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The Edinburgh Vein Study failed to show any evidence that the extent of valvular incompetence was related to the presence of symptoms. Aching in the veins at the end of the day, after prolonged standing, is the most common complaint of patients referred to hospital, but many patients with severe varicose veins never consult a doctor. Smaller varicosities are called reticular veins and are of dubious significance; the presence of these and thread veins within the skin is not necessarily associated with major varicose veins and is purely cosmetic.

There is often a clear family history of the disorder, with some patients inheriting abnormalities in the FOXC2 gene. Most develop in the tributaries of the greater and lesser saphenous veins, which are usually dilated but rarely varicose themselves. Varicosities in the thigh are indicative of long saphenous incompetence, whereas varicosities on the back of the leg are suggestive of short saphenous incompetence.

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