The Important Differences Between Spider Veins and Varicose Veins

Updated on: November 28, 2018

Spider veins and varicose veins are very different in appearance but are similar in their basic characteristics. An estimated 30-60 percent of the adult population develops varicosities during their lifetime. More women than men develop spider veins or varicose veins. Advancing age influences both sexes to develop problem veins.

There are many reasons why a person develops spider veins or varicose veins, but some factors include being female, genetics, careers involving long hours of standing, obesity, hormone fluctuations during puberty, pregnancy or menopause and taking birth control pills.

Causes of problem veins

Weak or non-functioning valves within a blood vessel cause varicose veins. Veins circulate blood back to the heart but when a valve does not function properly, it causes blood to leak backwards and pool in the vein. This is called venous insufficiency and causes vein enlargement.

Spider veins can develop for the same reason, but are further influenced by sun exposure, obesity, birth control pills and hormonal changes during puberty, pregnancy and menopause.


The symptoms are similar for both vascular conditions but symptoms of varicose veins are usually more severe than symptoms of spider veins.

Spider veins are often asymptomatic or cause minor burning or itching at the site. Varicose vein symptoms include leg aching or cramping, a feeling of heaviness in the legs, burning and throbbing or tingling in the legs. Skin ulcers, especially in the ankle area, are not uncommon with varicose veins due to severe vascular disease.

Spider vein basics

The basic physical characteristics of spider veins include:

  • Red, purple and blue veins
  • Tiny, web-like configuration (smaller than varicose veins)
  • Easily visible
  • Located close to the skin’s surface
  • Most frequently seen on legs and face

Varicose vein basics

The basic physical characteristics of varicose veins include:

  • Large, raised swollen veins
  • Gnarled, twisted veins
  • Often skin colored; can also present as purple and blue veins
  • Highly visible
  • Most often seen on the legs, especially the thighs, inside of leg and leg calves

Varicose veins sometimes develop into ulcers or deep sores. They can also evolve into an area of increased pigmentation, especially around the ankle.

Treatment protocols

Elevating the legs and wearing gradient compression or support stockings helps to relieve painful symptoms, especially in larger varicose veins.

Treatment options range from sclerotherapy and laser treatments to endovenous ablation and a surgical procedure called ligation and stripping of the affected veins.

Spider veins most often respond favorably to sclerotherapy in which a specialized chemical or saline solution is injected into the vein, causing it to collapse. The collapsed veins evolve into scar tissue, which causes the veins to fade. Laser treatment works in a similar way and is effective in treating spider veins.

Varicose veins, due to their larger size, need more advanced treatment. Endovenous or radiofrequency ablation is a procedure during which radio frequency waves or lasers are passed through a catheter positioned in the varicose vein. This causes the vein to collapse and form scar tissue. The scarring stops the blood from pooling and shrinks the enlarged vein. Ligation and stripping is a surgical procedure in which the surgeon ties off or completely removes the affected veins from the legs. It is less commonly done as it has been replaced by the more updated laser and radiofrequency ablation methods.

The best advice

A physical evaluation by a qualified healthcare provider, often with the aid of ultrasound, will provide you with reliable information and treatment options. This will be invaluable in making an informed decision as to how to proceed with treating spider or varicose veins for the safest and best results.

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