We often get asked about the stages of varicose veins. Most varicose veins are visible, bulging and ropey-looking veins protruding on the skin and often appearing blue or dark purple. But this is not always the case. They are not always visible and not always on the legs. Varicose veins can be in other parts of the body, including the pelvic region, where they may be painful and misdiagnosed for other conditions, particularly for women.
Varicose veins can get progressively worse in stages and you may become more aware of them aching or looking worse. As the stages progress, they may cause skin irritation and eczema, ulcers, surface and deep vein blood clots, infection or bleeding. Or you may just have more spider veins than you used to have. Like with most medical conditions, it is preferable to treat the condition early, when symptoms or signs first appear. This means outcomes are likely to be better. You can seek a diagnosis from a vascular specialist at any stage of varicose vein development.
Generally, the stages of varicose veins are:
What is stage 1 of varicose veins?
Spider Veins
This is the mildest form of venous disease. Spider veins are small, red, purple or blue vessels that appear on the surface of the skin. They are often the first visible sign of venous insufficiency, meaning that varicose veins may be beneath these. These veins do not usually cause significant discomfort but can be a cosmetic concern as they may look unsightly. Occasionally, they ache and cause a burning sensation. Spider veins can be effectively treated using tiny injections (microsclerotherapy) or high-spec laser at Laser Aesthetics.
What is stage 2 of varicose veins?
Reticular veins
Reticular veins are slightly larger than spider veins and are usually blue or green. They are located deeper under the skin but are still visible. Like spider veins, reticular veins are often more of a cosmetic issue than a medical one but they can mean that there are worsening vein problems. In some patients they cause aching and throbbing.
What is stage 3 – when do they become varicose veins?
Varicose veins
At this stage, veins become visibly swollen, twisted and bulging. Varicose veins can cause symptoms such as aching, throbbing, heaviness and fatigue in the legs. Especially if you are standing all day. Swelling, itching and skin discolouration may also occur in the affected areas. They may also contribute to leg and ankle swelling.
In the stages of varicose veins – what is stage 4?
Complicated veins
As varicose veins worsen, they may irritate the skin causing itching, eczema and ulcers. Fluid may build up in the tissues, leading to swelling (oedema) in the legs and ankles. This swelling can cause significant discomfort and may worsen at the end of the day or after prolonged periods of standing or sitting. There can be some relief if you wear compression stockings during your working day. Compression stockings offer graduated compression to help keep blood flowing. Ulcers, blood clots and bleeding veins are a feature of the more advanced stages of varicose veins.
How might the stages of varicose veins affect your skin?
Stage 5: Skin changes
Persistent swelling and increased pressure in the veins can lead to changes in the skin. The skin around the varicose veins may become dry, itchy and discoloured (often being a brown or reddish colour). In some cases, the skin can become thin and fragile, making it more prone to injury, infection and ulceration
What is the last of the stages of varicose veins?
Stage 6: Ulcers
The most severe stage of varicose veins involves the development of ulcers. These ulcers typically form just above the ankle bones and are a result of prolonged venous leakage of blood towards the feet, rather than being returned to the heart. This leakage of blood puts pressure on the skin, which eventually breaks down to form a venous ulcer. Venous ulcers are often not very painful, slow to heal and susceptible to infection requiring intense management from a vascular specialist.
