6 Stages Of Vein Disease Every Person Needs To Know

doctor conducting a vein ultrasound

The Stages of Chronic Venous Insufficiency (CVI)

Millions of Americans suffer from vein disease, and less than 10% of people know to seek treatment.  

Early stages of venous disease may not cause any noticeable symptoms. However, as the disease progresses, symptoms may become more pronounced, and even painful. In fact, without a proper diagnosis, chronic venous insufficiency may progress and lead to more long-term health problems. 

The list below outlines the stages of venous insufficiency. 

What Are The Symptoms of Chronic Venous Insufficiency?

Below are the most common symptoms of vein disease:

  • Spider Veins
  • Varicose Veins
  • Heavy and fatigued legs
  • Cramping, aching, or itching in the legs
  • Skin discoloration of changes in the texture of the skin
  • Leg swelling
  • Restless legs
  • Blood clots
  • Leg ulcers
  • Tingling legs
  • Numb legs

Knowing the signs and symptoms of venous insufficiency will help to seek treatment before the condition advances.

There Are 6 Clinical Classifications of Chronic Venous Disease:

stages of vein disease graphic

Below, this article will walk you through the various stages of vein disease and how the disease progresses:

Stages of Vein Disease

C0: No signs or symptoms of vein disease

At this classification, there are no symptoms or visible signs of venous insufficiency.

C1: Spider veins or reticular veins are present

Spider Veins

Spider veins are tiny, superficial veins and capillaries that will appear just under the surface of the skin.   Often pink, red, or purple in color, they measure about 1 to 1.5 mm.

Often, spider veins appear threadlike or like streaks that may cluster with other veins, often looking like branches of a tree.

At times, spider veins may cause pain or discomfort in the affected area.

Reticular Veins

Reticular veins, also known as “feeder” veins, are more significant than spider veins but smaller than varicose veins. They do not protrude above the skin and measure approximately 2 mm in diameter.   They are known as feeder veins as they often feed into spider veins, providing them with an excess source of blood.

Typically found on the inner or back of the thigh, they range in color from red, purple, blue to a greenish-blue.

Individuals describe symptoms of burning and itching when reticular veins are present in the veins of the legs.

Removal of reticular veins will often help eliminate spider veins.

C2: Varicose veins

Varicose veins are large (greater than 2.5 mm), swollen, twisted veins that often protrude above the surface of the skin.   Typically, individuals find this stage much more noticeable and bothersome due to the appearance and symptoms. Some may even experience pain, discomfort, and aching.

While many view spider veins and varicose veins as cosmetic issues, varicose veins may very well be the signs of progressing vein disease.

What Are the Symptoms of Varicose Veins:

  • Large, bulging veins that are typically blue or purple
  • Veins may appear twisted or tangled
  • A sensation of heaviness and fatigue in the legs
  • Aching, burning, or itching
  • Discomfort after sitting or standing for prolonged periods
  • Swelling
  • Hardening of the veins
  • Bleeding or leaking veins

Are There Risk Factors that Cause Varicose Veins?

Several risk factors increase the chances of developing varicose veins:

  • Age
  • Family History
  • Obesity
  • Pregnancy
  • Sex (varicose veins are more common in women)
  • An occupation that requires standing or sitting for prolonged periods

C3: Edema ( leg swelling)

As vein disease becomes more advanced, swelling will set in more frequently. Swelling is an indicator that the venous system is unable to reabsorb and circulate fluid properly. As a result, the pooling of blood and fluid will often occur in the legs and ankles.

What Are The Symptoms of Edema?

Many of the symptoms for edema are similar to those found in varicose veins. Therefore, should you be experiencing the following symptoms with varicose veins, you must seek medical consultation to prevent further health complications.

Symptoms of Edema include:

  • Tightness in leg calf and ankle
  • Burning or itching
  • Skin discoloration and texture changes
  • Restless leg syndrome
  • Discomfort and numbness near the varicose vein
  • Muscle spasms
  • Leg ulcers

What Causes Edema in the Legs and Ankles?

There are several causes to edema in the lower limbs:

  • Venous disorders
  • Heart disease
  • High blood pressure
  • Deep Vein Thrombosis
  • Poor diet
  • Lack of exercise
  • Smoking

C4: Changes in skin

As venous disease advances, the appearance of your skin is impacted. Skin discoloration and changes in the texture of the skin are often visible. During this stage of vein disease, your skin is at a higher risk of becoming injured and will take much longer to heal.

  • Skin discoloration: often reddish-brown and leathery in appearance
  • Skin texture changes: such as thickening, hardening, inflammation
  • Pain and discomfort
  • Leg ulcers
  • Tapering above the ankles

What Causes Skin Discoloration?

  • Chronic Venous Insufficiency
  • Heart Disease
  • Obesity
  • Poor diet
  • Hormonal changes
  • Standing or sitting for long periods 

C5: Healed venous ulcer

Venous ulcers are open sores that are caused by chronic disease. Often called venous ulcers or venous stasis ulcers, they are most commonly found low on the inner ankle.  

In this stage of vein disease, venous congestion is so poor that blood flow is prevented from delivering nutrition and oxygen to the skin, resulting in open sores at the surface of the skin.

Venous ulcers take a considerable amount of time to heal (months to years). Once healed, there is a risk that they can return.

C6: Active venous leg ulcer

The presence of an active venous ulcer is the most advanced stage of vein disease. While they are most commonly found low on the inner ankle, they can occur anywhere below the knee. The open sores typically start out as small ulcers but can grow to be quite large if left untreated.

Leg ulcers are tender, painful, shallow, and may ooze or drain fluid or pus. Keep in mind, once a leg ulcer is present, your risk of infection is high. Including the risk of developing an infection in the surrounding tissues, known as cellulitis.

What Are The Symptoms of Leg Ulcers?

  • A painful, open sore on leg or ankle
  • Swelling
  • Aching, burning, and itchy skin
  • Skin discoloration
  • Tightening around the leg calf and ankle
  • Yellow or green fluid leaking from the sore

What Are the Causes of Leg Ulcers?

  • Untreated Chronic Venous Insufficiency
  • Deep Vein Thrombosis (DVT)
  • Peripheral Vascular Disease
  • Diabetes
  • Pregnancy
  • Obesity
  • Heart Failure

When left untreated, leg ulcers cause a high amount of pain and have a significant impact on one’s quality of life. It is recommended that a wound-care teamwork to heal advanced ulcers.

What Are The Complications of Untreated Chronic Venous Insufficiency?

Several complications may develop should chronic venous disease be left untreated:

  • Superficial Venous Thrombophlebitis: When a blood clot forms in a vein that is just under the skin surface.
  • Bleeding: This will often be the result of local trauma or injury to the leg
  • Lymphedema: The buildup of lymphatic fluid in the tissue beneath the skin.

What can you do about vein disease?

At the onset of vein disease, many people seek help from their  their primary care doctor. They are often prescribed compression stockings to help alleviate their symptoms. 

However, if a person has late stage vein disease, compression stockings may only mask the problem. In fact, we ran a recent survey that indicated that just 9% of people were helped with the use of compression stockings. While 26% of people indicated they received no help at all. 

compression stockings survey

Find A Doctor Who Specializes In The Treatment Of Vein Disease 

vein clinic near me

A doctor who specializes in treating venous disease will help diagnose CVI by first evaluating the person, and running a non-invasive ultrasound test. This test is quick, and painless, and usually covered by medical insurance. You can often find a specialized doctor by doing a quick search for “vein clinic” or visiting the Medtronic® website to find a list physicians.


Veinly uses medical reviewed journals, medical research, and has strict editorial review guidelines by medical professionals. You can read more about  our editorial policy and how our writers produce content for Veinly.


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