Varicose Veins in Young People: Early Causes and Effective Solutions

Varicose veins are widely perceived as a condition affecting older adults — but Dr. Mohamed Haggag regularly sees patients in their twenties and early thirties with significant venous disease. In fact, studies show that up to 15–20% of varicose vein patients are under 35. The earlier disease develops, the more time it has to progress and cause complications, which makes early diagnosis and treatment in young people particularly important.

Why Do Young People Get Varicose Veins?

The root cause is venous valve incompetence — valves in the leg veins that should prevent blood from flowing backwards (down towards the feet) instead become leaky. This allows venous blood to pool, raising pressure in the superficial veins and causing them to dilate and twist. In young people, the main contributing factors are:

• Genetics: The strongest factor. If one or both parents have varicose veins, the risk is substantially elevated regardless of age. Inherited weakness of the vein wall and valve structure can manifest in the twenties.
• Prolonged standing: Jobs requiring long hours on foot — nurses, teachers, retail workers, chefs, factory workers — dramatically increase venous pressure over years. Many patients trace the onset of symptoms to starting their first job.
• Sedentary lifestyle: Long hours of sitting with little physical activity removes the calf muscle pump effect that drives venous return. Remote working and screen time have made this more prevalent in younger generations.
• Obesity: Increasing in younger age groups, excess weight raises intra-abdominal pressure and impairs venous return.
• Hormonal contraception: Some hormonal contraceptives, particularly older combined pills, promote venous dilation. Young women who are genetically predisposed may notice onset or worsening when starting oral contraception.
• Pregnancy: Even a first pregnancy in the early twenties can trigger or accelerate varicose vein development.

Symptoms That Young People Often Dismiss

Young patients frequently minimise their symptoms, attributing them to tiredness or long working hours. Signs not to ignore:

• Leg heaviness or aching that worsens as the day progresses and eases overnight
• Swollen ankles or calves by evening
• Itching or burning over the leg veins
• Restless legs at night — often linked to venous insufficiency
• Visible spider veins (fine red or purple threads) — often the earliest visible sign of underlying reflux
• Visible ropey or bulging veins, even small ones

Modern Treatment Options for Young Adults

Young patients are ideal candidates for minimally invasive treatments because they are generally healthy, heal quickly, and return to work rapidly:

• Endovenous laser ablation (EVLA): The treatment of choice for saphenous vein reflux in young, active patients. Local anaesthesia, same-day discharge, return to work in 1–2 days.
• Foam sclerotherapy: Excellent for reticular veins and varicose tributaries. Can be combined with laser for comprehensive results in a single session.
• Microfoam (UGFS): Ultrasound-guided foam sclerotherapy for larger tributary veins.
• Compression stockings: For those not yet ready for intervention, or during pregnancy — high-quality medical compression stockings manage symptoms effectively and slow progression.