Varicose veins are abnormal veins that can occur in the legs. They can appear as small, thin purple-colored lines (called "spider veins") that lie just below the skin surface, or they can be thick, bulging or knotty veins. While many people think that varicose veins are simply a cosmetic issue, there is in fact often an underlying medical problem that causes varicose veins. This medical condition is called venous reflux disease.