Varicose veins are enlarged, twisted blood vessels appearing just beneath the skin, most commonly in the legs. They develop when one-way valves inside the veins become weak or damaged, failing to effectively push blood back toward the heart. This valve dysfunction causes blood to pool, leading to venous hypertension, or high pressure within the veins. While often viewed as only a cosmetic problem, untreated varicose veins are a progressive vascular disease. Ignoring the underlying issue allows increased pressure to damage tissue over time, leading to complications that affect health and quality of life.
Progression of Discomfort and Swelling
Sustained venous hypertension causes symptoms that affect daily comfort and mobility. Constant blood pooling stretches the veins, irritating surrounding nerves and tissue. This results in a persistent aching, throbbing, or heavy sensation in the legs that worsens throughout the day, especially after long periods of standing or sitting.
Many individuals also experience muscle cramping, which frequently occurs at night and can interrupt sleep. As pressure builds, fluid is forced out of the veins into the surrounding soft tissues, causing edema, or visible swelling. This fluid retention often concentrates around the ankles and lower legs, temporarily subsiding only when the legs are elevated. These cumulative symptoms can limit physical activity and make routine tasks challenging.
Chronic Skin and Tissue Changes
When venous hypertension remains uncorrected for a prolonged period, it leads to Chronic Venous Insufficiency (CVI). The sustained high pressure restricts the flow of oxygen and nutrients to the skin and underlying tissues. One of the first visible signs is Venous Eczema, also called Stasis Dermatitis, which presents as itchy, red, scaly, or flaky patches of skin typically on the lower leg.
Another common change is hyperpigmentation, a brownish or reddish discoloration of the skin. This occurs because red blood cells leaking from pressurized veins break down, releasing iron-containing deposits called hemosiderin into the tissue. The most severe structural change is Lipodermatosclerosis, where the skin and the fat layer beneath it become hardened and thickened. This tissue fibrosis makes the skin feel tough and leathery, sometimes restricting ankle movement.
Development of Venous Stasis Ulcers
The progression of CVI and severe tissue damage from Lipodermatosclerosis eventually lead to the formation of Venous Stasis Ulcers. These are open, non-healing wounds that typically develop near the ankles, an area where venous pressure and fluid pooling are highest. The damaged, hardened tissue from CVI is poorly nourished and fragile, making it susceptible to minor trauma that can initiate a wound.
These ulcers are difficult to treat because the underlying issue of poor circulation remains. The lack of efficient blood flow hinders the delivery of immune cells and nutrients required for wound repair, leading to slow healing that can take months or years. The open wound also creates a high risk for secondary bacterial infection, such as cellulitis, which requires immediate medical intervention with antibiotics. The constant pain, drainage, and required long-term wound care significantly impact a person’s mobility and independence.
Increased Risk of Blood Clots
Untreated varicose veins also increase the risk of blood clot formation due to the stagnant, slow-moving blood flow, a phenomenon known as stasis. Clots can form directly within the visible, superficial varicose veins, a condition called Superficial Thrombophlebitis. This usually causes localized symptoms like redness, warmth, tenderness, and inflammation along the affected vein, but is generally not life-threatening.
A more serious concern is the increased risk of Deep Vein Thrombosis (DVT), where a clot forms in the deep venous system of the leg. Varicose veins are recognized as a risk factor for DVT. The danger of DVT is the possibility that the clot may break free and travel through the bloodstream to the lungs, resulting in a life-threatening Pulmonary Embolism.