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Varicose veins and venous insufficiency
Varicose veins are dilated, twisted superficial veins, almost always in the legs. They appear when the valves that help blood flow back to the heart stop working properly, a condition called venous insufficiency. They are not only a cosmetic problem: they can cause heaviness, pain and swelling and, if left untreated, skin changes and ulcers. They can be treated, and the right option depends on an assessment with Doppler ultrasound.
In summary
- Cause: vein valves that fail and let blood pool in the leg.
- Diagnosis: clinical examination and venous Doppler ultrasound.
- Options: self-care and compression, sclerotherapy, endovenous treatment and, in selected cases, surgery.
- See a doctor soon if you have pain, sudden swelling of one leg, wounds or skin color changes.
What are varicose veins and venous insufficiency?
Veins carry blood back to the heart. In the legs, that blood has to travel upward against gravity, helped by the calf muscles and by small valves that work like one-way doors.
When those valves weaken, some of the blood flows back down and collects. Pressure inside the vein rises and the vein widens: this is how varicose veins form. Chronic venous insufficiency is the broader name for this problem and ranges from spider veins to venous ulcers.
Some varicose veins bulge under the skin; others, deeper ones, cannot be seen but still cause symptoms.
Symptoms
- Heavy or tired legs, especially at the end of the day.
- Pain, burning or a feeling of tightness.
- Ankle swelling that improves when the legs are raised.
- Night cramps and itching.
- Visible, bulging or winding veins.
- In advanced stages: dark patches, hardened or eczema-like skin, and wounds that are slow to heal.
Symptoms usually get worse with heat and after long periods of standing or sitting, and improve with walking or raising the legs.
Causes and risk factors
- A family history of varicose veins.
- Pregnancies and hormonal changes, including the use of oral contraceptives.
- Age.
- Excess weight and little physical activity.
- Spending many hours standing or sitting without moving.
- A previous venous thrombosis.
Heredity plays a large role, so they cannot always be prevented. Good habits help relieve symptoms and delay new varicose veins.
How they are diagnosed
The doctor reviews your symptoms and history and examines your legs, standing and lying down. To confirm the diagnosis and plan treatment, a venous Doppler ultrasound is performed. This ultrasound exam shows which veins are failing, where the blood is going and whether there are clots. It does not hurt and uses no radiation.
Treatment options
There is no single treatment for every patient. It is chosen according to the size of the veins, which vein is affected, your symptoms and your personal circumstances.
Self-care and compression
Walking daily, raising your legs, avoiding long periods of standing or sitting and wearing compression stockings prescribed by your doctor relieve symptoms, but they do not remove varicose veins.
Sclerotherapy
A medication is injected to close small veins. It is used for spider veins and small varicose veins. More information in sclerotherapy.
Ultrasound-guided endovenous treatment
The diseased vein is closed from the inside using a catheter guided by ultrasound. It is an outpatient procedure with no open surgery. Several techniques exist (for example laser, radiofrequency or sclerosing foam) and the specialist chooses the most suitable one for each case.
Surgery
It is reserved for selected cases in which the other options are not suitable.
What to expect from treatment
- Procedures are usually done on an outpatient basis and, in general, with local anesthesia.
- Many patients return to their activities the next day, following the doctor's instructions.
- A compression stocking may be recommended for a while, along with daily walking.
- Bruising and tenderness in the treated area are common and improve over the following days.
- Serious risks are uncommon. They may include inflammation of a superficial vein, temporary skin color changes or, very rarely, a clot. The doctor explains these risks before the procedure.
- New varicose veins can appear over time, because the predisposition remains. That is why regular check-ups are recommended.
When to seek urgent care
Go to the emergency department or seek care immediately if you have:
- Sudden swelling, redness, warmth and pain in one leg only (it may be a thrombosis).
- Bleeding from a varicose vein: press with a clean gauze, raise the leg and go to the emergency department.
- Chest pain or difficulty breathing.
- A leg wound that does not heal or shows signs of infection.
Frequently asked questions
Are varicose veins only a cosmetic problem?
No. Besides their appearance, they can cause heaviness, pain, swelling and, if they progress, skin changes and ulcers. That is why they should be assessed even if they do not hurt.
Do varicose veins go away on their own?
No. They tend to stay the same or progress over time. Self-care relieves symptoms and treatment can improve or remove the diseased veins.
Do I need previous tests before the consultation?
You do not need to bring previous tests. At the first visit the clinical examination is done and, if needed, a vascular Doppler ultrasound in the same office.
Can they be treated during pregnancy?
In general, treatments are postponed until after pregnancy and breastfeeding. In the meantime, self-care and compression measures prescribed by the doctor are used.
Can they come back after treatment?
New varicose veins can appear, because the tendency to develop them is still there. A regular check-up helps detect and treat them early.
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Book via WhatsAppThe information on this page is general and for guidance only. It does not replace a medical consultation. If you have a warning sign, go to the emergency department. The pages are written for patients in Colombia; consultations are in Spanish.
Last updated: October 15, 2026