Bothered by those swollen, twisted veins visible in your legs and feet? They don’t make you feel confident about putting on your bathing suit to go swimming or wearing shorts to make the most of the warm weather.

If this is you, though, you’re not alone. Millions of Americans have varicose veins?—?estimates suggest up to 60 percent of men and women over age 60 have them and women are more prone?—?which is one reason varicose vein removal is a popular surgery. But there are more than cosmetic concerns.

What are varicose veins?

As we’ve said, varicose veins aren’t pretty. Basically, they are gnarled, enlarged veins. Truly any vein can become varicose, but those most commonly affected are those in your legs and feet. Standing and walking increases the pressure in the veins of your lower body. Not all veins are swollen and unsightly, though. Some are small and commonly known as spider veins?—?a milder form of varicose veins?—?while others look like cords lying across the surface of the skin.

If you have them, you’d know that some of these veins hurt, but others are just unappealing to look at. Some varicose veins are harmless, while some may be signs of another medical condition entirely or lead to more serious problems like circulatory concerns. For some people, they can be painful, too.

Causes of varicose veins

How do you get varicose veins in the first place? Arteries carry blood from your heart to the rest of your tissues, and then your veins return blood from the rest of your body through one-way valves to your heart, so the blood can’t flow backwards but is carried to your heart where it can be recirculated.

Diseases veins, however, have weakened valves, which allows blood to flow backward and pool inside the veins. This leads to a build-up of pressure inside the veins, resulting in venous disease.

The problem is, as you get older, your veins can lose elasticity causing them to stretch. That can make the valves in your veins weak. Blood pools in your veins, and your veins enlarge and become varicose. They appear blue because they contain deoxygenated blood?—?it’s still in the process of being recirculated through the lungs. You’re also at higher risk for varicose veins if you have a family history of the problem.