You’ve noticed new veins on your legs and want to know what they are. The quickest way to sort out spider veins vs varicose veins is to look…
Dr. Michelle Hardaway, M.D., F.A.C.S.
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You’ve noticed new veins on your legs and want to know what they are. The quickest way to sort out spider veins vs varicose veins is to look at size and at whether the vein bulges. Spider veins are small, usually red, and lie flat, while varicose veins are larger and twisted, and the larger ones may make the skin bulge out.
Spider veins, also called thread veins, are small veins you can see under the skin. According to the Office on Women’s Health, they’re usually red, may look like tree branches or spider webs, and are usually found on the legs or the face. They don’t make the skin bulge out the way varicose veins do, and they may affect more than half of women.
Joint 2023 vascular surgery guidelines use the medical name, telangiectasias, and describe them as spider veins under 1 millimeter in size.
MedlinePlus defines varicose veins as swollen, twisted veins that you can see just under the skin. The Office on Women’s Health adds that they can be blue, red, or skin-colored, and that the larger veins may appear ropelike and make the skin bulge out.
In the vascular surgery guidelines, a varicose vein measures 3 millimeters or more across.
When the one-way valves in your veins are weak or damaged, blood can back up and pool in your veins, which makes them swell, MedlinePlus explains. According to the Office on Women’s Health, your risk of varicose veins and spider veins may be higher if you:
| Spider veins | Varicose veins | |
|---|---|---|
| Size | Under 1 millimeter | 3 millimeters or more |
| Look | Usually red; may look like tree branches or spider webs | Blue, red, or skin-colored; the larger veins may appear ropelike |
| Surface | Can usually be seen under the skin without a bulge | The larger veins may make the skin bulge out |
| Where | Usually the legs or the face | Under the skin on the legs |
| Symptoms | Some people have none; others have tired, heavy, or achy legs | May include aching, heaviness, throbbing, cramping, swelling, and itching |
| Health problems | Don’t usually cause health problems | Can sometimes lead to sores, bleeding, or blood clots |
| Typical causes | Valve problems in the veins | Weak or damaged vein valves |
If comparing varicose vs spider veins on your own legs is hard to call, a provider can examine your legs and may check blood flow in the veins, according to MedlinePlus.
Federal health guidance and the vascular surgery guidelines don’t say whether spider veins turn into varicose veins, or how often.
The vascular surgery guidelines place spider veins in Class C1 of the system doctors use to classify vein disorders. They also state that:
If you’re trying to figure out first stage varicose veins vs spider veins, the guidelines sort veins by size: under 1 millimeter for a spider vein, 1 to just under 3 millimeters for a reticular vein, and 3 millimeters or more for a varicose vein. An exam is how you’ll find out which kind you have.
Federal health guidance and the vascular surgery guidelines don’t say whether untreated spider veins fade on their own.
The Office on Women’s Health does address pregnancy, but for varicose veins: for some women they shrink or disappear after childbirth, and for others they stay.
You may not be able to prevent them, especially if they run in your family. Steps that may help include:
According to the Office on Women’s Health, spider veins are often painless and don’t usually cause health problems. If you do get symptoms, your legs may feel extremely tired, heavy, or achy, often worse after sitting or standing for a long time and better after resting with your legs up.
Talk to your doctor if the veins cause you pain, or if:
Deep vein thrombosis, or DVT, is a blood clot that forms in a vein deep in the body. MedlinePlus lists a sudden increase in pain or swelling, fever, or redness of the leg as reasons to contact your provider. The CDC says to see your doctor as soon as possible for DVT signs such as swelling, pain or tenderness, warmth, or redness.
A clot can break off and travel to the lungs. Seek emergency medical help immediately if you have difficulty breathing, a faster than normal or irregular heartbeat, chest pain that worsens with a deep breath or coughing, coughing up blood, or lightheadedness or fainting, which the CDC lists as warning signs of a clot in the lungs.
Spider veins can be treated with sclerotherapy or laser therapy. Whether treatment makes sense for you, and which option fits, is something a provider can assess at a consultation.
MedlinePlus publishes a risk list for varicose vein treatment in general, a category it says includes sclerotherapy, which works best for spider veins, and laser treatment. That list includes blood clots, nerve damage, vein irritation, bruising or scarring, failure to close the vein, and the vein returning over time, and MedlinePlus suggests asking your provider about specific problems you might have.
How much difference you’ll see varies from person to person, and new spider veins can still form after treatment. Your consultation ends with a personalized treatment plan or with a referral elsewhere if the veins aren’t spider veins.
If you’re comparing providers, this guide to choosing a plastic surgeon in Farmington Hills covers the credentials worth checking.
Varicose veins are treated by vein specialists, such as vascular surgeons. The Society for Vascular Surgery says it’s important to see a vascular surgeon even when surgery isn’t needed and suggests an appointment if you have:
If spider veins on your legs or face bother you, Aesthetic Plastic Surgery & Laser Center in Farmington Hills treats them with sclerotherapy and laser therapy, described on the spider vein treatment page for Farmington Hills patients. For varicose veins, the practice will point you to a vein specialist.
Dr. Michelle Hardaway is a board-certified plastic surgeon with over 20 years of experience and a Fellow of the American College of Surgeons. She previously served as Chief of Plastic and Reconstructive Surgery and as Director of the Burn Center at DMC Detroit Receiving Hospital.
You can request a consultation in Farmington Hills or call (248) 780-0558. If you’d rather ask a question first, send a message to the Oakland County office. The practice is at 27920 Orchard Lake Rd, Farmington Hills.
All consultations are paid and appointment-based to ensure dedicated time and a personalized plan.
Spider veins and varicose veins differ in size and in how they look. Vascular surgery guidelines describe spider veins as under 1 millimeter, reticular veins as 1 to just under 3 millimeters, and varicose veins as 3 millimeters or more.
Federal health guidance and the vascular surgery guidelines don’t say whether untreated spider veins fade on their own.
Talk to your doctor if a vein becomes swollen, red, very tender, or warm, or if you notice sores, a rash, or skin color changes near your ankle or calf. See a doctor as soon as possible for sudden leg pain or swelling, and seek emergency care immediately for trouble breathing or chest pain.
The Office on Women’s Health says varicose veins and spider veins are often painless and don’t usually cause health problems. Sometimes, though, varicose veins can lead to more serious health problems, including sores, bleeding, or blood clots. Talk to your doctor if any vein becomes swollen, red, very tender, or warm, which can be a sign of a blood clot.
Spider veins can be treated with sclerotherapy or laser therapy. The Office on Women’s Health says you may need more than one treatment, that spider veins may come back, and that new ones can develop over time. For varicose veins, see a vein specialist such as a vascular surgeon.
Federal health guidance and the vascular surgery guidelines don’t say whether spider veins lead to varicose veins. The guidelines sort veins by size, and an exam is how you’ll find out which kind you have.
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