Understanding Vein Disease

The network of veins in your legs involves three types of veins: superficial veins lie closest to the skin; deep veins lie in groups of muscles; and perforating veins connect the superficial veins to the deep veins. The deep veins return blood back to your heart. Healthy leg veins contain valves, which keep blood flowing in the right direction and assist the return of blood back to the heart.

Venous reflux disease is a medical condition that occurs when the valves that keep blood flowing out of the legs and back to the heart become weakened, damaged or diseased. Over time and under the pressure of gravity, the veins may become dilated, elongated, twisted, and thickened. Backwards flow of blood due to damaged valves is called reflux. This can cause blood to pool in your legs, leading to visible varicose veins, symptoms such as pain, swelling, swollen limbs, leg heaviness / fatigue, and eventually, if uncorrected, skin changes, and skin ulcers.

Varicose Veins

Varicose veins often appear as enlarged veins that twist and bulge in a rope-like pattern. They can be blue, red, or flesh-colored. They are often found on the back of the calves, inner and front thighs, or anywhere in the leg above and below the knee. Because varicose veins contain valves that are damaged, they hold more blood at a higher pressure than normal. This extra pressure forces fluid into the surrounding tissue which causes your leg to swell and feel tired and achy.

Spider Veins (thread veins)

Spider veins appear as thin “webs” of dark colored veins just below the surface of the skin. Unlike varicose veins, spider veins typically are not enlarged or swollen. Though treatment is rarely needed for medical reasons, many patients seek laser therapy or sclerotherapy to reduce the appearance of spider veins for aesthetic reasons.

Venous Ulcers

Venous ulcers are wounds caused by pressure in the legs where veins do not function properly. The skin may appear red or brown in color and eventually become an open wound or sore. Medical treatment is often needed to promote healing.


Varicoceles are abnormally dilated veins in the scrotum. They are not only unsightly but can cause considerable pain, swelling and even lead to infertility. The appearance of such varicose veins is frequently likened to a ‘bag of worms’. Veins in the scrotum are involved in maintaining optimal temperatures for sperm development. When varicose veins develop in the scrotum it can affect the temperature of the testes, which can pose a risk of infertility.