Reticular veins are veins beneath the skin that have become swollen. They are also known as feeder veins or blue veins, although they can look either blue or red. They can look like spiderwebs, a wrapping cord or a cooked piece of spaghetti. They can show up on the legs or the face.
Reticular veins are larger than spider veins (telangiectasias) and smaller than varicose veins. Reticular veins also run deeper in the leg than spider veins, which are close to the surface of the skin. Unlike spider veins, reticular veins are more likely to bulge and cause discomfort, especially when you have been standing for a long time.
Causes and Symptoms of Reticular Veins
The most common symptom of reticular veins is their blue or red spiderweb-like appearance, which many people find cosmetically distressing.
Reticular veins can also bulge and cause discomfort. This often occurs when you have been standing for long periods. You may notice that the discomfort goes away if you elevate your legs for 10 to 30 minutes.
Like varicose and spider veins, reticular veins are caused by blood pooling in the veins rather than flowing toward the heart. This happens because the valves or walls of the veins are not working properly.
Normally, the valves in veins close to keep blood from flowing backwards—in the legs, backwards means toward the feet. When the valves don’t work right, blood collects in the veins in the legs.
Gravity tends to push blood in the veins toward your feet. So you may notice that reticular, spider or varicose veins in your legs become more swollen after you have been standing for long periods.
Reticular and spider veins are the most common types of vein problems. They often occur by themselves, but can also be a sign of a more serious vein condition, such as venous reflux in a larger, deeper vein in the leg. Reticular and spider veins occur more often in women than in men.
Treatments for Reticular Veins
After an initial evaluation, a vein specialist can provide you with the best options for treating your reticular veins, and let you know if you may have a more serious vein condition. With early diagnosis and treatment, your legs can look better in as little as a few months.
Sclerotherapy for Reticular Veins
Reticular veins can be treated with sclerotherapy, a procedure that involves injecting a special medication into the problem vein. This medication scars the inner walls of the vein and causes it to seal shut.
When this happens, blood will flow naturally to other healthier veins. The treated reticular vein will disappear within a few months.
Surface Laser/Light Therapy for Reticular Veins
For most people, sclerotherapy is the first treatment for reticular veins. However, surface laser or light therapy may be an option if sclerotherapy doesn’t work for you, if you are needle-shy, or if your veins are too small for the sclerotherapy needle.
Surface laser or light therapy uses focused light to heat up and close the reticular vein. Again, blood flow is naturally rerouted to healthier veins. It will take several months for the veins to disappear completely.
Spider veins are often treated alongside reticular veins. It takes several sessions before all the spider and reticular veins are treated, with a few months in between each session.
If you have other more serious vein problems—like venous reflux in larger veins of the leg—your doctor may choose to treat those first before taking care of your reticular veins. Sometimes treating the more severe problems can reduce the pooling of blood in the smaller veins.
Sclerotherapy and laser treatment will not keep you from developing new spider or reticular veins, or more serious vein problems. Because reticular veins are considered cosmetic problems, your insurance may not cover the procedure unless the vein has ruptured (hemorrhaged).
Updated Aug. 14, 2017