnych podkolanówek i rajstop przeciwżylakowych. Leczenie farmakologiczne polega na doustnym podawaniu środków uszczelniających naczynia (naturalnych i syntetycznych). Gdy to nie pomoże, stosowane są zabiegi lecznicze takie jak np. skleroterapia piankowa, kriostripping, laser. Natomiast w przypadku niewydolności zastawek żylnych oraz naczyń przeszywających, stosuje się stripping, który jest klasycznym zabiegiem chirurgicznym polegającym na częściowym lub całościowym usunięciu chorych żył.

Zaawansowane żylaki mogą prowadzić do wielu nieprzyjemnych powikłań, a nawet śmierci. Dlatego też, jeżeli zauważyliście u siebie pierwsze objawy żylaków, to nie ma co zwlekać z wizytą u specjalisty.