Superficial Venous Insufficiency

The superficial veins in the legs and feet play a key role in returning blood to the heart. When these veins do not function properly, it can lead to a common condition called superficial venous insufficiency (SVI).

Because superficial veins are close to the surface of the skin, the increased pressure and swelling can cause visible veins that appear blue, red, or flesh-colored. These veins are commonly known as spider veins, reticular veins, and varicose veins.

Like varicose veins, spider veins are small, feather-like veins visible through the skin, often resembling tree branches with short, jagged lines. Another vein issue linked to SVI is reticular veins. Located deeper in the skin, these veins can cause discomfort and may eventually develop into larger varicose veins.

To track the progression of venous disease, doctors often use the CEAP Classification, a widely accepted system for diagnosing and assessing the severity of varicose veins over time. CEAP helps illustrate how the condition can worsen and highlights why it’s important to seek care early if you suspect SVI. Ask your doctor to show you a CEAP Classification chart for reference.

Family history: A history of venous disease can increase your risk.

Previous trauma or injury: Damage to the veins can make it harder for blood to flow properly.

Gender: Women are about twice as likely as men to develop SVI.

Medications: Birth control or infertility drugs can raise estrogen and progesterone levels, which are linked to higher risks of spider veins.

Pregnancy: Increased pressure on the pelvic veins can lead to spider and varicose veins.

Other medical conditions: Obesity or being overweight can contribute to vein problems.

Prolonged standing: Standing for long periods can increase pressure on the veins and reduce circulation, raising the likelihood of venous disease.

Superficial venous problems may be visible on the legs, but it’s important to have a doctor confirm the diagnosis. This is because SVI can sometimes signal more serious issues in the deep veins that require immediate treatment.

To confirm an SVI diagnosis, a doctor may use a combination of a physical exam, review of your medical history, and one or more of the following tools:

• Duplex ultrasound: Examines blood flow in the legs.
• Venography: A type of X-ray that provides a detailed view of the veins.

If your doctor diagnoses SVI, they may recommend lifestyle changes, such as adopting a healthy diet and increasing exercise, to help reduce pressure on the legs. Other possible treatments include:

Sclerotherapy: Medications are injected to block blood flow in the diseased vein.

• Ablation therapy: Lasers are used to close off large varicose veins.
• Phlebectomy: A surgical procedure to remove large veins.

Still unsure about SVI diagnosis or treatment? Your doctor can provide more information and recommend options based on how the disease is progressing.