Varicose Veins Symptoms: What to Look For and When to Take Action

Varicose veins are often seen as a cosmetic issue, but the symptoms can be far more than skin deep. From aching legs to swelling, itching, and even changes in skin texture, the signs of varicose veins can affect your comfort, mobility, and long-term vein health.

In some cases, symptoms may appear before the veins are visibly enlarged — especially in the early stages or when deeper veins are involved. In this guide, we walk through the most common varicose veins symptoms, how to spot early warning signs, and when to seek medical advice or treatment.

What are varicose veins and how do they cause symptoms?

Varicose veins develop when the valves inside your leg veins stop working properly. These valves are meant to keep blood flowing upwards toward the heart. When they fail, blood pools in the veins, increasing pressure and causing the veins to enlarge, twist, or bulge.

But not all symptoms are visible. Many people experience symptoms of varicose veins such as discomfort, heaviness, or swelling well before the veins become obvious. In some cases, deep varicose veins (located below the surface) can cause significant symptoms without any external signs.

Most common varicose veins symptoms

The symptoms can vary depending on the severity and location of the affected veins. Here are the most frequently reported signs:

• Aching or throbbing legs, especially after standing or sitting for long periods
• Tired, heavy legs at the end of the day
• Itching or burning sensation along the vein path
• Night-time cramps, particularly in the calves
• Swelling in the ankles or feet, especially in the evening
• Skin discolouration or thickening around the lower legs and ankles

As we explain in our article on early stage varicose veins symptoms, these issues can begin subtly, making them easy to overlook or misattribute to fatigue or age.

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Can you have symptoms without visible veins?

Yes — and it's more common than many people think. When deep varicose veins are involved, the affected veins are buried under layers of tissue and fat, making them invisible to the naked eye. Still, they can cause the same (or worse) symptoms as superficial veins.

Patients often describe vague but persistent symptoms like pressure, dull ache, or a sensation of fullness in the legs. These symptoms are often misdiagnosed or dismissed until they progress.

If you suspect your discomfort may be vein-related, a duplex ultrasound can confirm the presence and severity of vein disease — even when the skin looks normal.

When to worry about varicose veins symptoms

Mild symptoms may seem harmless at first, but if left untreated, varicose veins can worsen over time and lead to complications such as skin damage, eczema, or venous ulcers. You should seek medical attention if:

• Your symptoms are getting worse or affecting your quality of life
• You notice changes in skin colour or texture near your ankles
• You experience pain or swelling that doesn’t go away
• You’ve had bleeding from a vein or a history of blood clots

We cover this more in our guide on when to worry about varicose veins, including red flags to look for and when it's time to book a specialist assessment.

What are the different stages of varicose veins?

Varicose veins develop gradually, progressing through different stages as the condition worsens. Symptoms also evolve — from mild leg fatigue to visible veins and eventually skin complications.

In this article, we explain the full varicose veins stages, from C0 (no visible signs but symptoms are present) to C6 (active venous ulcer). Understanding your stage can help you and your clinician choose the best treatment plan.

What can you do to relieve symptoms?

There are several ways to manage or minimise symptoms, especially in the early stages:

• Stay active: Gentle activities like walking or swimming promote circulation.
• Elevate your legs: Especially after long periods of sitting or standing.
• Wear compression stockings: These help support your veins and reduce swelling.
• Avoid prolonged standing: Take breaks to stretch or walk.
• Maintain a healthy weight: Excess weight increases pressure on your leg veins.

These strategies may not reverse vein damage, but they can slow progression and ease discomfort.

Conclusion: Take symptoms seriously, even if your veins aren’t visible

Varicose veins are more than just a cosmetic concern. Whether or not you can see the veins, varicose veins symptoms can signal underlying venous disease that needs attention. Early symptoms — like aching legs, swelling, or itching — are often manageable, but they can escalate without treatment.

If you’re unsure whether your symptoms are vein-related, book a consultation. Timely diagnosis and treatment can prevent further damage and restore comfort to your daily life.

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