Most people, especially women who are over 50 years of age often complain of vein issues in legs and feet. Venous diseases take different shapes and forms in different patients. While some may suffer from invisible yet painful venous insufficiency symptoms, a few others may have signs of painless but ugly looking varicose veins.

No matter the form, venous diseases not only point towards a serious health condition but are also highly progressive in nature which means that the patient’s condition may worsen in the absence of an effective treatment.

As all forms of venous diseases have more or less the same identical signs and symptoms, the doctors found it difficult to differentiate between the various stages and thus CEAP, the comprehensive classification system was used to clearly define distinctive boundaries between the various stages.

CEAP refers to the following :

  • Clinical observation – What does the affected vein look like?
  • Etiology – Is the venous disease inherited or there is some other underlying cause?
  • Anatomy – Which veins are affected?
  • Pathophysiology – What is the direction of blood flow (normal or abnormal)? Also, is the blood flow restricted ?

As per CEAP, the following is the official classification of venous insufficiency in 7 different stages, listed in increasing levels of severity:

  1. C0 : Asymptomatic : In this stage, there are no signs and symptoms of venous diseases and all veins are working normally. The veins are efficiently able to return the blood from the legs and the feet veins back to the heart.
  2. C1 : Spider Veins : Also called telangiectasia or reticular veins, these veins appear to be red, blue or purple in color and are tangled with one another, hence the names spider veins. These veins rise to the skin surface on the legs, upper thighs and around the ankles and hint towards underlying varicose veins.
  3. C2 : Varicose Veins : This is a condition where the valves of the leg and feet veins malfunction leading to severe difficulty in pumping the blood back to the heart. These veins force the blood to pool thus causing the patients to develop a heavy feeling and tiredness in the legs. Veins become enlarged and patients may complain of pain, cramps, itching or a burning sensation in the affected area.
  4. C3 : Edema : In this stage of venous insufficiency, there develops a prominently visible swelling in the legs around the affected veins. While daily use of compression stockings may offer extended support to the veins, it is vital to address the underlying cause of the symptoms for long term relief or the condition is bound to get worse over time.
  5. C4 : Skin Changes : By this stage of the venous disease, the skin around the affected veins tends to change its color, texture, and the overall look and feel. It some cases, patients have reported skin discoloration and eczema as well.
  6. C5 : Healed venous ulcer : Excessive pressure on the varicose veins and highly restricted blood flow may cause the leg tissues to die thus forming an open ulcer. This is not a very serious condition as the ulcer generally heals on its own as soon as the blood flow is rectified and brought back to normal.
  7. C6 : Active venous ulcer : This is the final and the most severe stage of venous insufficiency. Although found in less than 1% of the total reported cases of venous diseases, this is a serious health hazard. Prolonged therapy is needed for an effective cure of this condition. Endovenous laser treatment with extended compression therapy sessions may be suggested for quick wound healing.


Venous diseases hampers the patient’s overall quality of life. Owing to its progressive nature, a vein issue has a high tendency of getting worse with growing age. It is important to be able to differentiate between the various stages of venous insufficiency for pinpoint diagnosis and timely treatment.

Dr. Rajah V Koppala at Avis Hospitals has international medical certifications and years of extensive experience in offering the most advanced treatments for the various different stages of venous insufficiency.

He always analyses each patient’s unique symptoms and thoroughly goes through his/her medical history before advising medications or therapies. With the most technologically advanced medical care provisions of non-invasive treatments like laser ablation for venous diseases, Avis Hospitals is the most reliable medical centre for any vein diseases. Schedule a consultation with Dr. Rajah V Koppala today, visit : or