What Happens to the Veins in Varicose Vein Disease
Blood in the leg veins has to travel upward, against gravity. To stop it from flowing back down, the veins contain valves that open toward the heart and snap shut the moment blood tries to reverse.
In varicose vein disease those valves stop closing properly, allowing blood to fall back down — a process called reflux. The vein overfills, stretches, and can no longer return to its normal diameter: heaviness and swelling appear, and twisted, rope-like bulges form beneath the skin.
It's important to understand: a stretched vein will not 'shrink back on its own', and no cream or tablet can repair damaged valves. The only definitive solution is to close or remove the diseased vein. Blood is then naturally rerouted through healthy deep veins, which take over the workload without difficulty.
Symptoms of Varicose Veins
Early Warning Signs
- Heaviness and leg fatigue by evening
- Ankle swelling at the end of the day that resolves overnight
- Nocturnal calf cramps
- Burning or a feeling of pressure along the course of the veins
- Spider veins and bluish reticular networks
As the Condition Progresses
- Visibly bulging, twisted veins and nodules
- Persistent swelling that does not resolve overnight
- Darkening and hardening of the skin on the lower leg
- Itching and dryness of the skin over the veins
- Slow-healing sores — up to and including venous ulcers
Sudden, firm swelling of one leg, bursting pain, redness, and a tender hardened cord along a vein may indicate thrombosis. This is a medical emergency — don't wait for an appointment; call immediately. +998 99 883-93-21
Causes & Risk Factors
Heredity
The single most important factor. If both parents have varicose veins, the likelihood of inheriting weakened vein walls reaches 90%.
Pregnancy & Hormones
Progesterone relaxes vein walls, and the growing uterus compresses the pelvic veins — varicose veins frequently make their first appearance during pregnancy.
Prolonged Standing or Sitting
Retail workers, surgeons, hairdressers, drivers, office staff: without the calf's muscular pump working, blood pools in the legs.
Excess Weight
Raises pressure inside the leg veins and accelerates wear on the valves.
Age
Vein walls lose elasticity over time — risk increases with each passing decade.
Heavy Lifting & High Heels
Straining to lift heavy loads and wearing heels above 5–6 cm every day place extra stress on the valves.
Varicose Vein Stages Under CEAP
Phlebologists worldwide use the CEAP classification. Its clinical component runs from C0 to C6: the higher the stage, the more complex the treatment and the longer the recovery. A simplified overview follows.
- C0
Symptoms present, no visible veins
Heaviness and leg fatigue with outwardly healthy skin. Reflux may already be detectable on ultrasound.
- C1
Spider veins and reticular veins
A cosmetic concern and an early signal: in some patients the process continues to advance.
- C2
Varicose veins 3 mm or larger
The classic picture: twisted subcutaneous veins and bulging nodules. The ideal time to treat — the procedure is minimal and results are at their best.
- C3
Oedema
The veins can no longer manage drainage adequately: ankles and calves swell by evening.
- C4
Skin changes
Darkening, hardening, venous eczema — the skin is suffering from years of chronic congestion.
- C5
Healed venous ulcer
The ulcer has closed, but without treatment of the underlying veins the risk of it reopening remains high.
- C6
Open venous ulcer
The most advanced stage: treatment of the veins and comprehensive wound care are both required.
Stage is determined by a doctor through physical examination and duplex vein ultrasound. The earlier treatment begins, the simpler the procedure and the better the outcome.
The Risks of Leaving Varicose Veins Untreated
Varicose vein disease progresses slowly, but only in one direction. Complications don't develop in everyone — yet it is impossible to predict in advance who will be affected.
Thrombophlebitis
Inflammation and clotting in a varicose vein: pain, redness, and a firm, tender cord under the skin. Requires prompt treatment.
Deep Vein Thrombosis & Pulmonary Embolism
A clot in a superficial vein can extend into the deep venous system; if a fragment breaks free, it may cause a pulmonary embolism.
Venous Ulcer
The end result of years of congestion — a non-healing wound on the lower leg that severely affects quality of life and is difficult to manage.
Bleeding from a Varicose Nodule
The thinned vein wall can rupture even from minor trauma, and the resulting bleeding can be significant.
Chronic Venous Insufficiency
Persistent swelling, pain, and skin changes that limit your ability to work, exercise, and go about daily life.
Diagnosis: Duplex Vein Ultrasound
A physical examination alone is not enough: the source of reflux, the condition of the valves, and the state of the deep veins are only visible on duplex scanning. I perform the ultrasound myself — both legs, standing and lying down — and explain the findings to you on the spot: where the problem originates and what can be done about it. You leave your very first appointment with a written report and a clear treatment plan.
Learn more about vein duplex ultrasoundHow Varicose Veins Are Treated Today
The right approach depends on the stage, the diameter of the veins, and ultrasound findings. All modern options are outpatient procedures: no general anaesthesia, no incisions, no hospital stay.
Compression & Medications — Support, Not a Cure
Compression stockings and venotonics relieve symptoms and slow progression, but they do not close the diseased vein or repair the valves. They are the right choice during pregnancy, while awaiting a procedure, or when intervention is contraindicated — an honest and important part of the management plan, not a substitute for definitive treatment.
EVLA
Laser sealing of a diseased vein through a tiny needle puncture — the leading non-surgical treatment for varicose veins.
Learn moreSclerotherapy
Sclerosant injections eliminate spider veins and small vessels — no incisions, no scarring.
Learn moreMiniphlebectomy
Removal of varicose nodes through 1–2 mm micro-incisions — no stitches, no visible marks.
Learn moreMethods are often combined: the main trunk is closed with laser (EVLA), varicose nodules are removed by microphlebectomy, and spider veins are treated with sclerotherapy. As a rule, all of this is done in a single visit.
Common Myths About Varicose Veins
Myth:Creams and tablets 'dissolve' varicose veins
The Reality:No cream penetrates deep enough to reach a subcutaneous vein, let alone restore its valves. Medications ease symptoms — and that is all they do.
Myth:Surgery means pain, scarring, and a month off work
The Reality:That was true 20 years ago. Today it's a needle puncture, local anaesthesia, 40–60 minutes, and most patients are back at their desk the very next day.
Myth:Remove one vein and it'll just come back somewhere else — pointless
The Reality:A closed vein does not return. Other veins may enlarge over the years, but this is easily monitored with an annual ultrasound and addressed with sclerotherapy in a single visit.
Myth:You can't treat veins in summer
The Reality:Treatment is safe year-round: modern compression stockings are comfortable even in warm weather, and the post-procedure guidelines are the same regardless of the season.
Prevention
- A daily walk of at least 40 minutes — the best workout for your venous pump
- If you sit at a desk, stand up every hour and do 20–30 calf raises
- Wear compression stockings when flying, during pregnancy, and in jobs that require prolonged standing — your doctor will advise the right compression class
- Maintain a healthy weight and be moderate with heavy resistance training
- Avoid sitting cross-legged for long periods; limit hot baths and saunas if you already have symptoms
- If varicose veins run in your family, see a phlebologist for an ultrasound check-up once a year
Frequently Asked Questions
Can varicose veins be treated without surgery?
It depends on what you mean by surgery. Major incisions and general anaesthesia are a thing of the past: EVLA is an outpatient procedure performed through a needle puncture, after which you go home the same day. What you cannot do is treat a stretched vein with creams, tablets, or exercise — those only reduce symptoms.
My veins are visible but don't hurt. Do I really need treatment?
The decision is made based on ultrasound findings, not on how you feel. If there's no reflux, we monitor. If a source is found, treating it early is the better choice: the procedure is simpler, recovery is shorter, and we stay ahead of complications. Pain is a late symptom — and by no means a reliable one.
What should I do about varicose veins during pregnancy?
Procedural treatment is postponed until after delivery and the end of breastfeeding. During pregnancy the approach is compression stockings, regular monitoring, and ultrasound surveillance; if thrombotic complications arise, we decide on the course of action together with your obstetrician-gynaecologist.
Does exercise help with varicose veins?
Walking, swimming, and cycling — yes: the calf pump actively relieves pressure in the veins. Heavy resistance training with straining — the opposite. If varicose veins are already present, exercise won't replace treatment, but it will noticeably speed up recovery afterward.
How much does varicose vein treatment cost in Tashkent?
It depends on the stage and the extent of treatment needed — from spider vein sclerotherapy to EVLA combined with microphlebectomy. I give you an exact written quote after the ultrasound at your consultation, and it doesn't change during the course of treatment.
Which doctor should I see for varicose veins?
A phlebologist — a specialist in vein conditions. Ideally, the same doctor should perform the ultrasound, carry out the procedure, and follow you up afterward: that way nothing is lost in translation between different offices.
