Venous Insufficiency: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Venous Insufficiency?
A vascular surgeon, a doctor who treats vein and blood vessel problems, often treats venous insufficiency. A dermatologist, a skin doctor, or an interventional radiologist, a doctor who does imaging-guided procedures, may also help. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is venous insufficiency?
Venous insufficiency is a condition in which the veins have problems sending blood from the legs back to the heart. Chronic venous insufficiency is a long-term condition. Normally, valves in your deeper leg veins keep blood moving forward toward the heart. In chronic venous insufficiency, vein walls are weakened and valves are damaged, so the veins stay filled with blood, especially when you are standing.
Symptoms
Pain and other symptoms include:
- Dull aching, heaviness, or cramping in the legs.
- Itching and tingling.
- Pain that gets worse when standing and gets better when the legs are raised.
Skin changes in the legs include:
- Swelling of the legs.
- Red or swollen, crusted, or weepy skin, called stasis dermatitis.
- Varicose veins on the surface, which are swollen, twisted veins under the skin.
- Thickening and hardening of the skin on the legs and ankles, called lipodermatosclerosis.
- A wound or ulcer that is slow to heal on the legs or ankles.
Causes and who gets it
Chronic venous insufficiency is most commonly due to valves in the veins that do not work properly. It may also happen after a past blood clot in the legs. Things that raise your risk include:
- Age.
- A family history of the condition.
- Being female, which is related to levels of the hormone progesterone.
- A past deep vein thrombosis, a blood clot, in the legs.
- Obesity.
- Pregnancy.
- Sitting or standing for long periods.
- Tall height.
How doctors diagnose it
Your provider will do a physical exam and ask about your symptoms and medical history. Doctors often make the diagnosis from how your leg veins look when you stand or sit with your legs dangling. A duplex ultrasound of your leg may be ordered. It checks how blood flows in the veins and looks for other problems, such as a blood clot.
Treatment
Your provider may suggest self-care steps. Do not sit or stand for long periods. Care for any open sores. Lose weight if you are overweight. Compression stockings gently squeeze your legs to move blood up your legs. This helps prevent leg swelling and, to a lesser extent, blood clots.
Your provider may recommend more invasive treatments if you have leg pain, skin sores that do not heal or keep coming back, or thickening and hardening of the skin. Options include sclerotherapy, which injects salt water, a chemical solution, or foam into the vein so it hardens and disappears. Procedures that can be done in a provider's office or clinic include using a laser, radiofrequency ablation, or glue or foam to seal the vein.
Chronic venous insufficiency tends to get worse over time, but it can be managed if treatment is started in the early stages. It is likely that you will need medical procedures to treat the condition.
A venous leg ulcer is usually treated by cleaning and dressing the wound and using compression bandages or stockings. Most heal within 6 months with care from a professional trained in compression therapy. An ulcer can come back unless the cause is treated.
When to see a doctor
Call 911 if you see any bleeding from varicose veins. This is a medical emergency. Call 911 or go to the emergency room if you have chest pain, trouble breathing, or fainting.
Contact your provider if your varicose veins are painful, or if your condition gets worse or does not improve with self-care. Also call if you have a sudden increase in leg pain or swelling, fever, redness of the leg, or leg sores. See your doctor if you think you have a leg ulcer, because it needs specialist treatment to heal.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. A direct primary care doctor can examine your legs, review your risk factors, and refer you to a vein specialist when needed.
Common questions
What causes venous insufficiency?
Chronic venous insufficiency is most commonly due to valves in the leg veins that do not work properly. It may also happen after a past blood clot in the legs.
How is venous insufficiency related to varicose veins?
Varicose veins on the surface of the leg can be one sign of venous insufficiency. Varicose veins are swollen, twisted veins under the skin. They form when valves do not work properly and blood backs up in the vein.
Does venous insufficiency get worse over time?
Yes, chronic venous insufficiency tends to get worse over time. However, it can be managed if treatment is started in the early stages.
Can venous insufficiency cause leg sores?
Yes. It can cause a wound or ulcer that is slow to heal on the legs or ankles. Persistently high pressure in the veins of the legs can weaken the skin so that a minor injury leads to a venous leg ulcer.
Sources
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
