Causes

Normal, healthy veins have one-way valves that keep blood moving toward the heart. But when the valves in the superficial veins of the legs and feet are not working properly, the blood can pool into the lower extremities.3,4

The pooling of blood creates surrounding pressure and swelling internally, which may result in enlarged blue, red or flesh-colored vein that can be seen through the skin. Over time, this can lead to other changes to the texture of the skin, and ultimately leg ulcers, if not treated properly.

Prolonged standing, pregnancy, obesity, straining, trauma, heredity or age can contribute to the development and progression of varicosities. Learn more about varicose vein risk factors.

Varicose Vein Risk Factors

There are many risk factors that may predispose a person to developing spider, reticular, or varicose veins.

These risk factors include: 5, 7

  • Family history of varicose veins are common, as venous disease is hereditary
  • Previous trauma or injury can damage veins, making it more difficult for them to move blood
  • Gender can play a role as women are twice as likely to develop the condition than men
  • Medications such as birth control and infertility drugs can increase estrogen and progesterone—hormones that are associated with higher risks for spider veins
  • Pregnancy can put pressure on a woman’s pelvic area and veins, resulting in spider and varicose veins
  • Obesity or being overweight
  • Prolonged standing or long periods of immobility can increase pressure on the veins

What to Look For

Venous disease is a progressive condition that may start out with mild to no signs. With time, it may lead to moderate or even severe symptoms such as heaviness, aching, swelling, tiredness, and itching, which can lead to a leg ulceration.

The CEAP Classification is a common system that is widely used to diagnose and identify the severity of varicose veins as they progress with time.6

  • Clinical – Describes the physical appearance of veins
  • Etiologic – Whether the condition is inherited
  • Anatomic – Identifies the veins involved
  • Pathophysiologic – Evaluates the direction of blood flow

CEAP Classifications Scores

C1

Spider, Reticular & Varicose Veins

Spider veins (telangectasia)

Cosmetic problems

C2

Spider, Reticular & Varicose Veins

Varicose veins with or without symptoms

Cosmetic problems

C3

Spider, Reticular & Varicose Veins

Swelling in the ankle & lower leg (edema)

Medical problems

C4

Spider, Reticular & Varicose Veins

Skin damage due to varicose veins

Medical problems

C5

Spider, Reticular & Varicose Veins

Prior leg ulcer that healed on its own

Medical problems

C6

Spider, Reticular & Varicose Veins

Non-healing or slow healing leg ulcer

Medical problems

C1, C2, C3, C4, and C6 images courtesy of Dr. Raghu Kolluri, C5 image courtesy of Dr. Paul Gagne.

Associated Symptoms

Edema in the Ankle

When blood flow is interrupted, the surrounding pressure on the veins can lead to edema, or swelling in the extremities, especially the ankles. This is the result of fluid build-up in one or both legs.

The surrounding pressure can lead to uncomfortable symptoms such as heaviness, tightness, and overall discomfort. These symptoms may be relieved by elevating the legs or using compression stockings.

Skin Changes

As venous disease progresses, increased swelling and pressure occurs, and the skin around the legs can begin to deteriorate. The skin can become pigmented, dry, and thick (lipodermatosclerosis) and easily break down. The inflammation can lead to pain and significant discomfort the more severe the venous insufficiency.

Venous Ulcers

Without treatment of venous disease, increased swelling and skin inflammation due to poor circulation of blood flow can lead to serious complications8. The skin can break down and result in an open wound that requires medical attention. When the sores are open, they allow for bacteria and air to enter the wound, which can make the condition worse.

Most venous ulcers occur above the ankle and can be slow to heal. They are often accompanied with leg pain, skin discoloration, and sores that seep pus and a bad odor if infection has set in.

When to See a Doctor

If self-care techniques such as exercise, lifting your legs while sitting and/or wearing compression stockings have not worked and/or you wish for cosmetic improvement of your veins, make an appointment to see your doctor to discuss next steps.

It is important to seek help right away if you have developed a leg ulcer or other non-healing wounds because of SVI.

Helpful Resources

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Third-Party Resources

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Find a Doctor

Consult your doctor to learn more about varicose veins and SVI and how to maintain your vein health. You can also use our tool below to find an SVI specialist near you.

 
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Carl Fastabend

501 Dr. Michael DeBakey Drive (3rd Floor) | Lake Charles, LA, 70601

Thomas Lee

131 Madison Avenue 2nd Floor | Morristown, NJ, 7960

Peter Swischuk

3109 Stirling rd. Suite 100 | Fort Lauderdale, FL, 33312

David Draughn, FACS, RVT, RPVI

15825 John J Delaney Dr | Charlotte, NC, 28277

Joe Viramontes

960 N 16th Street Suite 108 | Springfield, OR, 97477

Michael Sergi

75 Kings highway Cutoff, Suite 4B | Fairfield, CT, 6824

Manish Chauhan

2200 Park bend | Austin, TX, 78757

James Cunningham

8767 Perimeter Park Blvd | Jacksonville, FL, 32216

Nouri Al-Khaled

4400 W 95th Street, Suite 306 | Oak Lawn, IL, 60453

Cindy Sturt

200 S. Orange Ave | Livingston, NJ, 7039

Jesus Jimenez

2800 S Seacrest Dr. Suite 200 | Boyton Beach, FL, 33435

Andrei Pop

800 Biesterfield Road | Elk Grove Village, IL, 60007

Ediberto Soto-Cora

1139 Caper Rd | El Paso, TX, 79925

Kaveh Shahmohammadi

1449 Old Waterbury Rd, Suite 101 | Southbury, CT, 6488

Lori Pounds

7703 Floyd Curl Drive | SanAntonio, Texas, 78229

Alex Caballero

1879 Nightinglae Ln | Tavares , Florida, 32778

Thomas Levin

10837 South Cicero Avenue Suite 200 | Oak Lawn, IL, 60453

Leandro Perez

8188 Jog Rd. Suite 100 | Boyton Beach, FL, 33427

Jose Almeida

1501 S Miami Ave. | Miami Beach, FL, 33129

Saba Khan

800 Biesterfield Road | Elk Grove Village, IL, 60007

Jordan Knepper

5325 Elliot Drive, Suite 101 | Ypsilanti, MI, 48197

Jason Andre

12720 McManus Blvd, Suite 303 | Newport News, VA, 23602

Micheal Ayad

300A Faunce Corner Rd N | Darthmouth, MA, 02908

Yazan Khatib

Suite #160, FL, 32256

Santhosh Mathews

316 Manatee Ave W | Bradenton, FL, 34205

Patricio Rosa

601 N Flamingo Rd. Suite 408 | Pembroke Pines, FL, 33028

Akhilesh Sista

2315 Broadway 4th floor | New York, NY, 10024

Kathleen Gibson

1135 116th Avenue NE, Suite 305 | Bellevue, WA, 98004

James Sampson

101 Bodin Circle 60 SGCS/SGCH | Travis AFB, CA, 94535

Brian Heeringa

880 Munson Ave, Suite A | Traverse City, MI, 49686

Ravi Chandra

1920 SW 20th Place | Ocala, Florida, 34471

Vaqar Ali

7011 AC Skinner Parkway | Jacksonville, FL, 32256

David Burkart

4801 College Blvd | Leawood, KS, 66214

Asad Sawar

3010 E. 138th Avenue Suite 12 | Tampa, FL, 33613

Andrew Barleben

9434 Medical Center Dr. | La Jolla, CA, 92037

Gennady Geskin

6637 State Route 30 | Jeannette, PA, 15644

William Grande

8200 east Belleview Ave Suite 600e | Greenwood Village, CO, 80111

Jeffrey Carr

1783 Troup Highway | Tyler, TX, 75701

Vincent Digiovanni

Riddle Health Center 3, 1098 W Baltimore Pike, Suite 3308 | Media, PA, 19063

Ido Weinberg

55 Fruit St | Boston, MA, 02114

Dale Buchbinder

1212 York Road | Lutherville, MD, 31093

Paul Gagne

85 Old Kings Highway North | Darien, CT, 6820

Vasco Marques

3010 E. 138th Avenue Suite 12 | Tampa, FL, 33613

Scott Koss

725 American Ave | Waukesha, WI, 53188

Janardhan Srinivasan

2232 Wilborn Avenue | South Boston, VA, 24592

Steve Lin

1401 Harrodsburg Rd Ste A300 | Lexington, KY, 40509

Kais Yehyawi

6375 W US 6 | Portage, IN, 46368

Diego Hernandez

43700 Woodward Avenue, Suite 207 | Bloomfield Hills, MI, 48302

Deepak Sudheendra

3400 Spruce Street | Philadelphia, PA, 19104

Fuad Rafidi

23101 Sherman Place | West Hills, CA, 91307

Thomas Kerr

19189 N Dale Mabry Hwy | Lutz, FL, 33548

Hesham Fakhri

3010 E. 138th Avenue Suite 12 | Tampa, FL, 33613

Aaron Hurd

630 13th Street Suite 250 | Augusta, GA, 30901

Sunil Rayan

9850 Genesee Ave | La Jolla, CA, 92037

David Lipski

6420 Dutchmans Pkwy Suite 180 | Louisville, KY, 40205

Rias Ali

4740 Mile Stretch Drive | Holiday, FL, 34690

Jed Peterson

10123 SE Market Street | Portland, OR, 97216

Constantino Pena

8900 North Kendall Drive | Miami, FL, 33176

Zahi Nassoura

2710 Alameda Ave | Burbank, CA, 91505

Nader Chadda

6633 Forest Ave Ste 302 | New Port Richey, FL, 34653

Richard Ofstein

8075 N Shadeland Ave Ste 200 | Indianapolis, IN, 46037

Robert Davies

1301 Sigman Road, NE Suite 130 | Conyers, GA, 30012

Elizabeth Brooke Spencer, MD, FSIR

8200 east Belleview ave Suite 600 E | Greenwood Village, CO, 80111

Mazen Abu-Fadel

825 NE 10th St #2500 | Oklahoma City, OK, 73104

David Frankel

10666 N. Torrey Pines Rd. | La Jolla, CA, 92037

Patricia Thorpe

333 W Thomas Rd, Suite 207A | Phoenix, AZ, 85013

Peder Horner

1746 Cole Boulevard | Lakewood, CO, 80401

Fuad Rafidi

2710 | Burbank, CA, 91505

Gene Tanquilut

20060 Governors Drive Suite 102 | Olympia Fields, IL, 60461

Kannan Natarajan

8433 Harcourt Rd. Suite 100 | Indianapolis, IN, 46260

Charles Ross

95 Collier Road NW Suite 5015 | Atlanta, GA, 30309

Windsor Ting

1468 Madison Avenue or 1190 Fifth Avenue | New York, NY, 10029

Dev Mangalat

705 Jesse Jewell Parkway 125 | Gainseville, GA, 30501

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23120 South LaGrange Road | Frankfort, IL, 60423

Michael Flisak

3231 South Euclid Avenue, Suite 207A | Berwyn, IL, 60402

Shahin Pourrabbani

3680 Imperial Highway | Lynwood, CA, 90262

Joe Viramontes, MD

960 N 16th Street | Springfield, OR, 97477

Blaine Borders

102 Thomas Rd. Suite 205 | West Monroe, LA, 71291

Pat Neville

4600 Memorial Dr. Suite 240 | Belleville, IL, 62226

Charles Wyble

61 Witcher Street, Suite 2100 | Marietta, GA, 30060

David Gillespie

363 Highland Ave | Fall River, MA, 2720

Polly Kokinos

2255 S. Bascom Avenue #200 | Campbell, CA, 95008

Howard Roth

23120 South LaGrange Road | Frankfort, IL, 60423

Anthony Avino, MD, FACS

4750 Water Avenue, Suite 500 | Savannah, GA, 31410

Murat Sor

3833 Fairfax Drive | Arlingston, VA, 22205

Mahesh Raju

3825 highland ave | downers Grove, IL, 60515

Kenneth Wright

19189 N Dale Mabry Hwy | Lutz, FL, 33548

Rick Coats

4600 Memorial Dr # 240 | Belleville, IL, 62260

Sendhil Subramanian

7130 Mt. Zion Blvd, Suite #10 | Jonesboro, GA, 30236

Richard Pin

363 Highland Ave | Fall River, MA, 2720

James McPherson

4644 Lincoln Blvd. Suite 500 | Marina del Rey, CA, 90292

Ben Marson

85 Old Kings Highway N, 1st Floor | Darien, CT, 6820

E. Jerry Cohn Jr., MD, FACS

4750 Water Avenue, Suite 500 | Savannah, GA, 31410

George Hemstreet

100 Rice Mine Road Loop | Tuscaloosa, AL, 35406

Harold Tabaie

18905 Sherman Way | Reseda, CA, 91335

Alberto Gonzalez

19189 N Dale Mabry Hwy | Lutz, FL, 33548

Ayaz Malik

1035 Bellevue Ave #500 | St. Louis, MO, 63117

Isabel Newton

200 W Arbor Dr. | San Diego, CA, 92103

Michael Ayad

363 Highland Avenue | Fall River, MA, 2720

Jozsef Lukacs

24800 S.E. Stark St. | Gresham, OR, 97030

Timothy Manoni

85 Old Kings Highway N, 1st Floor | Darien, CT, 6820

Larry Horesh, MD

4750 Water Avenue, Suite 500 | Savannah, GA, 31410

Amiel Moshfegh

11411 Brookshire Ave | Downey, CA, 90241

Lev Pukin M.D

2560 Ocean Ave | Brooklyn, NY, 11229

Parag Patel

6633 Forest Ave #300 | New Port Richey, FL, 34653

Hoang Nguyen

2 Good Samaritan Way Suite 220 | Mt. Vernon, IL, 62864

(Charles) Daniel Procter

725 Jesse Jewell Parkway #125 | Gainesville, GA, 30501

Michael Naumann

7777 Alvarado Road, Suite 108 | La Mesa, CA, 91942

Stephen Lalka

1001 Blythe Blvd., Suite 300 | Charlotte, NC, 28203

Taras Kucher

495 Hawley Lane, Suite 2-A | Stratford, CT, 6614

Junyang Lou

520 Medical Center Drive | Medford, OR, 97504

Michael Lepore

600 North Cattlemen Rd | Sarasota, FL, 34232

Robert Freedman

3311 Prescott Road | Alexandria, LA, 71301

Daniel Simon

347 Mount Pleasant Ave Suite 100 | West Orange, NJ, 7052

Daniel McDevitt

1035 Southcrest Dr, Suite 250 | Stockbridge, GA, 30281

Marvin Padnick

350 South 40th Street | Muskogee, OK, 74401

Patrick Mahon

87 McGregor Street | Manchester, NH, 3102

Jamie Strachan

1449 Old Waterbury Rd, Suite 101 | Southbury, CT, 6488

Aaron Aday

75 Francis St | Boston, MA, 02115

Russell Samson

600 North Cattlemen Rd | Sarasota, FL, 34232

Raghotham Patlola

5003 Hardy St, Ste 200 | Hattiesburg, MS, 39402

Bruce Brenner

200 S. Orange Ave | Livingston, NJ, 7052

Ernest Conti

3929 Mercy Drive | McHenry, IL, 60050

Sanjeev Trehan

6151 South Yale Ave Suite 1304 | Tulsa, OK, 74136

Tara Balint

2010 Health Campus Drive | Harrisonburg, VA, 22801

Stephen Bauer

1445 East Putman Ave, 1st Floor | Old Greenwich, CT, 6870

Deepak Nair

600 N Cattlemen Rd | Sarasota, FL, 34232

David Showalter

600 North Cattlemen Rd | Sarasota, Florida, 34232

Andrew Olinde

5131 O'Donovan Drive 301 | Baton Rouge, LA, 70808

Allison Barone

250 Engle Street | Englewood, NJ, 7631

Thomas Lutz

15 Tower Ct Suite 200 | Gurnee, IL, 60031

Mark Iafrati

800 Washington st | Boston, MA, 2111

Jerry Chen

2775 Laurel Street, Room 4203 | Vancouver, BC, V5Z1M9

Jonathan Bowman

495 Hawley Lane, Suite 2-A | Stratford, CT, 6614

Paul Vitulli

915 W Monroe St | Jacksonville, FL, 32004

Douglas Dorsay

600 North Cattlemen Rd | Sarasota, Florida, 34232

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1. Weiss et al. “Venous Insufficiency.” Medscape. May 26, 2016

2. Eberhardt et al. “Chronic Venous Insufficiency.Circulation. 2014;130:333-346. July 21, 2014.

3. “Varicose veins and spider veins.” Office on Women’s Health. U.S. Department of Health and Human Services. January 04, 2017.

4. Lin et al. “The Management of Varicose Veins.Int Surg. 2015 Jan; 100(1): 185–189.

5. “Who is at Risk for Varicose Veins?” National Heart, Lung and Blood Institute. U.S. Department of Health & Human Services. Jan. 29, 2016.

6. “What is CEAP?” American College of Phlebotomy.

7. “Minimally invasive treatments for bothersome leg veins,” Harvard Women’s Health Watch. Harvard Medical School Publications. April 2011.

8. “Venous ulcers.Medline Plus. U.S. National Library of Medicine. May 24, 2016.

Disclaimer

The opinions and clinical experiences presented herein are for informational purposes only. Individual results may vary depending on a variety of patient-specific attributes and related factors. Dr. Raghu Kolluri has been compensated by Philips for his services in preparing and providing this material for Philips further use and distribution.

We offer links to third-party websites that may be of interest to our website visitors and in no way, represent any affiliation or endorsement of the information provided on those linked websites. These links are provided solely for your convenience and to assist you in learning more information on this topic. However, Philips does not control, endorse or guarantee the accuracy of the information contained on the linked sites. In addition, Philips makes no representations or warranties of any kind with regards to any third-party websites or information contained therein. If you have any questions or concerns about the information on the linked third-party websites, please contact the third-party websites directly.