When photographs of President Donald Trump’s swollen hands and ankles went viral last summer, I saw my own reflection. The president was diagnosed with chronic venous insufficiency, a common vascular condition primarily affecting older adults. Tens of millions of Americans—around one in four people—live with this condition, most over 50. Venous insufficiency means weak veins impair blood flow in the legs, leading to high blood pressure, swelling, and even ulcers. According to his physician Dr. Sean Barbabella, the president experiences mild swelling in his lower legs due to the condition.
But at 32 years old, I am among the five percent of adults aged 18 to 65 plagued by this condition—one that has followed me since my teenage years. Mostly, it causes me embarrassment with red, purple, and blue veins crawling up my feet, ankles, and legs. When I was growing up, my dermatologist initially thought the small patches of red lines on the insides of my ankles were spider bites. Unfortunately, they were not—and they never went away.
My Journey with Visible Veins
Over time, my veins have only grown larger and more noticeable, first affecting the insides of my legs and then spreading outward. The veins on my feet and outer ankles mimic purple bruising. The condition has worsened over the last decade, making it harder to hide in photos and on first dates. I even considered getting tattoos—some with spider and varicose veins have embraced ink. But the Center for Vein Restoration warns that tattoos can damage veins, leading to bleeding or infections, and do not address the underlying issues of venous insufficiency. Also, my mother would disapprove. So, I have become an expert in camouflage on social media, using filters and blurring tools to cover the worst of the visible veins.
Yet the reality is I have a genetic condition that deserves attention. Experts say the best way to manage venous insufficiency is to understand it thoroughly. The condition occurs when valves in your leg veins malfunction, causing blood to pool in the limbs and slowing flow from the legs to the heart. This can result in pain, itchiness, and swelling, leading to dry, fragile, or flaky skin. In extreme cases, people may develop painful sores on their legs as skin quality degrades.
Risk Factors and Prevalence
While venous insufficiency is rare in younger adults, Dr. Rob Attaran, an interventional cardiologist at Yale New Haven Health, told The Independent he has treated patients as young as 19—and women are at higher risk. “If you’re a woman and you have one part with varicose veins, there’s probably an almost 50-50 chance you will have them, too,” he said. “In men, it’s a little bit lower—but it’s still pretty high.” Other risk factors include limited movement, genetic history, obesity, pregnancy, smoking, deep vein thrombosis, and sleeping in a chair.
It is unknown which factors might have led to the 79-year-old president’s condition. White House Press Secretary Karoline Leavitt said in July that Trump underwent an evaluation from the White House medical unit in an “abundance of caution” after noticing swelling. “The president underwent a comprehensive examination, including diagnostic vascular studies,” she said, reading a memo from Barbabella. “Bilateral lower extremity venous doppler ultrasounds were performed and revealed chronic venous insufficiency, a benign and common condition.” She added, “All results were within normal limits.”
Treatment Options
Venous insufficiency cannot be cured or reversed, but it can be treated with lifestyle changes and medical procedures. The top choice is wearing compression socks or hose, which ease swelling, push blood back toward the heart, and relieve pain. However, other options exist. Dr. Richard Meena, a vascular surgeon at Brown Surgical Associates, told The Independent, “A lot of the advances have been in catheter-based or minimally invasive procedures. There’s heat and laser, as well as injectable solutions like foams and glues, with the idea that if you cause some sort of irritation within the vein that’s a little leaky, you might be able to shut it down so that more blood can go back to the heart and less will accumulate in the leg.”
Cosmetic solutions can reduce the intense appearance of veins. Doctors can inject detergent-based medication called sclerosants into spider veins or remove veins with small needle pokes in an outpatient procedure known as microphlebectomy. “All of these procedures are minimally invasive, where you walk in and walk out of the clinic with little to no downtime and you can enjoy your legs again,” said Dr. Charles Leithead, a vascular surgeon with Ochsner Health. Meena also noted that treating symptoms may improve the cosmetic side of venous insufficiency.
I have often thought about trying those cosmetic treatments, but they are costly and often not covered by health insurance. New York City’s Metro Vein Centers prices some foam, catheter, and laser treatments at more than $2,000 each time. People may need multiple sessions because even if procedures close veins, new ones can appear later.
Lifestyle and Vigilance
Until I make that decision, experts suggest I remain active, wear compression socks, and stay as healthy as possible. Running is excellent for the condition, as is getting up and moving frequently during the workday. Meena said getting up and taking a short walk every 30 minutes over an eight-hour work day is enough to make a difference, according to Upstate University Hospital. Ultimately, my biggest takeaway has been the importance of staying vigilant about regular check-up appointments with a primary care physician or vascular specialist. Ignoring vein issues can lead to complications, including clots or blockages in arteries in the lungs. Getting checked out is crucial to prevent venous insufficiency from worsening, and each case is different. “Everyone has their own medical journey, including with their veins,” said Meena.
