What Are the Different Stages of Varicose Veins: Early to Severe Conditions

stages of varicose veins

Veins constitute a vital component of the body's circulatory system, responsible for transporting blood from the body's tissues back to the heart for oxygenation. Once oxygenated, the blood is conveyed back to the body's tissues through the arteries.

These veins possess one-way valves designed to ensure the continuous flow of blood toward the heart. However, if these valves suffer damage or weaken, the blood might not efficiently return to the heart, resulting in accumulation and pooling within the veins. This accumulation leads to the swelling of veins, a condition recognised as varicose veins. While these enlarged and twisted veins commonly manifest in the legs, they can emerge anywhere in the body.

Spider veins, a smaller version of varicose veins, consist of enlarged capillaries situated near the skin's surface. Capillaries, serving as delicate, thin-walled vessels bridging arteries and veins, play a crucial role in this process. Aptly named, spider veins often resemble a spider web or the branching pattern of a tree on the skin.

What Are Some Early Symptoms of Varicose Veins?

Varicose veins are observed in various ways, extending beyond the visibly swollen and twisted veins. Early signs and symptoms of varicose veins include:

  • Varicose veins often appear as bluish or purple bulging veins beneath the skin's surface, particularly on the legs.
  • Ankle and foot swelling can accompany varicose veins, especially worsening in warmer weather or after prolonged standing.
  • Spots on the lower legs may indicate venous insufficiency, increasing the risk of varicose veins.
  • The sensation of heavy or achy legs, particularly after physical activity, is a common early sign.
  • Leg cramps, especially at night, may be indicative of varicose veins.
  • Itchy legs, predominantly in the lower leg and ankle regions, can be a symptom.
  • Varicose veins may cause burning or throbbing sensations in the legs.
  • Discoloured patches of skin around varicose veins may indicate underlying issues.

It's important to note that symptoms may vary and can worsen with warmer weather or prolonged standing. Some individuals may develop stasis dermatitis, a rash associated with varicose veins, emphasising the need for professional medical attention.

Even without early signs and symptoms of varicose veins, individuals with a family history or other risk factors should remain vigilant. While varicose veins themselves may not pose long-term health risks, managing symptoms is crucial, especially as the condition can worsen over time.

Different Stages of Varicose Veins and Diagnosis

Varicose veins progress through distinct stages, each presenting unique symptoms and challenges. Effective management and treatment hinge on understanding these varicose veins stages.

Stage 1: Spider Veins

Spider veins, the initial varicose veins stages, are small, visible veins just beneath the skin's surface. Typically painless, they can manifest as red, blue, or purple veins, resembling a spider web or tree branch pattern. While primarily a cosmetic concern, some may experience mild itching or burning. Treatment for varicose veins in the legs includes sclerotherapy, involving the injection of a solution to collapse the veins, and laser therapy to selectively target and eliminate spider veins.

Stage 2: Enlarged Varicose Veins

In this stage, veins become visibly enlarged, often appearing blue or purple and may bulge or twist. Unlike spider veins, enlarged varicose veins can cause discomfort, including aching, throbbing, and a heavy sensation in the legs. Skin changes may occur, such as darkening or thickening. Compression stockings can be recommended for mild cases, while more severe varicose veins may require procedures like endovenous laser treatment (EVLT) or sclerotherapy.

Stage 3: Oedema

Edema, or swelling, results from poor circulation, leading to symptoms such as pain, itching, and muscle cramps. Lifestyle changes, including exercise and compression stockings, are recommended, with medical interventions for severe varicose veins.

Stage 4: Skin Changes

Prolonged oedema and poor circulation can lead to significant skin changes in Stage 4. The skin may develop brown discolouration, a leathery texture, redness, flakiness, and itching. These changes may result in venous ulcers and open wounds caused by blood leaking into the skin tissue. Treatment involves addressing the underlying chronic venous insufficiency.

Stage 5: Ulcers

Venous ulcers are the most severe stage, arising from prolonged untreated varicose veins. These open wounds, often around the ankles, can be painful, take a long time to heal, and may cause infections. Managing chronic venous insufficiency, the root cause, is crucial in treating venous ulcers.

Diagnosis -

To diagnose varicose veins, healthcare providers conduct a physical exam, including assessing leg swelling and asking about pain and aching. A venous Doppler ultrasound of the leg is a common noninvasive test to visualise blood flow through the veins and detect blood clots. The test involves using a handheld device (transducer) to transmit images of the leg veins to a monitor.

Accurate diagnosis is essential for determining the appropriate treatment plan. Seeking medical attention and discussing symptoms with healthcare professionals play a pivotal role in effective management.

When Should You Consult a Vein Specialist Doctor?

Recognising the signs demanding professional attention is vital. Seven pivotal signs indicating the need for a vein specialist include:

  • Severe Symptoms: Relentless aching, throbbing, or cramping suggests the need for medical assessment.
  • Dry Itchy Rash: Ankle rashes could be precursors to complications, necessitating immediate attention.
  • Vein Problems During Pregnancy: Pregnancy-related vein issues warrant specialised guidance for sustained vascular health.
  • Weeping or Ulcer on Ankle: Advanced vein disease signs demand urgent assessment and treatment, possibly including laser treatment.
  • Fragile Blue Veins: Visible blue veins, especially around the ankle, require professional scrutiny due to the likelihood of bleeding.
  • Swollen Ankle: Recurring ankle swelling indicates the necessity of a doctor's visit to prevent complications.
  • Tender Lump with Varicose Vein: A red, warm, tender lump signals the need for immediate attention to address potential complications like thrombophlebitis.

When choosing a vein specialist, factors such as qualifications, experience, hospital reputation, and available facilities should be considered. Consulting the primary doctor for recommendations ensures a comprehensive approach to vein care.


Understanding the varicose veins stages, early symptoms, and when to seek professional help is crucial in managing varicose veins effectively. Varicose veins, while common, require proactive care to prevent complications and ensure long-term vascular health. If you suspect varicose veins or experience any of the aforementioned signs, don't hesitate to consult a vein specialist for personalised guidance and treatment for varicose veins in your legs.