CEAP: How Phlebologists Classify the Severity of Venous Disease

by | Apr 17, 2018

Not all varicose veins are created equal.

The symptoms of varicose veins and vein disease appear across a spectrum; from the most superficial spider veins to severe chronic leg ulcers/open sores. Up to 30% of both men and women are affected by venous disease at various levels of intensity during their lifetime. Clues to your predisposition to vein disease correlate to a strong family history, aging, standing occupations, obesity, lack of mobility, previous venous thrombosis, and leg injury. Women are more likely to experience a vein condition earlier in life than men.

In the past it has been tricky for phlebologists and health professionals to define vein disorders because of the range and severity of symptoms. By creating a venous disease classification system discussion of conditions and treatments is standardised across the world.

CEAP stands for:

Clinical – What does the patient’s vein look like?
Etiology – Is the problem inherited or some other cause?
Anatomy – Which veins are involved?
Pathophysiology – Which direction is the blood is flowing (normal or abnormal), and is blood flow blocked?

CEAP Classifications

CEAP 0 – No visible or palpable signs of venous disease
CEAP 1 – Superficial spider veins, telangiectases, or reticular veins
CEAP 2 – Varicose veins only
CEAP 3 – Ankle oedema (swelling) of venous origin, not foot oedema
CEAP 4a – Dermatitis/eczema and/or hyperpigmentation
CEAP 4b – Lipodermatosclerosis and or atrophie blanche
CEAP 4c – Corona phlebectatica paraplantaris (CPP)
CEAP 5 – Healed venous ulcer
CEAP 6 – Active venous ulcer (open sore)

Venous disease is progressive. Not all people with CEAP 2 will progress to the later stages but many do. Here are some examples of each classification.

CEAP 1 Superficial spider veins, telangiectases, or reticular veins.

CEAP 2 Varicose veins only.

CEAP 3 Ankle oedema (swelling) of venous origin, not foot oedema
CEAP 4a Dermatitis/eczema
CEAP 4a Hyperpigmentation
CEAP 4b Lipodermatosclerosis
CEAP 4b Atrophie blanche

CEAP 4c Moderate – Corona phlebectatica paraplantaris (CPP)

CEAP 4c Severe – Corona phlebectatica paraplantaris (CPP)

CEAP 5 Healed venous ulcer
CEAP 6 Active venous ulcer (open sore)

How can a Phlebologist help?

A phlebologist is a medically qualified doctor with post-graduate training for expert diagnosis and treatment of many forms of venous disease. At the first consultation, your phlebologist will assess the patient’s medical history and perform a thorough physical examination with close attention to the areas of concern. Then a comprehensive duplex ultrasound will be performed to outline all the abnormal veins in the affected leg(s). The phlebologist will discuss the findings of each assessment with the patient and discuss which treatment suits your condition.

Key Takeaways

Worried about your veins?

Make an appointment to see phlebologist Dr Peter Paraskevas in our Vein Health Melbourne or Sydney clinics, and get your veins assessed and treated today.

We provide fast and easy, walk-in walk-out treatments. Our minimally invasive treatments utilise world-class technologies to achieve the best patient outcomes. Our results speak for themselves – see our before & after gallery.


Why choose us?

  • Walk-in, walk-out treatment in our accredited facility
  • High success rates
  • No general anaesthetic
  • No hospitalisation
  • Medicare rebates apply
  • Minimal downtime or time away from work
  • Comprehensive after-care and follow-up scans and reviews
Seek Expert Advice from one of Australia’s Leading PhlebologistsDr. Peter Paraskevas Phlebologist, Medical Director

Dr Peter Paraskevas is expert in the assessment and treatment of Varicose Veins. For 20 years Vein Health Medical Clinic has provided the latest in non-surgical laser, radiofrequency and sclerotherapy treatments and combined this with state-of-the-art ultrasound diagnostic testing to treat varicose veins and venous disease.

The content provided in this article is provided for information and educational purposes only and is not a substitute for professional medical advice and consultation.

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