3 minute read
A vein that stands out on your leg is not necessarily varicose. Healthy veins become visible when there is less between them and the surface, when they are carrying more blood, or when the skin over them thins. A varicose vein is different: it twists, it bulges unevenly, and it usually aches. The distinction matters because one needs nothing and the other benefits from treatment.
Here are the five common reasons a normal vein shows, how to tell them from a varicose vein, and the handful of signs that mean a visible vein should be looked at today.
1. Low body fat
Subcutaneous fat is what hides veins. Lose it, whether from training, dieting or simply your build, and the veins underneath appear. The Cleveland Clinic lists low-calorie diets that reduce body fat among the benign causes of prominent veins. Runners and lean people often have visible veins on the calves and feet with nothing wrong with them.
2. Exercise
Working muscle demands more blood, so the veins draining it dilate. Blood pressure rises during effort and pushes plasma into the muscle, which makes the muscle firmer and presses the veins outward. Lifters see this in the arms. Runners and cyclists see it in the legs. The veins go back down within an hour of stopping. A varicose vein does not.
3. Heat
On a hot day or after a bath, the body opens surface veins to shed heat. Veins on the legs and feet look fuller and darker, then settle as you cool. If a vein looks dramatic in July and ordinary in January, temperature is the likelier explanation.
4. Age and thinning skin
Skin loses collagen and fat with age, and the veins under it become easier to see. This is the reason older hands show veins. It happens on the shins too. The veins themselves may be perfectly healthy.
5. Genetics
Some people have veins that sit closer to the surface, or fairer skin that shows them. If a parent had visible leg veins with no symptoms, that is probably what you have too.
How a varicose vein looks and feels different
The tells are shape and symptoms. A normal visible vein runs in a fairly straight line, has an even width, and is soft. A varicose vein is 3 mm or wider by the CEAP definition, twists or coils, bulges more in some places than others, and often feels lumpy under the finger. It looks worse after standing and better first thing in the morning. And it usually comes with at least one of the symptoms on our varicose veins page: aching, heaviness, itching over the vein, or ankle swelling by evening.
One visible vein with none of those is almost always just a visible vein.
The signs that mean get it checked today
A vein that has recently started bulging and is also painful, warm, red, or accompanied by swelling in that one leg needs to be seen the same day. The Cleveland Clinic’s list of reasons to call a provider is bleeding, discoloration or redness, pain, warmth to the touch, and swelling around the vein. Together those describe a clot, either in the surface vein or in the deep veins beneath it, and a clot is the one thing on this page that can not wait for a routine appointment.
The honest part
We can not tell from a photo, or a phone call, whether a vein is varicose. What we can do is look and, if there is any doubt, run an ultrasound that shows whether the vein’s valves are working. If they are, we will tell you the vein is normal and send you home. That happens regularly and it is a good outcome. If the vein is refluxing, you will know what you are dealing with and what the options are, and nothing has to happen that day.
If it turns out to be varicose
The treatments are in-office and take under an hour. Varithena closes the feeding vein with a foam. Micro-phlebectomy removes the bulging surface vein itself through nicks so small they do not need stitches. Most people are back to their day the same afternoon. Insurance usually covers treatment when the ultrasound shows reflux and you have symptoms.
