The Stages of Vein Disease

Venous insufficiency is a fairly common condition and may affect up to 40% of people in the U.S. If you have noticed abnormalities like swollen or twisted veins, skin discoloration, pain, or itching and burning sensations, you might be dealing with venous disease.

Thankfully, there are various minimally invasive solutions for this condition. Learn about the chronic venous insufficiency stages, causes, symptoms and treatment options in this guide.

What Are the Signs of Vein Disease?

Chronic venous insufficiency (CVI) occurs when your leg veins and valves become damaged over time. Your valves regulate blood flow, so when they stop working properly, blood begins to pool in your veins. This can cause various unpleasant symptoms, including:

• Leg ulcers
• Leg discoloration
• Burning and itching
• Leg pain and swelling
• Deep vein thrombosis, a serious condition involving a blood clot formation in the deep vein
• Restless leg syndrome, the uncomfortable urge to move the legs due to throbbing, aching or itching

Stages of Venous Disease

Venous disease happens in several stages. Here are the different stages of venous insufficiency to be aware of.

1. Spider Veins

Spider veins are purple, blue and red weblike, superficial veins on the outer layer of your skin. They are visible on the face, neck, legs, ankles and other areas. Spider veins are not typically painful and are more of a cosmetic annoyance. Common causes include:

• Aging
• Obesity
• Heredity
• Hormones
• Pregnancy
• Excessive sun exposure
• Excessive standing or sitting

Many people tend to ignore spider veins, cover them up and forgo having them checked. While they are not necessarily related to varicose veins, they may still indicate the same underlying CVI. They can cause pain, swelling, itching and burning.

Fortunately, it is easy to treat spider veins through a procedure called sclerotherapy. This treatment involves injecting a small dose of a chemical solution into the spider vein. Sclerotherapy causes the vein walls to swell, stick together and close up, ceasing blood flow. The vein fades within a few weeks as a result.

You can also treat small spider veins with cutaneous laser therapy, where a professional uses a highly concentrated laser to remove any signs of spider veins by heating them up and closing them.

2. Varicose Veins

Varicose veins stem from venous insufficiency, where blood pools and collects in the legs rather than traveling upward, enlarging and twisting the veins. Varicose veins are not always an immediate cause for concern, but they can often cause blood clots, ulcers and chronic venous issues. Common symptoms include:

• Leg cramps
• Aching muscles
• Itching and burning 
• Pain from sitting or standing
• Skin discoloration or texture changes

Varicose veins are primarily caused by damaged vein or valve function. This damage may come from:

• Obesity
• Genetics
• Pregnancy
• Aging and menopause
• Excessive standing or sitting

Besides sclerotherapy, other treatments for patients with varicose veins include:

• Radiofrequency ablation: Radiofrequency ablation (RFA) uses a thin catheter to release heat into the varicose vein via radiofrequency energy, permanently sealing it shut.
• Varithena: Verithena uses a low-nitrogen microfoam treatment to redirect blood flow for stronger, healthier vessels. It doesn’t require any incisions since it delivers injections into the veins. The microfoam is specially formulated to displace blood even in wide vessel shapes and sizes.
• VenaSeal: VenaSeal is a minimally invasive treatment that injects a small dose of FDA-approved medical glue to seal the veins. This procedure collapses the veins and redirects the blood.

Additionally, your doctor will likely recommend certain lifestyle adjustments to prevent future vein-related issues. Changes may include regular exercise, weight loss or wearing compression stockings. Compression stockings are special socks that help maintain blood flow and reduce swelling and discomfort by applying gentle pressure to the legs and ankles.

3. Edema

If you have varicose veins, you may experience the next stage of edema or swelling in the legs and ankles, especially after prolonged standing or sitting. Swelling is generally due to pooled-up blood in the legs that the body cannot circulate.

Edema can stem from sedentary lifestyles, pregnancy, heart or kidney disease and other factors. Edema can also be a side effect of certain medications, such as high blood pressure medications, non-steroidal anti-inflammatory drugs (NSAIDs) and steroids.

Other symptoms may accompany inflammation in the legs, ankles and feet, such as:

• Itchy skin
• Muscle spasms
• Leg restlessness
• Pain when walking
• Tight ankles and calves
• Tenderness and numbness

Every circumstance is different, so edema can be a temporary or lifelong issue. The skin may continue to stretch if left untreated. After determining the root cause of your edema, your health care provider may recommend certain lifestyle changes.

Your doctor can help treat vein circulation issues that trigger edema, developing a comprehensive plan to boost blood flow in swollen areas. Treatment may include leg elevation and supportive hosiery. If these do not improve your condition, they might suggest minimally invasive procedures like:

• Endovenous laser ablation surgery (ELAS): This procedure uses a minimally invasive laser to shrink and destroy veins.
• Ultrasound-guided sclerotherapy: When a vein is hidden beneath the skin and not visible, ultrasound-guided sclerotherapy may be necessary. The sclerosant solution is injected into the affected vein after it is visualized with ultrasound imaging.

If your edema is related to a medication, stopping this medication may resolve the swelling. However, you should check with the doctor who prescribed it first.

4. Skin Changes and Discoloration

This stage generally overlaps with the third stage. As swelling sets in, almost every patient will also experience noticeable changes in skin appearance, especially as the skin continues to thin.

Changes can include anything from hard, leathery skin texture to brown discoloration. The skin can also become red, itchy and flaky. Color and texture changes often result from blood leaking from the vessels into the skin tissue. These changes can cause cracking and bleeding, which leads to venous ulcers and sores.

5. Leg Ulcers and Sores

Leg ulcers or sores usually indicate that the venous disease has reached an advanced stage. Ulcers are incredibly painful and itchy. When they become infected, bacteria enter the legs, causing further complications. Common symptoms of this stage include:

• Leaking veins
• Reduced mobility
• Pain in the legs and ankles
• Yellow, pus-filled sores on the legs and ankles
• Thickened, hardened skin around varicose veins

If you have a leg ulcer, it is crucial to lower the pressure in your lower leg veins. Compression stockings or bandages can boost circulation and prevent blood pooling. Elevating the affected limb above the heart three to four times daily for 30 minutes may help lower the pressure. Your doctor will also prescribe pain medications and antibiotics as needed.

Once the wound has healed, you may need surgery like laser ablation, sclerotherapy or ambulatory phlebectomy to seal the diseased veins. Lifestyle changes like healthy dieting, exercise and quitting smoking may also help prevent future ulcers.

Contact Texas Vein to Treat Your Vein Disease

If you believe you are dealing with venous disease, turn to our experienced team at Texas Vein & Wellness Institute. Since 2013, our team has treated each patient compassionately and professionally, offering various minimally invasive treatment procedures for spider and varicose veins in our state-of-the-art facility. Request a consultation appointment today to begin treatment.