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If one day, while looking at yourself, you notice some bulging tortuous veins – you are not alone! In fact, varicose veins are very common in 40-55% of the population, depending on gender and ethnicity. Women are more likely to suffer from varicose veins. Fluctuation in female hormones before and after menopause, use of birth control medication, pregnancy and childbearing, all can contribute to vein wall relaxation. The other common reasons for varicose disease are: heredity, obesity, prolonged standing, aging, trauma and pelvic cavity malformations. Spider veins are small red or red-blue segments of vessels, which appear often in clusters (webs), anywhere on your thighs or along the shins. They are visible just beneath the skin surface. These veins are the common source of the cosmetic concerns to our patients. Varicose veins are larger in diameter and are located deeper under the skin. They can usually be identified along the inner aspect of your thigh, or behind the knees and ankles. Pain and swelling are the common components of varicose veins. They appear in forms of tortuous ropes and lumps. Severe varicose disease can compromise the health of the skin layers and lead to dermatitis, rash, itchiness and brown skin discoloration. Finally, the skin changes can progress to chronic ulcers and lymph stasis (insufficient blood/lymph flow) with chronic infection.