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Chronic Venous Insufficiency: What It Is, Why It Happens, and How It’s Treated
Medically verified
Last updated on 1/29/2026
By Dr. Michael Nguyen
Vein Doctor at Vein Treatment Clinic
Harvard Medical School
Board Certified by the American Board of Venous and Lymphatic Medicine
Many patients live with symptoms of venous insufficiency for years without realizing there is an underlying circulation problem. Swelling, heaviness, skin discoloration, or recurrent vein issues are often mistaken for normal aging or lifestyle-related changes.
If you’re experiencing ongoing leg symptoms or skin changes, a vein evaluation can help determine whether chronic venous insufficiency is the underlying cause.
What is chronic venous insufficiency?
Chronic venous insufficiency occurs when the valves inside the leg veins fail to close properly, allowing blood to flow backward and pool in the lower legs.
This ongoing pressure damages the veins over time and leads to progressive symptoms affecting circulation and skin health.
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Healthy vs. damaged vein valves.
Healthy vs. damaged vein valves
What causes chronic venous insufficiency?
The most common cause is long-standing valve failure in the leg veins, often related to genetics, aging, pregnancy, or prior blood clots.
Prolonged standing, obesity, and untreated varicose veins can worsen venous pressure and contribute to progression.
What symptoms are associated with chronic venous insufficiency?
Common symptoms include leg swelling, heaviness, aching, fatigue, and a feeling of tightness in the lower legs.
As the condition progresses, skin changes such as darkening, thickening, itching, or open sores may develop near the ankles.
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How is chronic venous insufficiency related to varicose veins?
Varicose veins are often an early visible sign of chronic venous insufficiency, reflecting underlying valve failure and increased vein pressure.
Not all patients with venous insufficiency have large varicose veins, but many share the same underlying circulation problem.
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How is chronic venous insufficiency diagnosed?
Diagnosis typically involves a physical exam and a non-invasive ultrasound to evaluate blood flow and valve function in the leg veins.
Ultrasound helps identify reflux, vein damage, and the extent of disease, guiding treatment decisions.
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Is chronic venous insufficiency dangerous?
Venous insufficiency is not immediately life-threatening, but it is a progressive condition that can lead to complications if left untreated.
Advanced cases may result in significant skin damage, chronic inflammation, and venous ulcers that are difficult to heal.
Before
After
A 37-year-old patient visited our Vein Treatment Clinic, seeking relief from unsightly and painful varicose and spider veins. We performed radiofrequency ablation and sclerotherapy treatments, significantly improving the veins’ appearance and completely eliminating discomfort. The patient is now enjoying a more active and pain-free lifestyle.
Before
After
A 69 year-old patient visited our California Vein Clinic, embarrassed by spider veins that had impacted their self-esteem. We performed radiofrequency ablation and sclerotherapy treatments, leaving their legs smooth and healthy. The patient now feels more confident, thanks to this transformative treatment.
Before
After
This 84 year-old patient at our New Jersey Vein Treatment Clinic came in with spider veins that had affected their daily routine. We used radiofrequency ablation and sclerotherapy treatments to relieve discomfort and restore both their leg health and confidence. The patient now enjoys a more active and fulfilling lifestyle, free from pain.
Before
After
At our Long Island Vein Clinic, we treated this 75 year-old patient with spider veins using radiofrequency ablation and sclerotherapy. These minimally invasive treatments improved both the patient’s appearance and overall well-being, offering transformative results.
Before
After
This 75 year-old patient visited our Long Island Vein Treatment Clinic with painful spider veins. We used radiofrequency ablation and sclerotherapy, minimally invasive treatments, to eliminate the veins and restore comfort and confidence. The patient experienced life-changing results
What are the treatment options for chronic venous insufficiency?
Treatment focuses on improving blood flow and reducing vein pressure using a combination of lifestyle measures and minimally invasive procedures.
Modern treatments target the underlying vein dysfunction rather than just surface symptoms.
Can chronic venous insufficiency get worse over time?
Yes. Without treatment, venous insufficiency often progresses, leading to worsening symptoms and skin changes.
Early evaluation and treatment can slow progression and improve quality of life.
When should you see a vein specialist?
Evaluation is recommended for persistent leg swelling, skin discoloration, aching, heaviness, or recurrent vein problems.
A vein specialist can determine whether symptoms are related to venous insufficiency and whether treatment is appropriate.