How to prevent varicose veins

What causes varicose veins?

You may have heard of varicose veins - a fairly common condition that around one in three of the UK population will develop during their lifetime¹. What you may not know is that varicose veins aren't always obvious. This can mean that many of us neglect to follow the lifestyle habits that support our vein health.

Professor Mark Whiteley, leading consultant venous surgeon and founder of The Whiteley Clinic says: "In their simplest form, varicose veins can be identified as bulging veins which protrude from the legs. However, up to half of all people who have them will show no overt symptoms of varicose veins, as the problematic veins remain hidden under the skin. We call these 'hidden varicose veins'.

"Most people have a combination of causes for their varicose veins or 'hidden varicose veins', and so it is essential that all the causes are found and treated. This is why the National Institute for Health and Care Excellence (NICE) guidelines say that patients with varicose veins need to be seen by doctors working in teams²."

1. The first cause - a number of small communicating leg veins (perforators) that take blood in from your skin to the deep veins in your muscles. When their valves fail, blood is released into the surface veins.

2. The second cause (pelvic congestion syndrome, or PCS) - a medical condition caused by internal varicose veins in the lower abdomen and pelvis, which cannot be seen on the surface.

Are varicose veins dangerous?

Sadly, even though they happen to a lot of us, visible varicose veins often affect people's self-esteem. One study of 100 people even found a strong link between varicose veins and undiagnosed depression³.

The appearance of them is often a driving force for people becoming interested in how to prevent varicose veins. Yet, Whiteley also stresses that it is a common misconception that this condition is solely a cosmetic issue. If treatment for varicose veins is ignored, they can go on to cause a lot of problems.

"This is why the NICE guidelines² say that varicose veins with any symptoms or signs should be scanned and treated in specialist units," he adds.

Possible health problems

Although varicose veins rarely lead to serious health issues, Whitley outlines some possible complications:

• Blood clots - superficial vein thrombosis (SVT) and deep vein thrombosis (DVT) are blood clots that develop within a vein.

• SVT (also called phlebitis) - the clot is in the superficial veins and appears as a hard, red, painful lump. If the SVT gets within 5-7 cm of the deep vein, it can throw a clot off to the lungs - a pulmonary embolism (PE). Anyone with SVT, or 'phlebitis' should be referred for a duplex scan to see if they need anticoagulation.

• DVT - a clot in the deep veins that usually does not move, but if left untreated can cause scar tissue in the wall. This can result in swollen, discoloured and painful legs, and sometimes leg ulcers, a condition called post thrombotic syndrome (PTS). In more serious cases, DVT can lead to PE.

• Leg ulcers - research suggests that one in 20 people with 'simple' varicose veins will go on to experience leg ulceration if left untreated. Leg ulcers occur when the skin has broken down to reveal open sores which are unable to heal naturally and can often become infected if not treated correctly. However, they can now be treated - and even prevented - by local anaesthetic varicose vein surgery.

Can you prevent varicose veins?

Unfortunately, developing varicose veins is sometimes unavoidable - for example, your age, family history of the condition, and being female. Other factors in your life can also increase your likelihood of developing varicose veins. These include obesity, hormone replacement therapy, and pregnancy - varicose veins are almost twice as common in women who have been pregnant, compared to women who have never been pregnant⁴.

Patient picks for Veins

Heart health and blood vessels

Deep vein thrombosis

A deep vein thrombosis (DVT) is a blood clot in a vein. Blood clots in veins most often occur in the legs but can occur elsewhere in the body, including the arms. This leaflet is about blood clots in leg veins. The most common cause of a blood clot developing in a vein is immobility. A complication can occur in some cases where part of the blood clot breaks off and travels to the lung (pulmonary embolus). This is usually prevented if you are given anticoagulation treatment.

by Dr Toni Hazell

"You cannot prevent varicose veins," says Whiteley. "However, there are some things you can do to minimise any discomfort in your legs, and slow down the progression of the condition, if you do have varicose veins or 'hidden' varicose veins."

Habits that help prevent varicose veins

Let's explore the five healthy lifestyle habits that can aid prevention of varicose veins and help to delay problems with your veins.

1. Elevate your legs

"Raising your legs while you're sitting will help lower the pressure in your legs by allowing blood that has pooled in the veins to drain away - reducing your chance of skin damage and blood clots," advises Whiteley.

"This is a simple daily habit you can adopt while on the sofa. If you work at a desk from home, you could even prop up your legs while working using a footstool or cushions."

2. Get moving

"It is very important you get moving every hour to help keep your blood circulation working," says Whiteley. "Sitting or standing for long periods of time can make it harder for your blood to travel in the leg veins against gravity. This causes an increase in pressure in the veins, resulting in blood beginning to pool around the ankles."

3. Exercise regularly

We know that regular exercise supports our health in all sorts of ways, from keeping our hearts healthy to regulating our weight. Preventing varicose veins may be one of the lesser-known reasons to work out.

"Low-impact exercises such as yoga are particularly good at improving blood circulation," Whiteley adds. "The bending and stretching movements involved in the practice help to compress and decompress the blood vessels."

4. Watch your diet

Being overweight or obese increases the pressure in the veins lower down in your legs and could cause your ankles to swell. Therefore, a poor diet that is high in saturated fats and sugar increases your likelihood of varicose veins.

To maintain a healthy weight, make sure you eat a nutritious diet made up of all the food groups⁵ - including lots of fruit and vegetables. Be mindful of the recommended daily calorie intake for your sex.

5. Wear supportive socks or stockings

Supportive stockings from your doctor - also called graduated pressure or compression stockings - can help to relieve aching legs. Whiteley advises that even ones that sit below the knee can make your legs feel much better. These are often prescribed after your doctor has checked there are no problems with the arteries in your legs.

Further reading

1. Premier Veins, Are varicose veins dangerous?

2. National Clinical Guideline Centre, Varicose veins in the legs.

3. Sritharan et al. The burden of depression in patients with symptomatic varicose veins.

4. Nursing Times, Venous leg ulcer prevention 1: identifying patients who are at risk.

5. Eatwell Guide.