What are the Stages of Chronic Venous Insufficiency?

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doctor evaluates legs with chronic venous insufficiency

What Are the Stages of Chronic Venous Insufficiency?

Chronic venous insufficiency, also known as vein disease, is the underlying cause of varicose and spider veins. Dr. Yan Katsnelson, CEO and Founder of leading vein clinics throughout the U.S. wants you to know that vein disease is a progressive condition that can lead to painful and uncomfortable symptoms like swelling, cramping, itching, or fatigue. Most commonly, the legs, ankles, and feet are affected.

Each year, millions of people in the United States are impacted by chronic venous insufficiency. When left untreated, this common disease can lead to worsening symptoms and dangerous health conditions like blood clots and venous ulcers. Deep Vein Thrombosis (DVT) is a life-threatening blood clot that requires emergency treatment.

If you are experiencing chronic venous insufficiency symptoms, you may be wondering what to do next. The good news is that our leading experts perform a range of effective, minimally invasive chronic venous insufficiency treatments that can alleviate pain and discomfort, reduce your risk of developing complications, as well as quickly get you back to normal daily activities. 

We generally recommend early intervention and treatment for best results, so it may be beneficial to consult a vein specialist at the first sign of trouble. Our experts are here to help from initial diagnosis to recovery after treatment. 

Below, we discuss symptoms, causes, and stages of chronic venous insufficiency. We also cover what you need to know about outpatient vein treatment at USA Vein Clinics.


What Is Chronic Venous Insufficiency?

Chronic venous insufficiency can develop when one-way valves in the veins are placed under ongoing strain and begin to malfunction. Both genetics and lifestyle are contributing factors. When vein valves are damaged, veins struggle against gravity to send blood back to the heart from your lower extremities. Instead of circulating efficiently, blood starts to flow backward or pool in the legs, ankles, and feet. Ultimately, this leads to the formation of varicose veins.

Common signs of chronic venous insufficiency include:

  • Swelling in the legs and ankles
  • Tired, aching legs
  • Burning in the calf or thigh
  • Leg pain that feels better when you raise your legs
  • Itchy, dry, hardened, or cracked skin
  • Numbness or tingling sensation
  • Difficulty standing for long periods
  • Non-healing wounds on your legs
  • Restlessness felt especially at night

Along with causing these symptoms, untreated vein disease can place you at increased risk for dangerous health conditions like blood clots and venous ulcers (open, non-healing wounds). If you have signs of chronic venous insufficiency, we recommend contacting your doctor or a vein specialist as soon as possible. 

Chronic Venous Insufficiency Causes

You should be aware that there are a range of chronic venous insufficiency causes and contributing risk factors. Some of these include:

Genetics: Vein disease tends to run in families. If you have a parent or close relative with varicose veins, you are more likely to develop them. 

Age: Your risk for developing venous issues increases as you get older. Although varicose veins can appear at any age, you are more likely to get them after age 50.

Sex: If you are a woman, you are four times more likely to develop vein disease. 

Pregnancy: Vein disease often develops during pregnancy due to increased blood flow and an influx of hormones.

Prolonged sitting or standing: If you have a job that requires long periods of standing or sitting, you are at higher risk for developing chronic venous insufficiency symptoms

Excess weight: Being obese or overweight places additional strain on your veins and can cause damage, leading to venous insufficiency.

Inactivity: A sedentary life can affect blood circulation, contribute to weight gain, and lead to chronic venous insufficiency.

Smoking: Along with increasing your risks for serious health issues like heart and lung disease, smoking can weaken your veins and reduce blood flow. 

High blood pressure: If you have high blood pressure, you are more likely to develop vein health issues.

Chronic Venous Insufficiency Stages

Chronic Venous Insufficiency

We want you to understand the five main stages of chronic venous insufficiency, which include:

Stage 1: Spider Veins

Your first sign of trouble may be the development of spider veins. Spider veins are tiny, colorful, weblike veins that appear on the surface of the skin. Like varicose veins, they most commonly impact the lower extremities; however, the face and other areas of the body can also be affected.

Although often thought of as just a cosmetic issue, spider veins are actually early signs of chronic venous insufficiency. They can cause symptoms like leg swelling, restlessness, tingling, numbness, burning, itching, tenderness, or redness. 

Stage 2: Varicose Veins

Although it may be easy for some to ignore spider veins, the appearance of varicose veins may get your attention. Varicose veins are enlarged, twisted veins that rise above the surface of the skin. Along with being unsightly, varicose veins can cause a range of painful and uncomfortable symptoms that include leg heaviness, swelling, itching, or burning. Although not all individuals experience pain or discomfort, symptoms can eventually develop and worsen over time.

Stage 3: Leg Swelling

When earlier vein symptoms are left untreated, additional ones are likely to occur. One chronic venous insufficiency symptom, leg swelling, is a common sign of progressing vein disease. You may notice difficulty or pain when putting on your shoes or boots. Your legs and ankles may feel heavy and can make climbing stairs more difficult. This type of swelling may become severe enough to limit your mobility and impact your quality of life.

Stage 4: Skin Discoloration

As vein disease continues to progress, you may notice skin changes surrounding your varicose or spider veins. Some individuals develop thin, dry, or hardened skin; others a dark brownish or purplish discoloration. You may also see a type of itchy, red rash called venous stasis dermatitis. Since venous insufficiency is the underlying cause of these skin problems, lotions and creams are not usually effective. Skin discoloration can easily be ignored; however, it’s important to seek help from a vein specialist as soon as possible.

Stage 5: Venous Ulcers

The final stage of chronic venous insufficiency is the development of venous ulcers. Venous ulcers, also known as stasis ulcers, are slow or non-healing wounds that tend to form on the legs and ankles near visible varicose veins. Their presence can leave you vulnerable to serious skin and blood infections. Cracked, dry, or hardened skin can easily turn into non-healing wounds that fester with time. Venous ulcers may start out as a small wound that looks similar to a scratch and progress into a serious, open wound. If you notice redness or pus around the affected area, you may need to visit the emergency room to get treatment for possible infection.

No matter which stage of vein disease you are experiencing, we want you to know that help is available. One of our top vein specialists can help you explore your full range of minimally invasive vein treatment options. 

When Should I Act on My Chronic Venous Insufficiency?

Unfortunately, your vein pain and discomfort are unlikely to disappear on their own. “When it comes to vein disease, early medical intervention can help you obtain the best health outcomes. Treatment can also save you from a lot of needless suffering,” says Yan Katsnelson, M.D. 

If you are at risk for developing chronic venous insufficiency, it may be helpful for a vein specialist to monitor your condition over time. If you already have varicose or spider veins, we recommend discussing the benefits of vein treatment with one of our experts as soon as possible. 

The good news is that minimally invasive, outpatient vein treatment at USA Vein Clinics can alleviate painful and uncomfortable symptoms, reduce your risks of developing dangerous health issues, as well as improve your overall quality of life.

Chronic Venous Insufficiency Treatment at USA Vein Clinics

At USA Vein Clinics, we care about your vein health. Whether you have signs of early venous insufficiency or late-stage symptoms, minimally invasive vein treatment can help. Most of our state-of-the-art outpatient procedures can be performed in only 15 to 30 minutes. Afterward, you can leave immediately and return to most normal activities.

To learn more about your treatment options, schedule an initial consultation today. We offer consultations at over 90 clinic locations across the country, along with virtual doctor appointments. No matter where you choose to schedule your visit, we look forward to helping you take back control of your life.



Dr. Yan Katsnelson is a philanthropist, business owner, and highly skilled cardiac surgeon. He is the Founder and CEO of USA Vein Clinics, which is part of USA Clinics Group, the parent company of USA Fibroid Centers, USA Vascular Centers, and USA Oncology Centers with more than 90 facilities nationwide. Dr. Yan has established himself as a strong advocate for accessibility and affordability of the most advanced medical care close to home, and his mission is to create a positive experience for each patient with compassionate, personalized, and expert care.

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