A Patient's Guide to Superficial Venous Insufficiency

Updated on: November 28, 2018

Superficial venous insufficiency is a type of vein disease that affects the veins near the surface of the leg and causes symptoms of discomfort, pain, and can develop into more serious complications.

Diagnosing this condition is not always easy. Other conditions may have similar symptoms. You can also have other medical problems alongside vein disease. So if you have any symptoms of superficial venous insufficiency, see a vein specialist for proper evaluation, diagnosis and treatment.

Symptoms of superficial venous insufficiency

Superficial venous insufficiency develops slowly, often over years. The early symptoms tend to be vague. As a result, people with this condition may dismiss symptoms as a sign of growing older or due to another health problem like diabetes.

Depending on which veins are affected, symptoms can occur anywhere in the lower legs. Common symptoms in the leg include:

  • Heaviness, aching or cramping
  • Itching
  • Swelling in the leg, ankle or foot
  • Leg fatigue
  • Restless legs

Some people with superficial venous insufficiency develop varicose veins or spider veins. However, these may not always be visible due to the thickness or color of your skin, or the amount of fat under the skin.

If this condition is left untreated, your symptoms can worsen. You may also develop serious complications that can greatly affect your quality of life such as:

  • Thick, leathery skin
  • Brown discoloration of the skin (hyperpigmentation)
  • Open sores (ulcers), even without injury

How the superficial venous insufficiency progresses varies from person to person. You may experience pain for years with few visible symptoms of the condition, or you may develop more severe complications such as ulcers after only a short time.

Causes of superficial venous insufficiency

Superficial venous insufficiency is caused when the valves or walls of the veins don’t work properly. This allows blood to collect in the veins, which causes them to swell. Over time, the increased pressure of the extra blood can cause the symptoms of this condition.

Like other vein diseases, superficial venous insufficiency is often a hereditary condition. This means that if your parents had this condition, you are more likely to develop it.

There are, however, several factors that increase your risk of developing superficial venous insufficiency, such as:

  • Sitting or standing still for long periods
  • Older age
  • Having multiple pregnancies
  • Obesity
  • Smoking

Diagnosing superficial venous insufficiency

To diagnose superficial venous insufficiency, your doctor will talk to you about your symptoms and do a physical examination.

Your doctor will use ultrasound or another type of imaging test, such as an MRI or CT scan to identify which veins are affected and whether there are other health problems present. These imaging tests allow your doctor to detect abnormalities in your blood flow and check the health of your veins.

This will help your doctor diagnose your condition and also decide which treatment is most appropriate.

Compression stockings for superficial venous insufficiency

If you have superficial venous insufficiency, compression stockings may provide some relief from symptoms. Compression is a conservative therapy for venous disease, but isn't a cure.

Compression stockings squeeze the legs to help move the blood in the veins toward the heart. This can help your legs feel better, reduce swelling, and may slow down the progression of a venous condition.

Compression stockings can be purchased from pharmacies or medical supply stores and come in different styles and compression strengths. Your doctor can help you decide which type of compression stocking is best for you.

Treating superficial venous insufficiency

Superficial venous insufficiency is a serious disease. Early diagnosis and treatment can relieve your symptoms and prevent your condition from becoming worse.

If you have any symptoms of superficial venous insufficiency, a vein specialist can determine the root cause and determine the best treatment options for you.

There are several treatments available for superficial venous insufficiency, including:

  • Sclerotherapy: A chemical is injected into the vein, which causes it to close off. Eventually, the vein is reabsorbed by the body and fades away. Sclerotherapy using foam and ultrasound guidance can be used to treat larger veins that aren't visible from the surface of the skin.
  • Ambulatory phlebotomy: Veins near the surface of the skin are removed in sections with a special hook through several small cuts in the skin.
  • Endovenous ablation: A narrow tube (catheter) is inserted into the vein through a cut (incision) in the skin. A special device in the tube uses laser or radiofrequency energy to heat the inside of the vein and close it. It eventually fades away.
  • VenaSeal. A catheter is inserted into the vein and medical glue is injected to seal it.
  • Vein stripping: The vein is tied shut and surgically removed through a cut in the skin. This treatment is no longer commonly performed and mostly replaced with endovenous ablation which is effective and less invasive.

The best treatment for you depends upon which veins are affected and how severe your symptoms are. For example, ambulatory phlebectomy is best suited for larger veins near the surface of the skin, and endovenous ablation can close off deeper veins in your legs. Your doctor may use multiple treatments at the same time for different veins.

Updated Nov. 1, 2017

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