Why are varicose veins bulgy and curly?

Denise from Godalming, Surrey asked why varicose veins are bulgy and curly?

“Normal veins in legs are rarely seen and certainly shouldn’t bulge. If you are very, very fit and very, very slim with not much sub-cutaneous fat you might see the veins themselves particularly around the ankles. But usually normal veins are rarely seen, and if they are, it would be just a bit of green on the surface.

Varicose veins are caused by underlying veins which have lost their functional valves. When that happens and as you stand up, blood falls through the deeper veins and out through the little veins near the surface. Eventually this causes the walls to both distend, which makes them curly, and also become wider which makes them bulge. It’s this constant battering from the inside, that used to be thought of as just pressure but actually is a constant backwards flow, which is the problem. You could think of it as an impact pressure, a constant pushing outwards which results in making the veins elongate becoming very serpent like and dilate which makes them bulge and stand away from the sub-cutaneous fat, bulging through the skin. When you see these bulging wiggly veins that’s of course what we call varicose veins.

What is most important to remember though, is that varicose veins are not the problem; the problem is the underlying veins that cause them, the ones that have lost their valves, and that’s why it is essential to have a Duplex Ultrasound Scan to find out what’s actually causing the problem on the inside.”