Varicose Veins and Spider Veins

  • Medical Author:
    Gary W. Cole, MD, FAAD

    Gary W. Cole, MD, FAAD

    Dr. Cole is board certified in dermatology. He obtained his BA degree in bacteriology, his MA degree in microbiology, and his MD at the University of California, Los Angeles. He trained in dermatology at the University of Oregon, where he completed his residency.

  • Medical Author:
    Siamak N. Nabili, MD, MPH

    Siamak N. Nabili, MD, MPH

    Dr. Nabili received his undergraduate degree from the University of California, San Diego (UCSD), majoring in chemistry and biochemistry. He then completed his graduate degree at the University of California, Los Angeles (UCLA). His graduate training included a specialized fellowship in public health where his research focused on environmental health and health-care delivery and management.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    Steven Doerr, MD

    Steven Doerr, MD

    Steven Doerr, MD, is a U.S. board-certified Emergency Medicine Physician. Dr. Doerr received his undergraduate degree in Spanish from the University of Colorado at Boulder. He graduated with his Medical Degree from the University Of Colorado Health Sciences Center in Denver, Colorado in 1998 and completed his residency training in Emergency Medicine from Denver Health Medical Center in Denver, Colorado in 2002, where he also served as Chief Resident.

  • Medical Editor: Melissa Conrad Stöppler, MD
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Spider and Varicose Veins Slideshow Pictures

What surgical procedures are available to treat varicose veins?

Varicose veins are frequently treated by surgically eliminating the "bad" veins. This forces the blood to flow through the remaining healthy veins. In vein stripping surgery, the problematic veins are "stripped" out by passing a flexible device through the vein and removing it through an incision near the groin. Smaller tributaries of these veins also are stripped with this device or removed through a series of small incisions. Those veins that connect to the deeper veins are then tied off. This stripping method has been used since the 1950's. This is now usually performed using outpatient surgical procedures and rarely requires general anesthesia.

Spider veins cannot be removed through surgery. Sometimes, they disappear when the larger varicose veins feeding the spider veins are removed. The remaining spider veins also can be treated with sclerotherapy.

Are these procedures painful?

For all of these procedures, the amount of pain an individual feels will vary, depending on the person's general tolerance for pain, how extensive the treatments are, which parts of the body are treated, whether complications arise, and other factors. Because surgery is performed under anesthesia, pain is not felt during the procedure. After the anesthesia wears off, there can be some pain at or near the incision(s).

For sclerotherapy, the degree of pain will also depend on the size of the needle used and which solution is injected. Most people find hypertonic saline to be the most painful solution and experience a burning and cramping sensation for several minutes when it is injected. Some doctors mix a mild local anesthetic with the saline solution to minimize the pain.Continue Reading

Medically Reviewed by a Doctor on 10/15/2014
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Related Slideshow: Spider and Varicose Veins Pictures Slideshow: Causes, Before-and-After Treatment Images

A photo of spider veins on a woman's legs by the pool.

Spider and Varicose Veins

Spider veins and varicose veins are common conditions that affect many adults. These abnormally enlarged vessels, which affect women more often than men, appear most often on the legs and become more prevalent with age. Spider veins and varicose veins affect up to 50% of the adult population. The following slideshow will highlight the important facts about spider veins and varicose veins, with accompanying pictures to better understand what they look like, what they are, and how to treat them.

A photo of spider nevus.

What Are Spider Veins?

Spider veins (also called telangiectasias) are clusters of tiny blood vessels that develop close to the surface of the skin. They are often red, blue, or purple; and they have the appearance of a spiderweb. They are commonly found on the face and legs.

Varicose veins on a woman's legs.

What Are Varicose Veins?

Varicose veins are abnormally enlarged veins that appear most often on the legs. They are typically blue, purple, or skin-colored; and they appear as dilated, twisting and bulging vessels that may be raised above the surface of the skin.

Illustration showing normal vein blood flow and a vein where blood backflows causing varicose veins.

What Causes Spider and Varicose Veins?

Spider veins and varicose veins are caused by structural abnormalities of blood vessels. Veins carry blood back to the heart from other parts of the body. They utilize a series of one-way valves to avoid backflow of blood. For a variety of reasons, these valves can become defective, allowing the backflow of blood within veins. The subsequent pooling of blood and pressure increase within the vein, and weakens the blood vessel wall. Spider veins and varicose veins then develop from the engorgement and dilation of the affected blood vessels.

A photo showing the legs of people standing in line.

Who Gets Spider and Varicose Veins?

Spider veins and varicose veins are very common in adults, though women tend to develop them more frequently than men. There are a variety of different risk factors that increase the chances of a person getting spider veins and varicose veins. Risk factors include advanced age, prolonged sitting/standing, obesity, pregnancy, hormone therapy (HT), birth control pills, injury, prior vein surgery, a history of blood clots, and a family history.

A woman’s leg displaying spider and varicose veins.

Spider/Varicose Vein Symptoms

Spider veins and varicose veins often cause no symptoms or signs other than their undesirable cosmetic appearance. However, certain individuals may experience problematic symptoms from varicose veins. Symptoms may include swelling, throbbing, aching, burning, itching, heaviness, tingling, or cramping of the legs. These symptoms often worsen after prolonged sitting or standing. Individuals can also develop a brown discoloration of the skin and skin ulcers.

An example of a varicose ulcer on an ankle.

Spider and Varicose Vein Complications

Though spider veins and varicose veins rarely cause serious complications, some individuals may develop skin ulcers. These open wounds usually appear on the lower leg, and they may sometimes lead to soft tissue infections. Some individuals with varicose veins can also develop blood clots within the veins (superficial thrombophlebitis). Localized bleeding from varicose veins also can occur.

A doctor examines varicose and spider veins on a woman's legs.

Spider and Varicose Vein Diagnosis

Your health care professional can diagnose spider veins and varicose veins by closely examining the affected areas, which are usually on the legs. The exam will consist of a visual inspection, and palpation of the areas of concern. Special attention will be given to areas of redness, swelling, skin discoloration, and skin ulcers. Though most cases of spider veins and varicose veins do not require treatment, those individuals who develop complications should seek medical care and treatment. The treatment of spider veins and varicose veins also is sought for cosmetic reasons. There are various measures that can be used at home to help alleviate some of the symptoms should they develop. These conservative measures also can help prevent any potential complications.

A woman wearing support hose (stockings) to treat her varicose and spider veins.

Treatment: Support Stockings

Support stockings, also called compression stockings, are an easy intervention to use at home to help alleviate symptoms in the legs. Compression stockings improve circulation by increasing the pressure in the legs. These stockings come in a variety of styles and compression strengths. Your health care professional can recommend the proper pair for you. They are typically sold in drug stores and medical supply facilities.

People exercising on treadmills.

Treatment: Lifestyle Changes

A regular exercise program and weight loss can help relieve the symptoms of spider veins and varicose veins. Affected individuals should avoid standing or sitting for prolonged periods of time, and elevate the legs while sitting or sleeping to improve the circulation and decrease swelling in the legs.

A person undergoing sclerotherapy to eliminate spider and varicose veins.

Treatment: Sclerotherapy

Sometimes the conservative management of spider veins and varicose veins at home may not yield the desired results. In these cases, more specialized medical procedures may be available, depending on the location and size of the abnormal veins. These medical procedures are often undertaken for cosmetic reasons. Sclerotherapy is a common procedure that can be performed in your physician’s office, and it is very effective in eliminating the majority of spider veins and some varicose veins. During this procedure, which requires no anesthesia, your physician will inject a liquid solution directly into the affected vein, which causes the vein to collapse and eventually fade away. Several sessions may be required for optimal results. Potential side effects include bruising, swelling, bleeding, infection, and skin discoloration.

Before and after photos of spider vein sclerotherapy treatment.

Sclerotherapy: Before and After

Treatment with sclerotherapy can require multiple treatment sessions, and healing time may vary from individual to individual. Generally, spider veins will begin to fade within three to six weeks after treatment, while varicose veins may require several months to respond.

Laser therapy treatment for spider and varicose veins.

Treatment: Laser Therapy

Laser therapy is another alternative medical procedure that also can be performed in your physician's office. It is sometimes used as a complement to sclerotherapy in order to maximize results. It is most effective for spider veins and tiny varicose veins. For those individuals who do not like needles, this provides an alternative option, though your physician will counsel you on which treatment modality is best given your particular situation. Laser therapy uses a focused beam of light that heats and damages the affected blood vessel, which eventually fades. Potential side effects include minor redness or swelling around the treated area, skin discoloration, blisters, and rarely scarring. Intense Pulsed Light (IPL) therapy is a recently developed treatment for spider veins. IPL delivers pulses of different bands of light to targeted areas.

Before and after photos of spider vein laser therapy treatment.

Laser Therapy: Before and After

As with sclerotherapy, several sessions are frequently necessary for optimal results with laser therapy. Resolution can take anywhere from several weeks to several months after treatment.

Doctors performing varicose vein surgery.

Treatment: Vein Surgery

Surgery is an option for more severe cases of varicose veins. Your physician will discuss with you the various surgical procedures available in order to help you determine which treatment is optimal for varicose veins. One of the surgical procedures available is vein ligation and stripping, which involves cutting and tying off the affected vein (ligation) and surgically removing (stripping) it through small incisions in the skin.

Before and after photos of varicose veins after vein surgery.

Vein Surgery: Before and After

Vein ligation and stripping is frequently successful at resolving both the symptoms and cosmetic appearance of varicose veins. This procedure is done under local, spinal, or general anesthesia in a hospital or outpatient surgical center. An overnight stay is rarely necessary. Full recovery from this procedure usually takes about two to four weeks. Potential complications may include infection, bleeding, scarring, nerve injury, a deep vein blood clot, or an adverse reaction to anesthesia.

A doctor performing endovenous laser treatment for varicose veins.

Treatment: Endovenous Laser

Endovenous laser treatment is a minimally invasive surgical procedure which involves the emission of laser light through a thin fiber inserted into the affected vein, causing the vein to contract. Endovenous laser treatment has a 98% initial success rate. This procedure is performed as an outpatient procedure under local anesthesia or using light sedation. Patients report less pain and a faster recovery time with endovenous laser treatment when compared to vein ligation and stripping.

Illustration of a radiofrequency ablation to treat varicose veins.

Treatment: Radiofrequency Ablation

Endovenous radiofrequency ablation is a minimally invasive procedure that is similar to endovenous laser treatment. Instead of using a laser light, a catheter is inserted into the vein and using radiofrequency energy, the affected vein is heated and contracts. As with endovenous laser treatment, patients report less pain and quicker recovery times compared to vein ligation and stripping.

A female runner stretching.

Preventing Spider and Varicose Veins

Although spider veins and varicose veins may not always be entirely preventable, there are various measures you can take to reduce your chances of developing them. Prevention tips include:

  • exercising regularly,
  • maintain a healthy weight,
  • avoid prolonged sitting or standing,
  • avoid crossing your legs while seated,
  • elevate your legs when resting, and
  • avoid wearing tight-fitting clothing around your waist, groin and legs.

  • /
  • Reviewed by on Thursday, September 19, 2013
  • Spider and Varicose Veins Pictures Slideshow: Causes, Before-and-After Treatment Images sources


    1. Original photograph by Toby Maudsley / Iconica
    2. SPL / Photo Researchers, Inc.
    3. Medicimage
    4. Halli Vervinder / Dorling Kindersley
    5. Andrew Olney / Riser
    6. Copyright © BSIP / Phototake -- All rights reserved.
    7. Dr. P. Marazzi / Photo Researchers, Inc.
    8. Copyright © BSIP / Phototake -- All rights reserved.
    9. N Aubrier / age footstock
    10. Darryl Leniuk / Digital Vision
    11. “Color Atlas of Cosmetic Dermatology”; Marc R. Avram, Sandy Tsao, Zeina Tannous, Mathew M. Avram; Copyright 2007 by The McGraw-Hill Companies, Inc. All rights reserved.
    12. "Color Atlas of Cosmetic Dermatology"; Marc R. Avram, Sandy Tsao, Zeina Tannous, Mathew M. Avram; Copyright 2007 by The McGraw-Hill Companies, Inc. All rights reserved.
    13. Michael Donne / Photo Researchers, Inc.
    14. “Color Atlas of Cosmetic Dermatology”; Marc R. Avram, Sandy Tsao, Zeina Tannous, Mathew M. Avram; Copyright 2007 by The McGraw-Hill Companies, Inc. All rights reserved.
    15. Copyright © BSIP / Phototake -- All rights reserved.
    16. Photo courtesy of Hormoz Mansouri, MD/ Long Island Laser Center for Vein Treatment
    17. PHANIE / Photo Researchers, Inc.
    18. WebMD
    19. John Kelly / Iconica


    • UpToDate: "Patient information - Chronic venous disease (Beyond the Basics)"
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