Varicose veins are bulging, twisted veins (primarily in the legs) that are at least 3 mm in diameter and are a form of chronic venous disease. Although they can cause discomfort and may change in size, serious complications are rare, and they do not resolve without treatment.

Varicose veins may be cosmetically concerning, but they do not often cause serious complications and can be asymptomatic. When symptoms occur, they typically include aching, tightness, burning, itching, and swelling in the legs, which may worsen after prolonged sitting or standing and improve with leg elevation.

Varicose veins are diagnosed through a combination of symptom assessment and a physical examination (often performed while standing) to evaluate their presence, location, and severity. In some cases, a painless duplex venous ultrasound may be used to assess blood flow and identify issues with vein valves, and the condition is classified using the CEAP system.

Medical treatments for varicose veins depend on severity and individual preferences and range from conservative management with compression stockings and lifestyle changes for mild cases to interventional options like thermal ablation and sclerotherapy for more severe symptoms or cosmetic concerns. Although conservative methods can alleviate symptoms, they typically do not significantly alter the appearance of the veins.

Phlebotonics, a group of venoactive compounds that includes natural flavonoids and synthetic derivatives, have been studied for treatment of varicose veins and may help reduce symptoms like edema and pain. Evidence suggests that horse chestnut seed extract and French pine bark extract could be effective, although the overall research on phlebotonics is limited.

Diet has an unclear direct effect on varicose veins; some studies suggest that higher iron levels increase risk, whereas calcium, magnesium, and zinc may decrease it. Additionally, factors such as alcohol and coffee consumption, as well as dietary patterns involving omega-3 fatty acids and fiber intake, may also influence varicose vein risk.

Various treatments for varicose veins include exercise programs that enhance endothelial function and circulation, as well as balneotherapy and aquatic exercise, which improve quality of life and symptoms. Additionally, weight loss may alleviate symptoms for people with overweight, and avoiding prolonged standing can also help reduce symptoms.

Varicose veins are caused by a combination of genetic and environmental factors that lead to venous dysfunction, in which blood flow is impaired due to high blood pressure and insufficient valve function. This results in venous reflux, increased pressure, and structural changes in the veins, which are exacerbated by risk factors such as obesity, pregnancy, and prolonged standing or sitting.