Unveiling the Veins: Understanding the Causes of Varicose Veins

Varicose veins, those enlarged, twisted veins often seen on the legs, are a common vascular condition that affects millions of people worldwide. While they may be a familiar sight, the underlying causes of varicose veins are not always well-understood. In this comprehensive blog, we’ll delve into the intricate web of factors that contribute to the development of varicose veins, shedding light on both genetic and lifestyle-related aspects that play a role in this condition.

Understanding Varicose Veins:

Before we explore the reasons behind varicose veins, it’s essential to understand the normal functioning of veins. Veins carry blood back to the heart, and this journey involves overcoming gravity. To aid this process, veins contain one-way valves that prevent blood from flowing backward. When these valves weaken or fail, blood can pool in the veins, leading to their enlargement and the formation of varicose veins.

Reasons for Varicose Veins:

  1. Genetics:
    • Family history plays a significant role in the development of varicose veins. If your parents or grandparents had varicose veins, you may be genetically predisposed to the condition. Inherited factors can affect the strength and integrity of vein walls and valves, making you more susceptible.
  2. Age:
    • Aging is a natural factor that contributes to the weakening of vein walls and valves. As we age, the elasticity of our veins decreases, making them more prone to stretching and becoming varicose.
  3. Gender:
    • Women are more likely to develop varicose veins than men. Hormonal changes, especially during pregnancy and menopause, can affect vein elasticity. Additionally, the use of hormonal contraceptives may contribute to the development of varicose veins.
  4. Pregnancy:
    • Pregnancy is a common factor in the development of varicose veins. The increased pressure on the pelvic veins and the hormonal changes that accompany pregnancy can weaken vein walls and valves. Varicose veins that develop during pregnancy often improve postpartum, but they may persist.
  5. Obesity:
    • Excess weight places additional pressure on the veins in the legs, increasing the risk of varicose veins. Obesity is often associated with poor circulation, which can contribute to the development and progression of this condition.
  6. Prolonged Sitting or Standing:
    • Jobs or lifestyles that involve prolonged periods of sitting or standing can hinder blood circulation, leading to the pooling of blood in the lower extremities. Over time, this can contribute to the development of varicose veins.
  7. Lack of Physical Activity:
    • Regular physical activity helps maintain healthy blood circulation. A sedentary lifestyle can contribute to poor blood flow and increase the likelihood of developing varicose veins.
  8. Deep Vein Thrombosis (DVT):
    • A history of deep vein thrombosis, a condition where blood clots form in the deep veins of the legs, can damage vein valves and increase the risk of varicose veins.
  9. Chronic Constipation:
    • Straining during bowel movements due to chronic constipation can elevate abdominal pressure, affecting blood flow and contributing to the development of varicose veins, especially around the rectal area (hemorrhoids).
  10. Trauma or Injury:
    • Previous injuries or trauma to the veins can impair their functionality, increasing the likelihood of varicose veins.

Interventional treatments for varicose Veins:

Interventional treatments for varicose veins have evolved significantly over the years, offering less invasive alternatives to traditional surgical procedures. These interventions are designed to address the underlying causes of varicose veins, such as venous reflux or insufficiency, by closing or removing the affected veins. Here are some commonly used interventional treatments for varicose veins:

  1. Endovenous Laser Ablation (EVLA):
    • EVLA is a minimally invasive procedure that uses laser energy to close off varicose veins. A thin laser fiber is inserted into the affected vein, and laser energy is applied, causing the vein to collapse and seal shut. EVLA is typically performed in an outpatient setting and is associated with minimal discomfort and a shorter recovery period compared to traditional surgery.
  2. Radiofrequency Ablation (RFA):
    • RFA is a similar procedure to EVLA but uses radiofrequency energy instead of laser energy. A catheter is inserted into the vein, and radiofrequency energy is applied to heat and close the vein. RFA is effective in treating the underlying cause of varicose veins and has a high success rate with minimal side effects.
  3. Sclerotherapy:
    • Sclerotherapy is a versatile and widely used treatment for both varicose veins treatment and spider veins. In this procedure, a sclerosing solution is injected directly into the affected vein, irritating the vein walls and causing them to stick together. Over time, the treated vein is absorbed by the body, and blood is rerouted through healthier veins.
  4. Foam Sclerotherapy:
    • Foam sclerotherapy involves injecting a foam version of the sclerosing solution. The foam has the advantage of covering a larger surface area within the vein, making it particularly effective for larger varicose veins. This technique is often used in conjunction with other treatments or as an alternative for veins that are not suitable for laser or radiofrequency procedures.
  5. Ambulatory Phlebectomy:
    • Ambulatory phlebectomy is a minimally invasive surgical procedure that involves the removal of varicose veins through small incisions in the skin. This is typically done for surface veins that are too large or tortuous for treatments like sclerotherapy. The incisions are usually so small that stitches are not required, and the procedure is performed on an outpatient basis.
  6. Mechanochemical Ablation (MOCA):
    • MOCA combines the use of mechanical agitation and a liquid sclerosing agent. A catheter with a rotating wire is inserted into the vein, mechanically disrupting the endothelial lining of the vein, and a sclerosing agent is simultaneously infused. This dual-action approach enhances the closure of the treated vein.
  7. VenaSeal Closure System:
    • The VenaSeal system is a relatively new approach that uses a medical adhesive to seal the affected vein. A catheter is inserted into the vein, and the adhesive is delivered, closing the vein. This procedure does not require the use of heat or sclerosing agents and has a rapid recovery time.

It’s important to note that the choice of interventional treatment depends on various factors, including the size and location of the varicose veins, the overall health of the patient, and the underlying cause of the condition. A qualified vascular interventional specialist will assess these factors and recommend the most appropriate treatment for each individual. These interventional Varicose Veins treatment have revolutionized the management of varicose veins, offering effective solutions with fewer complications and a quicker return to normal activities.


Varicose veins, while often considered a cosmetic concern, can be a result of a complex interplay of genetic and lifestyle factors. Recognizing these contributing factors is crucial for both prevention and effective management. If you are experiencing symptoms of varicose veins or are at risk due to genetic predisposition or lifestyle factors, consult with a healthcare professional. Understanding the causes of varicose veins empowers individuals to make informed choices about their vascular health and take proactive steps towards prevention.

About the Author:



DR. SURESH GIRAGANI CONSULTANT INTERVENTIONAL RADIOLOGIST at Apollo hospitals Jubilee Hills has more than sixteen years of clinical experience in vascular interventions with a special interest in neurovascular and peripheral vascular disease interventional procedures.


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