Varicose Veins Stages Explained: A Beginner’s Guide

Varicose veins are twisted, swollen veins that can be blue, red, or skin-colored. They’re widespread in the American population, affecting 22 million women and 11 million men between the ages of 40 and 80.¹ Varicose vein stages are a progression and cause worsening signs and symptoms, including chronic venous insufficiency and venous ulceration. 

Most often, varicose veins happen in the veins of the legs. Sometimes, they can occur in the pelvis, affecting larger veins like the iliac veins or inferior vena cava. Varicose vein progression can give rise to troublesome symptoms and some complications.² Besides their unsightly appearance, varicose veins can cause symptoms like aching and swelling in the ankles and legs, burning sensations, cramps at night, and itchy and scaly skin.

How Do Varicose Veins Form?

Blood flow in all veins is toward the heart. Valves inside the veins prevent blood from flowing backward, away from the heart. Blood collects in the veins if the valves are weakened or damaged. This increases the pressure within the veins. As the walls of the veins weaken, the veins swell and grow larger.³ 

Stages of Varicose Veins

The early stages of varicose veins are associated with improper functioning of the venous valves, reversal of blood flow, and increased pressure in the veins. Varicose vein development causes inflammation that further weakens the walls and valves of the veins. Early treatment and lifestyle changes such as regular exercise can stop the inflammation.⁴ 

Varicose vein development happens in six stages:⁵

• Telangiectasies or reticular veins — thin, thread-like veins visible under the skin
• Varicose veins — dilated, twisting veins more than 3 millimeters wide
• Edema — swelling, most often on the feet and ankles
• Changes in skin — such as brown discoloration of the skin or eczema
• Healed venous ulcer with scarring and fibrosis
• Active venous ulcer — painful open sores that need specialist treatment

The early stages of varicose vein progression often cause no problems except for their appearance. As the condition develops, you may have discomfort and aches that disturb your sleep. As the pressure in the veins increases and blood flow is obstructed, other symptoms and complications may appear. 

Causes and Risk Factors

Risk factors for developing varicose veins:⁶

• Standing for long periods
• Obesity
• Being female
• Age
• Pregnancy
• Hormonal therapy and oral contraceptives

Varicose veins are common; as many as 30% of people have them.⁷ Most often, they are a cosmetic problem with a few mild symptoms. 

However, as they progress, they can cause troublesome symptoms and complications. They can cause significant bleeding that is difficult to stop. A particular danger is blood clots, which can cause thrombophlebitis (clots with local swelling) and thromboembolism (a clot that breaks off, travels to the lungs, and blocks blood flow). Other complications are chronic venous insufficiency and venous ulcers.⁸ 

These complications can be severe and need medical treatment. If you have varicose veins and notice pain, swelling, redness, warmth, or skin changes, you should consult your doctor. They may advise you to see a vein specialist. 

Find a Vein Specialist

For more in-depth information about varicose veins and your treatment options, check out the MyVeinTreatment articles on varicose veins. Our website also has a vein specialist locator to help you connect with an expert in your area.

SOURCES:

1. Circulation: “Varicose Veins.” 
2. National Health Service: “Varicose veins.” 
3. John Hopkins Medicine: “Varicose Veins.” 
4. U.S. Department of Health and Human Services: “Varicose veins and spider veins.” 
5. Journal of Vascular Surgery: “Revision of the CEAP classification for chronic venous disorders: Consensus statement.” 
6. StatPearls: “Varicose Veins.” 
7. National Health Service: “Varicose veins. Complications.”
8. Advances in Therapy: “How Does Chronic Venous Disease Progress from the First Symptoms to the Advanced Stages? A Review.”