Varicose veins affect the legs so much because of the hydrostatic pressure caused by Gravity. Blame your veins on Isaac Newton! Because your legs are below the level of your heart, blood has to travel “up hill” to get from your legs to your heart. The veins have a series of one way valves to ensure the blood travels toward your heart. When those valves fail, gravity pulls the blood back down into your legs. This condition is called venous insufficiency, or venous reflux. Because the legs are the lower most part of your body, the hydrostatic pressure is greatest. Your upper body is at roughly the same level as your heart, or higher than your heart, so there is little or no hydrostatic pressure affecting those areas. Bulging veins in the hands are caused by two factors. First, because the hands are below the level of the heart, gravity pulls the blood down the arm, and hydrostatic pressure causes the veins to distend. Second, as we age, the skin on the back of the hand becomes thinner, letting the veins bulge more and making the veins more visible. Prominent veins on the face are not due to the effects of gravity, but rather due to increased venous pressure form coughing, sneezing, and exertion.