Venous Insufficiency Pictures

Venous insufficiency picture with ocean backdrop

Venous insufficiency comes in many different forms. Spider veins and varicose veins are easy enough to recognize, but even these common symptoms can present in different colors, shapes, and locations depending on the stage, severity, and extent of venous insufficiency Our vein specialists review the venous insufficiency pictures and provide an extensive gallery of visual features of vein disease from the earliest visual manifestations to the most severe end stages.

Vein Specialist Dr. Michael Lalezarian in Los Angeles, California

Vein Specialist

Dr. Michael Lalezarian

Vein problems? We can help you get your legs back.

Dr. Michael Lalezarian is a double-board certified Vascular Interventional Radiologist specializing in minimally invasive vein treatments. He is a committed partner in the battle against the devastating consequences of venous insufficiency.

5-Star vein treatment in Los Angeles
“He is truly dedicated, and an extraordinary physician who’s really concerned with his patients!”

Adrianne S, October 2018

Venous Insufficiency Pictures

To help you better understand your venous insufficiency, we’ve compiled an extensive gallery of venous insufficiency pictures and sorted them from least severe (spider and reticular veins) to chronic venous insufficiency (skin changes and ulceration). This gallery serves as a visual model of venous insufficiency progression, while also shedding light on the different ways that vein disease can present on different parts of the legs. We provide more explanation on the different visual features of venous insufficiency in more detail below the gallery.

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Venous Insufficiency Visual Features

Spider and Reticular Veins

Spider veins, also called “telangiectasia,” are clusters of small red, blue, or purple colored capillary veins on the surface of the legs. They are extremely common, affecting around 65% to 75% of adult legs. [1,2] On their own, spider veins are not medically significant. In other words, spider veins do not cause symptoms that necessitate medical treatment, but they are easily treated for aesthetic purposes with either sclerotherapy injections or laser therapy.

Though they’re distinct, we sometimes talk about spider veins and reticular veins interchangeably. To clarify the difference, spider veins (also called “telangiectasia”) are actually widened venules, whereas reticular veins are small rope-like veins. Both spider veins and reticular veins are visible on the surface of the skin, as demonstrated in the venous insufficiency pictures above.

Spider veins are the very first stage chronic venous insufficiency. Spider veins can occur independently of other symptoms of chronic venous insufficiency, and they often accompany varicose veins or other skin changes related to vein disease. In rare cases, spider veins may be the only outward sign of more advanced vein problems [1,2].

Varicose Veins

Varicose veins are bulging veins that course along the surface of the leg. The underlying cause of most vein problems is a phenomenon known as “venous reflux.” Venous reflux refers to the condition in which blood in a vein or a group of veins flows backwards (away from the heart), causing blood to pool in the veins. This pooling is responsible for the visual bulging and discoloration that is characteristic of varicose veins [3].

Varicose veins are commonly thought of as just a cosmetic issue, and while this is true in some cases, many individuals with varicose veins also deal with medically significant swelling and pain. When flow stagnates and blood pools in the veins, it can have systemic effects on the tissues of the leg, affecting skin and muscle health. Patients often report cramping, aching, throbbing, and heaviness in their leg, among other sensations. As vein disease progresses, the skin can become dry and itchy, hardened, or discolored, as demonstrated in the venous insufficiency pictures above.

Varicose veins are treated with minimally invasive medical devices that close down or eliminate the diseased vein, allowing blood to flow through nearby healthy veins.

Skin Changes

When blood accumulates in the veins, some of it leaks out into surrounding tissues, causing the leg to become swollen and heavy. When blood cells leak out of the veins, they release a chemical called hemosiderin, which has a red-brown color, and it also activates melanocytes, which produce the brown melanin pigment. As inflammatory cells leak from the vein, they can also cause the skin to become red, irritated, and itchy. At the same time, fibrin can also leak out of the vein and deposit into the skin, causing it to become thick, tough, and inflexible. As the skin changes, patches of the leg may take on a darker reddish color (lipodermatosclerosis) or become pale and lose color (atrophie blanche) [4].

Corona phlebectatica is another visible skin change caused by venous insufficiency. This symptom is characterized by visible dark spots (“stasis spots”) and spider veins around the ankle, and abnormally dilated veins in the same region. Together, these features make the inside of the foot appear colorful and spotted with red, blue, and purple vessels [4].

Venous Leg Ulcers

Venous leg ulcers are the most severe manifestation of venous insufficiency. Venous leg ulcers develop when blood flow is seriously impaired in the major veins of the leg. They typically form on the back of the lower leg between the mid-calf and the ankle bone, and are usually accompanied by skin discoloration, skin hardening, itchiness, and leg pain. The last four images in the gallery above show different cases of venous leg ulcers.

The goal of venous leg ulcer treatment is to restore healthy blood flow throughout the veins. While less severe vein disease can usually be addressed with varicose vein treatments, venous ulcers often have deep vein issues that must be addressed as well to allow the leg to heal.

Vein Screening in Los Angeles
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More Resources
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Venous Leg Ulcer Treatment

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Stages of Venous Insufficiency

Learn about the stages of venous insufficiency, from spider veins to venous leg ulcers.
Los Angeles Vascular Specialist Dr. Michael Lalezarian

Vascular Specialist in Los Angeles

Learn more about Los Angeles Vascular Specialist Dr. Michael Lalezarian.
References

[1] Michael H. Criqui, Maritess Jamosmos, Arnost Fronek, Julie O. Denenberg, R., & D. Langer, John Bergan, and B. A. G. (2003). Chronic Venous Disease in an Ethnically Diverse Population The San Diego Population Study. American Journal of Epidemiology, 76(October 2009), 211–220.
[2] Chiesa, R., Marone, E. M., Limoni, C., Volonté, M., Schaefer, E., & Petrini, O. (2005). Chronic venous insufficiency in Italy: The 24-cities Cohort study. European Journal of Vascular and Endovascular Surgery, 30(4), 422–429.
[3] Raffetto JD. Pathophysiology of Chronic Venous Disease and Venous Ulcers. Surg Clin North Am. 2018;98(2):337-347.
[4] Lurie F. Passman M. Meisner M, Dalsing M, Masuda E, Welch H, Bush RL, et al. The 2020 Update of the CEAP classification system and reporting standards. J Vasc Surg: Venous and Lym Dis 2020;8:342-52.

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