CEAP Classification for Chronic Venous Disorders (2020 Updated Version)

Classification	Severity and Signs
Clinical Classification (C)
C0	No visible or palpable signs of venous disease
C1	Telangiectasia or reticular veins
C2	Varicose veins
C2r	Recurrent varicose veins
C3	Edema
C4	Skin and subcutaneous tissue changes secondary to chronic venous disease (CVD), now subdivided into three subclasses to better distinguish disease severity.
C4a	Pigmentation or eczema
C4b	Lipodermatosclerosis or atrophie blanche
C4c	Corona phlebectatica
C5	Healed venous ulcer
C6	Active venous ulcer
C6r	Recurrent active venous ulcer
Each clinical class is supplemented with a subscript indicating the presence (symptomatic, s) or absence (asymptomatic, a) of symptoms attributable to venous disease. Symptoms include dull pain, aching, throbbing, skin discomfort, heaviness, muscle cramps, and other discomfort related to CVD.
Etiologic Classification (E)
Ep	Primary
Es	Secondary
Esi	Secondary – Intravenous
Ese	Secondary – Extravascular
Ec	Congenital
En	No identifiable venous etiology
Anatomic Classification (A)
As	Superficial veins
Ap	Perforating veins
Ad	Deep veins
An	No identifiable venous location
Pathophysiologic Classification (P)
Pr	Reflux
Po	Obstruction
Pr,o	Reflux and obstruction
Pn	No identifiable venous pathophysiologic abnormality
Reference	Lurie F, et al. The 2020 update of the CEAP classification system and reporting standards. J Vasc Surg Venous Lymphat Disord. 2020 May;8(3):342-352.

CEAP Classification for Chronic Venous Disease (2020 Update)