10 Myths About Varicose Veins: What Is True and What Is Not

Only some of the ten common statements about varicose veins are partially true: the condition does not occur only in older people, does not always cause pain, and visible veins do not always require surgery. The treatment approach is determined after an examination and vein duplex ultrasound, not from a photograph of the leg.

People often notice heaviness by the evening, spider veins, or bulging veins but postpone an examination. Some consider this an age-related feature or a cosmetic imperfection, while others buy an ointment and wait for the veins to disappear.

I am Anvar Midxatov, a phlebologist. I have worked in vascular surgery since 2019. In my practice, I regularly see how myths prevent people from identifying the cause of their symptoms in time.

Myths About Varicose Veins: Straight to the Point

Myth 1. Varicose Veins Occur Only in Older People

Varicose veins can appear at a young age as well. Vein health is influenced by heredity, pregnancy, occupational factors, prolonged standing or sitting, excess weight, and previous disorders of venous blood flow.

Age matters, but it is not a mandatory condition. If your veins have become more visible and you have developed heaviness, swelling, or night cramps, do not wait for the “right age”.

Learn more about this symptom in the article on leg heaviness.

Myth 2. It Is Just a Cosmetic Issue

Spider veins and enlarged veins can look different and do not always indicate the same problem. In some cases, the issue is indeed primarily aesthetic. However, in some people, visible changes are caused by impaired function of the venous valves.

The first step is to determine whether pathological reflux, or backward blood flow, is present. Vein duplex ultrasound is used for this purpose. In the article “Reflux on Vein Ultrasound: What Does It Mean?”, I explain why the appearance of the leg cannot replace an examination.

Spider veins should not automatically be considered varicose veins either. CLaCS may be used to correct them: the cryolaser acts through the skin, while a sclerosant is injected into the feeding vessel branch. This is not removal of a vessel through punctures. Bulging veins are removed through mini-accesses using miniphlebectomy.

Myth 3. The Laser Burns the Vein, and It Then “Rots” Inside

During EVLA, the laser does not leave a rotting or blood-filled vein in the leg. Under ultrasound guidance, the doctor closes the altered section from the inside. Blood is redirected through other functioning veins, while the closed vessel gradually undergoes fibrosis and becomes less noticeable.

EVLA is not “charring” the leg and is not treatment performed blindly. Before the procedure, the anatomy of the veins, the direction of blood flow, and the condition of the deep veins are assessed. I perform EVLA using the Biolitec laser system. Learn more about the method on the EVLA page.

Myth 4. Varicose Veins Will Definitely Return After Treatment

A recurrence is possible, but this does not mean that the treatment was useless or that the same vein has returned. Over time, another section of the venous system may become pathological. Heredity, pregnancy, weight, lifestyle, and adherence to recommendations also affect the result.

After treatment, it is important not only to remove the visible vein but also to identify the source of the impaired blood flow. If new symptoms appear, do not independently buy compression garments of another class or repeat the previous treatment. Follow-up and, if necessary, a new ultrasound examination are needed.

Myth 5. Varicose Veins Must Never Be Treated During Pregnancy

Planned removal of varicose veins during pregnancy is generally not the first choice. During this period, observation, safe physical activity, and compression recommendations are more often used if they are appropriate for the individual woman.

However, the statement that they must never be treated is too categorical. If concerning symptoms appear, a pregnant woman should see a doctor rather than wait until delivery or take medications independently. After pregnancy, the approach is reassessed: some changes decrease, while others require separate treatment.

Myth 6. You Should Walk Less and Lie Down More

Constant rest does not treat varicose veins. In the absence of contraindications, calm walking is usually more beneficial than prolonged sitting or standing without movement. The calf muscles act as a natural “pump” and support venous return.

This does not mean that you should suddenly increase your workload or exercise through pain. Practical measures:

• get up and walk a little every 40–60 minutes when working while seated;
• do not stand still for prolonged periods;
• move your feet and perform heel raises without pain;
• do not use exercise to test “how serious everything is”.

Myth 7. Ointments and Tablets Will Remove Enlarged Veins

Ointments may temporarily reduce the sensation of dryness, discomfort, or heaviness. Medications are sometimes prescribed to control symptoms, but they do not “glue” damaged valves back together or remove an enlarged vein.

If a venous trunk is functioning incorrectly, the doctor selects the treatment approach based on ultrasound findings. Options may include observation, compression, sclerotherapy, EVLA, or another approach. Do not combine several medications independently.

Myth 8. Varicose Veins Occur Only in Women

Women seek care more often because of pregnancy and visible changes, but varicose veins also occur in men. Men often postpone their visit because they consider the problem “a woman’s issue” or seek care only when the changes become pronounced.

Sex does not determine whether an examination is needed. If one-sided swelling, bulging veins, heaviness, itching, or recurrent night cramps have appeared, it is reasonable to begin with an examination and vein duplex ultrasound.

Myth 9. If It Does Not Hurt, It Does Not Need Treatment

The absence of pain does not prove that the venous system is functioning normally. Varicose veins may manifest as heaviness, evening swelling, itching, skin changes, or simply visible veins.

However, the opposite mistake is also common: a person sees one vein and immediately decides that surgery is needed. The treatment approach depends on the symptoms, the condition of the skin, the pattern of blood flow, and the ultrasound results. Sometimes observation is sufficient. In some cases, treatment is recommended even with minor complaints if there are objective indications. I have discussed separately whether varicose veins need to be operated on if nothing hurts.

Myth 10. Surgery Means General Anesthesia and a Long Sick Leave

Modern treatment of varicose veins does not always resemble major surgery. Depending on the situation, minimally invasive methods, local anesthesia, or another type of anesthesia may be used, selected according to the extent of the intervention and the patient’s condition.

EVLA, sclerotherapy, and miniphlebectomy are different procedures. Sclerotherapy closes the selected vessel by injecting a medication. During miniphlebectomy, bulging venous tributaries are removed through small punctures. CLaCS is intended for spider veins: the laser works through the skin, while the sclerosant acts on the feeding vessel.

It is not possible to promise the same recovery period for all patients in advance. It depends on the method, the extent of treatment, and individual factors. The cost is also determined after ultrasound and documented in a written estimate.

What Should You Choose: Observation, Treatment, or an Examination First?

A Simple Self-Check for Today

This list does not diagnose a condition, but it can help you understand whether you are postponing an examination without a good reason. Answer “yes” or “no”:

• one leg becomes noticeably more swollen than the other by the evening;
• heaviness decreases after rest but regularly returns;
• new bulging veins have appeared;
• the skin near a vein itches, becomes darker, or feels thicker;
• night cramps recur;
• symptoms worsen after prolonged sitting or standing;
• you have previously undergone vein treatment, but visible changes have appeared again.

If you have several “yes” answers, note when the changes appeared, what makes them worse, and whether they decrease in the morning. These notes and the ultrasound results will make your discussion with the doctor more precise.

At the consultation, it is useful to ask:

• Is there pathological reflux on the ultrasound?
• Which veins are the source of the problem?
• Can the condition be observed, or is treatment already advisable?
• Which method is suitable specifically for this anatomy, and why?
• What is included in the plan before and after the procedure?
• What type of compression garment is needed, and how should the size be selected?
• Which signs after treatment require an unscheduled consultation?

When to See a Doctor Urgently

Do not wait for a routine consultation if you develop:

• sudden noticeable swelling of one leg;
• rapidly increasing pain, tenderness, or a sensation of heat in the limb;
• pronounced redness or a change in skin color along the course of a vein;
• sudden shortness of breath, chest pain, difficulty breathing, or coughing up blood, in which case call an ambulance;
• bleeding from a bulging vein that does not stop after firm pressure is applied;
• a rapidly enlarging wound or a sharp deterioration in the condition of the skin on the lower leg.

It is not possible to reliably determine the cause of these symptoms through correspondence. An in-person examination is needed, and sometimes urgent medical assistance is required.

Practical Conclusion

The main mistake is treating one’s own idea of a venous problem rather than the problem itself. Ointments do not remove enlarged veins, the absence of pain does not rule out changes, and a laser does not leave a vessel to “rot” inside. At the same time, not every spider vein means that surgery is necessary.

Start with an examination and vein duplex ultrasound, then discuss the treatment approach with your doctor. If you need a consultation at M-Clinic, appointments are available by phone at +998 99 883-93-21.

This article is for informational purposes only and does not replace a consultation with a qualified physician. If you are experiencing symptoms, please see a specialist.