What Causes Varicose Veins in Legs?

What Causes Varicose Veins in Legs?


This article will tell you in simple terms what truly causes varicose veins.

Then we will discuss the factors that aggravate the condition but don’t actually cause varicose veins.

Wives tales were meant to pass down wisdom and advice. People hear these silly theories and repeat them. Remember that game when you whisper something down a row of people and it gets distorted? Varicose vein myths were started the same way.

First, let’s hear from some experts on the subject.

 1.  “Varicose veins are the result of an improper selection of grandparents.”

The father of modern medicine, -William Osler quotes (Canadian physician, 1849-1919)

2.  “If you compare yourself to others, you may become vain and bitter.”

– Max Ehrmann, Desiderata: A Poem for a Way of Life (American writer, 1872-1945)

3.  “However, if you compare yourself to others and you have more veins, you may become even more bitter.”

– John Happel MD (American physician, 1953-still “happelly” working)

The Truth about the Causes of Varicose Veins

The following is the plain and simple truth.

To be blunt, varicose veins are simply genetic in origin.

You knew that.


However, can you prevent varicose veins if your parents or grandparents had them?


I know.  That’s not what you wanted to hear.

The fact is that if one of your parents had them, you have about a fifty per cent chance of developing varicose veins. If both of your parents had them, your odds are closer to one hundred per cent if you live long enough.

However, there is:

  • No exercise program
  • No diet
  • No cream
  • No pill
  • No support stocking

that will prevent varicose veins from occurring if you are genetically predisposed to develop varicose veins.

More specifically, what is the genetic defect that causes varicose veins in the legs to bulge and become painful?

If you were born with the tendency to develop varicose veins, you have defective valves or “check valves” inside your veins, which are not closing properly.

When you stand or sit, gravity pulls the blood in your veins toward your feet (in the wrong direction).

As a result, your veins dilate. The pressure builds up inside them. They become twisted, ropey and tortuous. Your legs ache and feel heavy.

Can you slow down the inevitable development of your varicose veins ?


Things That Speed Up the Development of Varicose Veins

If you already have the genetic predisposition to be susceptible to varicose veins sometime in your life, there are risk factors that can speed up this condition. Varicose veins can occur earlier in life and be aggravated by the following factors:

     1.  Obesity

Being overweight increases your risk of developing varicose veins. Obesity also increases the risk of recurrence. To be more precise, if you are overweight, new varicose veins will recur faster after treatment. Extra weight causes varicose veins to come back faster.

     2.  Pregnancy

Becoming pregnant results in an increase in your blood volume. The extra blood is stored in your veins. That results in them dilating. The dilatation and extra blood volume causes pressure on the valves.

If the valves are not torn, the dilated veins may return to normal after the baby is delivered. Pregnancy also involves an increase in hormones that can dilate the veins. Finally, the baby compresses the vena cava. That acts like a tourniquet inside the abdomen. This further increases the pressure in the veins of the legs.

     3.  Increased abdominal pressure

This factor is similar to the tourniquet effect. Imagine that someone tied a tourniquet around your waist preventing the blood from returning to your heart. The blood would back up into your legs. That would increase the pressure in your veins. The veins would dilate and enlarge as a result.

     4.  Standing and sitting for long periods on a daily basis

Varicose veins are more common in people whose occupations involve standing. Some examples are hair stylists, bartenders, bank tellers and surgeons.

However, recent research has clearly demonstrated that long periods of standing does not actually cause varicose veins.  Standing or sitting merely makes the condition worse if the genetic predisposition for varicose veins is already present.

     5.  Heart valvular disease

When the valves in your heart (especially on the right side of the heart) don’t close properly, blood will back up into your legs. This concept is similar to the abnormal valves in your legs causing blood to back up. As a result, this causes varicose veins to form from the pressure building up in them.

     6.  Being a female

Women have a higher incidence of varicose veins by most reports. However, many men have varicose veins but never seek care for them unless they hurt, clot, or bleed.

Let’s Dispel Some Myths about What Causes Varicose Veins

The following list of causes of varicose veins are wive’s tales. These factors do not cause varicose veins.

  • Walking on concrete
  • Crossing legs
  • Tight clothing
  • Hot baths or hot tubs
  • High heels

On the other hand, contraction the calf muscles is needed for the pumping of the blood through your veins. If the calf muscle pump is eliminated by wearing high heels, the pressure inside your veins increases. The development of varicose veins is accelerated.


This article is different.

We have told you what actually causes varicose veins. Then we described the conditions that just aggravate the condition but don’t actually cause varicose veins.

For example, there are obese people and people who stand a lot who don’t have varicose veins. There are women who have had many children who don’t have a single abnormal vein in their legs.

So here’s the bottom line:

  • You can’t pick your parents.
  • Varicose veins are genetic.
  • You can’t prevent but you can alter your inherited vein problems.

They can be easily fixed with modern minimally invasive techniques.

Winter is a great time to have your veins fixed because the required stockings after your treatment will keep your legs warm.

Your legs will look great this coming summer.

Most importantly, your legs will be healthy again.

Not all vein centers are the same.

The tag team approach to varicose vein treatment is not our approach at Happel Laser and Vein Center. You will be treated in the traditional one-on-one manner. Dr. Happel alone will treat you from the beginning to end.

Dr. Happel does not pass your care off to another provider, assistant or doctor in the middle of your treatment. There are no ancillary personnel to diagnose or treat your veins.

Dr.Happel will discuss your vein condition in easy to understand terms. He will design a customized treatment plan that is specific for your vein problem.

So what are you waiting for?

Call us at 724-969-0600 if you’re tired of hiding your legs to make an appointment.

Click here to learn more.

About The Author

Dr. John Happel

Dr. John Happel has been in practice as a surgeon since 1986 in the Pittsburgh region. He specializes in vascular surgery and has subspecialized in the treatment of varicose and spider veins since 1999. Dr. Happel is board certified in vascular surgery and recertified in vascular surgery in 2012. He was chosen in 1985 to fulfill the position for the vascular surgical fellowship at the world renowned Mayo Clinic.