5 Stages of Vein Disease


Like many health ailments, leg vein disease happens in phases, and gradually impacts a person’s quality of life and overall health. There are easy-to-miss early warning signs in the stages of varicose veins and vein disease and if left untreated, can lead to chronic venous insufficiency, or CVI.

Vein disease worsens over time and will not go away on its own. While every case and situation is different, there are generally five stages of varicose veins and vein disease that patients should be aware of. Vein disease starts with spider veins and if not addressed, ends with ulcers and open sores.

Stage One: Spider Veins and Reticular Veins

Spider veins are usually small, flat bluish-purple veins just beneath the surface of the skin. Since spider veins are typically not painful or bothersome and are fairly common, many people either ignore them or do not even notice them.

Reticular veins are slightly larger than spider veins and are considered “feeder veins.” They sometimes serve as an extra source of blood to spider veins and can increase the appearance and symptoms.

Spider veins and reticular veins do not always lead into the other stages of vein disease, but in some cases, they can. Seeking the advice of a medical professional in this early stage of vein disease can help prevent a more serious issue.

Stage Two: Varicose Veins

Varicose veins are similar to spider veins and reticular veins, however, their signs and symptoms are usually harder to ignore and are more obvious. Varicose veins occur when the valves in the veins aren’t working properly causing the blood to pool. The damaged valves cause the veins to become large, swollen, and bulging, usually in the legs and feet.

Risk factors for varicose veins include:

  • Increasing age
  • Genetics
  • Hormonal changes including pregnancy
  • Obesity
  • Lack of movement
  • Sun exposure

There are several ways someone can reduce their risk of varicose veins including adopting a healthy diet, starting an exercise plan, taking breaks to avoid sitting or standing for long periods of time and wearing compression stockings. A vein specialist can help people with varicose veins develop a plan to address their symptoms.

Stage Three: Swelling of the Legs

When varicose veins go untreated, the next stage of vein disease occurs – swelling of the legs and ankles. Venous disease causes poor circulation or blood flow which makes it harder for the body to absorb excess water. While elevating the legs may help to reduce discomfort, this cannot cure the underlying condition. Other symptoms associated with stage three include:

  • Itchy legs
  • Pain or discomfort when walking
  • Restless leg syndrome
  • Tight, leathery skin near the varicose veins

Individuals that experience symptoms in this stage should seek treatment from a medical professional.

Stage Four: Skin Discoloration (Lipodermatosclerosis)

As venous disease progresses in the legs, discoloration and a change of texture in the skin can occur. The skin will appear reddish-brown or white and feel more like leather than soft skin. At this stage in vein disease, people may experience leg pain and additional swelling of the legs and ankles. The skin may also start to crack and bleed leading to the next phase, ulcers.

Stage Five: Leg and Ankle Ulcers

By the time venous disease progresses to this phase, ulcers and open wounds or sores begin to appear on the legs and ankles resulting in extreme pain and discomfort. The skin tissue begins to break down because blood cannot circulate the nutrients needed to promote healing. Scarring is common, and some wounds may never heal completely.

How to Prevent Varicose Veins from Getting Worse

While it may be easy to ignore the early signs of vein disease, the best thing to do to prevent vein disease from getting worse is to talk to a medical professional as early as possible. Vein disease in stages one and two can be addressed and treated with minimally invasive procedures or even with modified behaviors such as adjusting diet and exercise.

Dr. John Mathai, M.D, F.A.C.S., F.A.C.C. is the leading physician and director at Premier Vein Specialists. Dr. Mathai offers a free, private vein-health screening at both the York and Hanover offices. During the screening, he will assess the stage of vein disease and discuss options to prevent it from getting worse, and come up with a treatment plan.

To request a free vein-health screening, call Premier Vein Specialists at 717-412-7226 or complete the vein health screening form. Our compassionate team can help you love your legs again.

At Premier Vein Specialists, your health is our priority. Our offices in York and Hanover only admit one patient at a time, and we follow all health and safety guidelines to prevent the spread of COVID-19.