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The Different Stages Of Varicose Veins

Stages of varicose vein

Understanding The Stages Of Varicose Vein

The Varicose vein is a severe growing across the world. The problem is usually seen in the lower limb and can affect daily life. Due to the surface of the vessels becoming thin, the walls cannot withstand the pressure of blood flow and become swollen. The primary stages of varicose veins might not be a concern. But as their severity increases, abnormalities start appearing.

Therefore, it is important to treat varicose veins by understanding the right stage. We will have a keen view of the different stages of varicose veins and how they will affect your lifestyle.

7 Different Stages Of Varicose Veins

Stage 1: Weakening Of Valves

The beginning stages of varicose veins does not appear physically or have symptoms. Therefore, it is difficult to detect the initial stage. In the first stage of varicose veins, the valves of the vessels become clogged, and blood flow starts to be impeded.

There is no primary swelling, but it can include indirect symptoms like itching, burning, or mild leg pain. With time, one can feel fatigue in the leg and pulsation in different parts of the lower limb. It is one of the prominent signs that you are suffering from the first stage of varicose veins.

Weakening of valves

Stage 2: Spider-Like Veins

The second is also known as the morphological phase, when the physical signs of varicose veins start to appear. Due to high blood pressure and low oxygen supply, the blood vessels appear bluish-purple with mild pain in the legs.

In the latter half of the second stage, one can see crawly or spider-like veins popping out of the skin. However, no potential swelling or pain is claimed at this stage. However, general symptoms like burning, itching, and fatigue are seen in some of the patients.

Stages of varicose vein - Spider vein

Stage 3: Swollen Veins(Varicosities)

It appears at the end of the fourth week. Primary swelling appears in the third stage. The initial swelling stage is painless and has no critical impacts. But with time, the swelling might cause pain, skin discolouration, burning, and itching around the veins.

If not treated in this stage, it can have severe effects, leading to loss of sensation and terrible pain. Moreover, according to specialized varicose doctors, the third stage is very sensitive and can show potential effects in contact with fabrics, oils, and skin creams. Therefore, it is better to consult a doctor and get treatment when symptoms appear.

Stages of varicose vein - Swollen Veins

Stage 4: Edema

If not treated during the third stage, the severity of varicosities will increase, and more disturbing signs will appear. In the final period of the third stage, or during the initial phase of the fourth stage, enlarged veins and edemas in lower limbs become prominent.

The impeded flow in vessels leads to edemas, bubble-like wraps filled with lymph-like fluid. Furthermore, due to the obstruction of the general path, fluid accumulates in lower parts like the ankle. Hence, most of the patients experience ankle swelling in this stage.

Stages of varicose vein - Edema

Stage 5: Ankle Changes

In the final phases of the fourth stage, we saw swelling near the ankle. These changes become prominent in the fifth stage. Patients’ ankles will be filled with spider veins, and significant swelling can be seen in the ankles. Edemas can appear due to prolonged standing, which is painful and can cause leg fatigue.

The emerging blue veins around the ankles symbolize the severity of the fifth stage and can cause problematic situations like venous eczema if not treated immediately. A group of ulcers can grow around the spider veins in the ankle, producing a severe itching and burning feeling.

Stages of varicose vein - Ankle Change

Stage 6: Skin Changes

Skin changes are unexpected in many cases, however, in some recent cases, it is reported as one of the common symptoms of the sixth stage. In this phase, the skin or affected areas of the lower limbs undergo discoloration initially and can turn yellow in the latter half. According to varicose doctors, these changes are due to abnormal flow of blood in the vessels and high affinity of carbon dioxide in the veins.

The density of coloration indicates the severity of swelling. Skin changes prominently help the varicose vein doctor detect operative areas and areas having maximum swelling.

Stages of varicose vein - Skin change

Stage 7: Ulcers

Appearance of ulcers is counted as the last stage of varicose veins. It is the most advanced stage, which causes painful swellings in different areas of veins. Patients in this stage suffer from predominant symptoms like lymphatic ulcers, grooved veins, painful cramps, and slow healing. Operation is the last way to treat such a condition.

Stages of varicose vein - Ulcers

Summarizing The Stages Of Varicose Veins

Varicose veins development typically takes place in different stages. The below table shows the first stage of varicose veins to last stage of varicose veins in detail.

Stage 1This stage has no symptoms.
Stage 2Spider veins or telangiectasia are the potential symptoms of the second stage. However, bulging veins are not visible.
Stage 3Minor swelling of the veins can be seen at this stage. Skin discoloration also begins in the latter half of the 3rd stage.
Stage 4This stage includes some severe skin changes such as lipodermatosclerosis.
Stage 5Discomfort in walking and fatigue. Ulcers become even more painful in this stage.
Stage 6Discomfort in walking and fatigue. Ulcers become even more painful in this stage.
Stage 7Advanced ulcers with significant skin changes and severe discomfort.

Treatment For All Stages Of Varicose Veins

Understanding the varicose veins stages and plan for an early treatment is necessary to ensure safety. Experienced doctors must treat varicose veins as they can help you with the right advice, accurate treatment, and timely healing.

At Advanced Medical Group, we provide expert treatment of varicose veins with latest proven techniques and ensure you recover on time.

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Fatima Shaik MD


Fatima Shaik is a board certified internist and cardiologist. She specializes in general cardiology and heart rhythm disorders. She cares for patients at Advanced Medical Group in Jersey City and North Bergen. She also performs procedures at Jersey City Medical Center.

She completed her undergraduate education at NYU and received her MD degree for SUNY Downstate Medical Center. She completed her residency training at Mount Sinai Beth Israel Medical Center and her cardiology fellowship at New York Presbyterian Queens. She went on for advanced training in electrophysiology at Cooper Hospital in Camden, NJ.
She is trained in device implantation, SVT and atrial fibrillation ablations as well as watchman implantations.
She is fluent in English and Hindi.
She is currently accepting new patients.

Reema Parikh, DPT

Physical Therapist

Reema Parikh received two bachelor’s degrees from Long Island University and Touro College, and graduated as a Doctor of Physical Therapy from Touro College in 2013. In her early years as a DPT, she received an award for excellence in research and taught a course for the national physical therapy licensing board exam. Dr. Parikh has a passion for helping patients on their health journey; she is experienced in all ages and care of patients, ranging from pediatric care to geriatric care. She has hosted live and virtual workouts for varying levels of physical activity, incorporating mobility and strength segments. Dr. Parikh has furthered her education by receiving certifications in many aspects of physical therapy and holistic care including Nutritional PT, Restorative Yoga, Pilates, and Reiki.

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Aishwarya Parab, PT

Physical Therapist

Aishwarya Parab received her Bachelors in Physiotherapy in India in 2015 and furthered her studies at Long Island University where she graduated with her Masters in Exercise Science, Sports, and Nutrition in 2019. She has experience working with various conditions, including herniated disks, spondylolysis, and post-operative mobility issues. Aishwarya has taken courses to expand her knowledge in the physical therapy world, including spinal mobility courses, neuromuscular reeducation courses, and getting a certificate with Revolution in Motion. Aishwarya finds it exceedingly rewarding to build a long-term relationship with her patients and shows commitment towards providing structured and effective healthcare.

Dr. Prajakta Avhad

Prajakta Avhad, MD

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About Dr. Avhad
Dr. Prajakta Avhad is double board-certified in Pain Management and Anesthesiology. Dr. Avhad received her M.B.B.S. from MIMER, India, and completed her Surgical internship and Anesthesia residency at Brookdale University Hospital in Brooklyn, New York during which she interned at Memorial Sloan Kettering, St. Luke’s Roosevelt, and Staten Island Hospital.

She then completed her Pain Management Fellowship from Cleveland Clinic Foundation.

Dr. Avhad is a diplomate of the American Board of Anesthesiology and a member of the American Academy of Pain Medicine.

Dr. Avhad has been in practice in Central and South Jersey for more than 12years. She is a caring physician with expertise and experience in treating a spectrum of Pain conditions like chronic back and neck pain, herniated discs/sciatica with minimally invasive interventional procedures.

Dr. Avhad and her family reside in New Jersey. She is an avid gardener active with her kids, dog, and garden if not tending to her broad and exotic orchid collection.

Radhika Patel PA-C

Radhika Patel, PA-C

Physician Assistant located in Jersey City, NJ

About Patel
Graduating summa cum laude from Rutgers University with a BA in Biological Sciences and minor in Spanish, Radhika Patel obtained experiences in outpatient medicine as well as in emergency medical services prior to pursuing a career as a physician assistant. She graduated from the Rutgers University Physician Assistant program with a Master of Science after training in cardiology, internal medicine, and urgent care, among many other fields at various hospitals and private practices throughout the state of New Jersey. She is a proud member of the team at Advanced Garden State Cardiology and looks forward to meeting with patients each day in our Jersey City office.

Enrique D Chappilliquen Lucio, PA-C

Enrique Chappilliquen, PA-C

Physician Assistant located in Union City, NJ & Jersey City, NJ

About Dr. Chappilliquen
Graduated from Mercy College Physician Assistant Program with a Masters of Science in Physician Assistant Studies, Enrique has extensive experience in the medical field for more than 6 years.

He has clinical experience and training in internal medicine, cardiology, general and vascular surgery, hematology, oncology, and emergency medicine. He joined Dr. Richard’s practice in October of 2016. Since then, he has been a dedicated medical provider working in the Union City office and the Hematology/Oncology office in Jersey City as well.

As a Hispanic, he proudly serves his community with passion and devotion. Being able to communicate fluently with his patients allows him the opportunity to provide excellent medical care to the Hispanic community in Union City and Jersey City. Also, sharing the same language, culture, and values as his patients allows him to connect at a personal level with his patients. Enrique continues to develop his knowledge and skills constantly to continue satisfying the needs of his patients.

Dr Christopher Samaniego, DPM

Christopher Samaniego, DPM

Podiatrist located in Jersey City, NJ, Union City, NJ, and West New York, NJ

Christopher Samaniego, DPM, is originally from Freehold, New Jersey. He attended college at Messiah College, where he graduated Magna Cum Laude with a degree in Biology. He earned his podiatric medical degree from Temple University School of Podiatric Medicine in Philadelphia, PA and completed his surgical residency training at Detroit Medical Center in Detroit, MI. 

Dr. Samaniego provides comprehensive foot and ankle care at Advanced Medical Group in Jersey City, Union City, and West New York. His specialized surgical training includes

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  • Diabetic foot care
  • Fungal nail care
  • Plantar fasciitis, tendinitis, orthotics
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  • Arthroscopy, joint replacement, minimally invasive techniques

Samaniego is a member of the American College of Foot and Ankle Surgeons and the American Podiatric Medical Association. He keeps up to date on the latest surgical techniques and available technology in foot and ankle care.

Prior to joining Advanced Medical Group, Samaniego studied public healthcare in Zambia and assisted in providing care to the local community. He has also presented research at the annual meeting of the American College of Foot and Ankle Surgeons. Samaniego achieved the highest rank of Eagle Scout through the Boy Scouts of America and volunteered with Troop 454 for scouts with special needs and the Freehold Public Library. In his free time, Samaniego volunteers with his local church community service and youth programs.

Samaniego resides in Jersey City, NJ and maintains his health by cycling and interval training several times a week. He explains, “Healthy doctors inspire healthy patients. I follow the same advice I give my patients, and I read constantly to become a better physician every day. I encourage my patients to ask questions and learn about the cause of their symptoms. An ounce of prevention is worth a pound of cure.”

Dr. Merwin Richard, MD. A cardiologist

Merwin Richard, MD

Cardiologist located in Jersey City, NJ & Union City, NJ

As an established board-certified internist and cardiologist, Merwin Richard, MD, has a reputation for helping patients with the most complex of health conditions. He cares for patients at Advanced Medical Group in West New York, Jersey City, and Union City, New Jersey.

Richard began his undergraduate education in medicine at Stanley Medical College in India. He earned his doctor of medicine degree from Tamil Nadu Dr. M.G.R. Medical University before relocating to New York City.

After completing both his internship and internal medicine residency through the Albert Einstein College of Medicine, Dr. Richard went through advanced fellowship training. He completed a cardiovascular fellowship at Columbia University College of Physicians and Surgeons, then went on to finish a second fellowship in interventional cardiology through Mount Sinai School of Medicine (now Icahn).


Throughout his career, Richard has stayed involved in numerous research projects and previously served as a professor at the University of Medicine and Dentistry of New Jersey (now Rutgers University). Richard went on to become the director of the first cardiac catheterization and interventional laboratory in Jersey City and has extensive training in vein treatments.

To ensure he continues staying up to date with the latest research and techniques, Richard maintains his board memberships. He’s board certified through the American Board of Internal Medicine in cardiovascular disease and interventional cardiology.

Being fluent in English,  Spanish, and Tamil gives Richard the opportunity to communicate with patients from diverse cultural backgrounds. Richard is currently accepting new patients.