Are Varicose Veins Genetic?

The Short Answer

Yes, varicose veins are genetic. If one parent has varicose veins, your risk of developing them increases by 40-50%, and if both parents have them, your risk jumps to 70-90%. Research shows that genetics account for approximately 28% of the population variance in varicose vein disease, with more than 30 independent genetic variants associated with the condition.

Why This Happens

Inherited Vein Wall Weakness

Some people are born with thinner or more elastic vein walls that stretch more easily over time. Your genetic makeup determines the structural integrity of your blood vessels, and if your parents have veins prone to weakening, you're more likely to inherit this trait. The strength and elasticity of vessel walls are directly influenced by specific genes that control connective tissue formation and vascular structure.

Faulty Valve Function

Varicose veins develop when the one-way valves inside your veins fail to close properly, allowing blood to flow backward and pool. Genetic variations can cause these valves to be inherently weaker or malformed from birth. Scientists have identified specific genetic loci that affect valve function, including genes like CASZ1 on chromosome 1 and PIEZO1 on chromosome 16, which play critical roles in vascular development.

Height and Body Structure

Research has found a strong genetic correlation between height and varicose veins, with approximately 16% genetic overlap. Taller individuals are at higher risk because blood has to travel a longer distance against gravity to return from the legs to the heart, putting more strain on vein valves. Since height is largely determined by genetics, this represents another hereditary risk factor you can't control.

Hormonal Sensitivity

Women are more prone to varicose veins partly due to genetic factors that affect how their bodies respond to hormones like estrogen and progesterone. Elevated hormone levels can thin vein walls and damage valves, making pregnant women particularly susceptible to chronic venous insufficiency. This hormonal sensitivity often runs in families, which is why maternal family history carries a slightly higher risk (40%) compared to paternal history (30%).

Multiple Gene Involvement

Varicose veins are polygenic, meaning they're influenced by many different genes working together. Scientists have identified 139 risk loci and 30 independent genetic variants associated with varicose vein disease. These genes are involved in biological processes like vascular development, endothelial cell differentiation, VEGF signaling, and blood pressure regulation. Some genes previously linked to hereditary skeletal conditions and connective tissue disorders also appear to play a role.

Normal vs Concerning

Normal if:

• You develop varicose veins gradually as you age, especially if family members had them
• They appear during or after pregnancy
• You notice them after prolonged periods of standing or weight gain
• They cause mild discomfort but don't significantly impact daily activities

Call a doctor if:

• You experience severe pain, swelling, or heaviness in your legs
• The skin around varicose veins becomes discolored, hardened, or develops open sores
• You ntice sudden swelling in one leg compared to the other
• Veins become warm, red, or tender to touch (signs of possible blood clots)
• You develop skin ulcers near the ankle
• Bleeding occurs from a varicose vein

How Doctors Evaluate It

At IVY Cardiovascular & Vein Center, we begin with a comprehensive evaluation that includes your family history and detailed assessment of your symptoms. A physical exam allows us to visually inspect your legs and identify the location and severity of varicose veins.​

We typically perform a venous ultrasound (duplex scan) to assess how blood is flowing through your veins and whether valves are functioning properly. This non-invasive test shows us the structure of your veins, identifies areas of reflux (backward blood flow), and helps us determine the best treatment approach. In some cases, we may check for underlying conditions like blood clotting disorders that can coexist with genetic predisposition to varicose veins.

Treatment Options

Lifestyle Modifications

While you can't change your genetics, you can reduce the severity of varicose veins through lifestyle changes. Maintaining a healthy weight reduces pressure on leg veins. Regular exercise, especially walking and swimming, improves circulation and strengthens calf muscles that help pump blood back to the heart. Elevating your legs when resting allows gravity to assist blood flow back toward your heart. Wearing compression stockings provides external support to weakened vein walls and helps prevent blood from pooling.​

Minimally Invasive Treatments

Modern vein treatments are highly effective and require minimal downtime. Sclerotherapy involves injecting a solution into spider veins and small varicose veins that causes them to collapse and fade. Endovenous laser ablation (EVLA) uses laser energy to seal off larger varicose veins from the inside. VenaSeal is a newer procedure that uses medical adhesive to close diseased veins. Radiofrequency ablation uses heat energy to collapse and seal varicose veins. These procedures are typically performed in-office with local anesthesia.

Surgical Options

For severe cases, surgical intervention may be necessary. Ambulatory phlebectomy removes varicose veins through tiny incisions, leaving minimal scarring. Vein stripping and ligation, though less common today, may be recommended for very large varicose veins or when other treatments aren't suitable.

FAQs

Do varicose veins run in families?

Yes, varicose veins have a strong hereditary component. If one parent has varicose veins, you have a 40-50% chance of developing them; if both parents have them, your risk increases to 70-90%.

Can I prevent varicose veins if they run in my family?

While you can't change your genetic risk, you can reduce the likelihood and severity through lifestyle modifications like maintaining a healthy weight, exercising regularly, avoiding prolonged standing or sitting, and wearing compression stockings.

Are women more likely to inherit varicose veins than men?

Women are more prone to varicose veins overall due to hormonal factors, and maternal family history carries a slightly higher risk (40%) compared to paternal history (30%). However, genetic predisposition affects both men and women.

Will my varicose veins get worse over time?

Varicose veins are typically progressive, meaning they tend to worsen with age if left untreated. Early intervention with lifestyle changes and medical treatment can slow progression and prevent complications.​

If I get my varicose veins treated, will they come back?

Treated veins don't return, but your genetic predisposition means you may develop new varicose veins in other locations over time. Maintaining healthy habits and follow-up care can minimize this risk.​

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If you have a family history of varicose veins or are experiencing symptoms, our team at IVY Cardiovascular & Vein Center can help. We offer comprehensive vein evaluations and the latest minimally invasive treatments to address your concerns. Schedule a consultation online or call our office today at 561-210-9495 to discuss your genetic risk and treatment options.