How Are Varicose Veins Diagnosed?
Medically verified
Last updated on 1/29/2026
By Dr. Michael Nguyen
Vein Doctor at Vein Treatment Clinic
Harvard Medical School
Board Certified by the American Board of Venous and Lymphatic Medicine
Varicose veins are often easy to see, but proper diagnosis involves more than just looking at visible veins.
Many patients are surprised to learn that vein problems can exist beneath the surface, even when veins are mild or symptoms seem unrelated.
Understanding how varicose veins are diagnosed helps patients know what to expect during a vein evaluation and why certain tests are important.
This page provides a comprehensive overview of how varicose veins are diagnosed, answers the most common patient questions, and explains when evaluation and treatment may be helpful.
If you’re unsure whether your symptoms are related to varicose veins, a vein evaluation can help clarify the diagnosis.
Table of contents
1. Is visual examination enough to diagnose varicose veins?
2. What happens during a physical vein exam?
3. Why ultrasound is important for diagnosis
4. What is venous reflux and how is it detected?
5. Is vein ultrasound safe and painless?
6. When is ultrasound recommended?
7. Can varicose veins be diagnosed without symptoms?
8. How diagnosis affects treatment planning
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Is visual examination enough to diagnose varicose veins?
Visible bulging veins are often the first clue, but appearance alone does not tell the full story.
Some patients have significant vein dysfunction with only mild visible changes, while others have prominent veins with fewer symptoms.
What happens during a physical vein exam?
During a physical exam, the legs are evaluated while standing and sitting to assess vein appearance, swelling, and skin changes.
The exam helps identify patterns that suggest underlying venous reflux or progression.
Why ultrasound is important for diagnosis
A vein ultrasound is the most important diagnostic tool for varicose veins.
It shows how blood flows through the veins and whether valves are allowing blood to flow backward.
Symptom Checker
What is venous reflux and how is it detected?
Venous reflux occurs when blood flows in the wrong direction due to valve failure.
Ultrasound allows clinicians to see reflux in real time and identify which veins are affected.
Is vein ultrasound safe and painless?
Yes. Vein ultrasound is non-invasive, does not use radiation, and is generally painless.
Most patients tolerate the test easily and can resume normal activities immediately afterward.
When is ultrasound recommended?
Ultrasound is recommended when patients have symptoms such as pain, swelling, heaviness, skin changes, or recurrent veins.
It is also important before planning treatment to ensure the correct veins are addressed.
Can varicose veins be diagnosed without symptoms?
Yes. Some patients have varicose veins without noticeable symptoms.
Ultrasound helps determine whether monitoring or treatment is appropriate in these cases.
Results that speak for themselves
You can expect results like these with our specialized treatments for spider & varicose veins performed by the best experts in the country.
Before
After
A 37-year-old patient visited our Vein Treatment Clinic, seeking relief from unsightly and painful varicose and spider veins. We performed radiofrequency ablation and sclerotherapy treatments, significantly improving the veins’ appearance and completely eliminating discomfort. The patient is now enjoying a more active and pain-free lifestyle.
Before
After
A 69 year-old patient visited our California Vein Clinic, embarrassed by spider veins that had impacted their self-esteem. We performed radiofrequency ablation and sclerotherapy treatments, leaving their legs smooth and healthy. The patient now feels more confident, thanks to this transformative treatment.
Before
After
This 84 year-old patient at our New Jersey Vein Treatment Clinic came in with spider veins that had affected their daily routine. We used radiofrequency ablation and sclerotherapy treatments to relieve discomfort and restore both their leg health and confidence. The patient now enjoys a more active and fulfilling lifestyle, free from pain.
Before
After
At our Long Island Vein Clinic, we treated this 75 year-old patient with spider veins using radiofrequency ablation and sclerotherapy. These minimally invasive treatments improved both the patient’s appearance and overall well-being, offering transformative results.
Before
After
This 75 year-old patient visited our Long Island Vein Treatment Clinic with painful spider veins. We used radiofrequency ablation and sclerotherapy, minimally invasive treatments, to eliminate the veins and restore comfort and confidence. The patient experienced life-changing results
How diagnosis affects treatment planning
Accurate diagnosis ensures treatment targets the underlying cause, not just visible veins.
This leads to more effective and longer-lasting results.
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When should you see a vein specialist?
Evaluation is recommended if varicose veins cause pain, swelling, skin changes, or interfere with daily activities.
Seeing a specialist helps determine whether monitoring or treatment is appropriate.
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About the Medical Team at Vein Treatment Clinic
Vein Treatment Clinic is powered by VIP Medical Group and built around a single guiding principle: deliver the highest standard of vein care using an academic, evidence-based approach combined with the most advanced, minimally invasive technology available today.
Clinical leadership at Vein Treatment Clinic is guided by a panel of board-certified vein specialists responsible for establishing and maintaining the clinic’s medical standards. Their approach reflects training and experience developed at nationally recognized academic institutions such as Harvard, Yale, Columbia, and Mount Sinai, with a focus on disciplined evaluation, accuracy, and outcomes-driven care.
All physicians at Vein Treatment Clinic follow a structured, highly standardized clinical model. This includes ongoing training in the latest non-surgical vein treatments, continuous review of emerging research, and strict adherence to proven safety and quality protocols. The approach reflects the values of academic medicine: thoughtful evaluation, disciplined decision-making, and a commitment to outcomes grounded in science.
Patients benefit from a team-based model of care where expertise is shared, best practices are consistently applied, and treatment recommendations are driven by data, experience, and long-term results. This ensures that every patient receives the same high level of care, regardless of which physician they see.
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At Vein Treatment Clinic, education is considered a core part of treatment. Patients are encouraged to understand their condition, their options, and the reasoning behind each recommendation, so they can move forward with clarity and confidence.
If you’d like clarity about whether your varicosas may worsen over time and what next steps make sense, a vein evaluation can help guide that decision.
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