Spider veins and varicose veins are two of the most common vein disorders. Most people believe the only differences between the two are cosmetic — spider veins are thinner and smaller, and varicose veins are larger and more prominent. While that’s true, that’s not the entire reality. Spider veins and varicose veins have numerous differences in terms of appearances, accompanying symptoms, and treatment options. And contrary to popular belief, spider veins and varicose veins aren’t purely cosmetic concerns — they can also be caused by underlying chronic venous insufficiency, a dangerous circulatory disorder caused by collapsed vein valves.

Long Island Vein Centers is led by board-certified vein doctors who have underlying advanced fellowship training to identify the specific differences between spider veins and varicose veins. They use cutting-edge diagnostic tools to identify the root cause of your vein problems and curate personalized minimally invasive vein treatments. But what are the specific differences between spider veins and varicose veins? How can you tell if you’re suffering from spider veins and varicose veins? This article provides a comprehensive distinction between spider veins and varicose veins, including their symptoms and treatment options.

Long Island Vein Centers has offices throughout Long Island, including the North Shore, South Shore, Hamptons, and Port Jefferson. Schedule an appointment at your nearest spider vein and varicose vein center in Long Island.

Discover the differences between spider veins and varicose veins, their causes, symptoms, and effective minimally invasive vein treatments at Long Island Vein Center.

Why You Mostly Get Spider Veins & Varicose Veins In The Lower Extremity

Spider veins and varicose veins most commonly occur in the lower extremity, which includes your legs and feet. In your lower extremities, especially your legs, your veins must transport blood upward against gravity to return it to the heart. To aid in this process, veins have one-way valves that prevent blood from flowing backward. However, when these valves weaken or become damaged, gravity can force blood to pool in the veins, causing them to enlarge and become visible as varicose veins or spider veins. That’s why spider veins and varicose veins commonly appear in the legs and feet.

Spider Veins vs. Varicose Veins: Appearance

Spider Veins

Spider veins are small and delicate in their appearance. They usually measure less than one millimeter in diameter and appear close to the surface of the skin. They often form intricate, web-like patterns or thin, branching lines, resembling the legs of a spider or fine red, blue, or purple threads. Because of their small size, you cannot feel them when you run your fingers over your skin. However, since they look like a dense cluster of spider webs on the skin’s surface, they can cause considerable self-consciousness.

Varicose Veins

Varicose veins are much larger and more prominent. Varicose veins have a diameter greater than three millimeters and often appear as bulging, twisted, or knotted structures beneath the skin’s surface. Varicose veins are typically blue or green in color, and their size and appearance can change dramatically. Unlike spider veins, varicose veins are easily palpable, meaning you can feel them when you touch your skin. Because of their size, varicose veins cause considerable physical discomfort, including pain, aching, and swelling in the legs.

Spider Veins vs. Varicose Veins: Symptoms

Spider Veins

Spider veins are primarily a cosmetic concern and typically do not cause physical symptoms. While they may appear unsightly and affect your self-esteem, they do not lead to discomfort, pain, or medical complications. People often seek treatment for spider veins to improve the appearance of their legs, especially if the veins are visible in areas like the face or legs. However, it’s important to note that while spider veins aren’t inherently dangerous, they can be a symptom of chronic venous insufficiency, a dangerous circulatory disorder.

Varicose Veins

Varicose veins, on the other hand, can lead to a range of physical symptoms and complications. These enlarged veins may cause pain, aching, throbbing, or a feeling of heaviness in the legs. Swelling, cramping, and restless legs are also common symptoms associated with varicose veins. In some cases, varicose veins can lead to skin changes, such as darkening skin, discoloration, inflammation, and even ulceration (non-healing leg wounds). It’s important to address the symptoms of varicose veins to prevent potential complications.

Spider Veins vs. Varicose Veins: Root Cause

Spider Veins

Spider veins are primarily a cosmetic issue and are usually caused by the dilation of small blood vessels near the skin’s surface. While their exact cause can vary, some factors include genetics, hormonal changes (such as those during pregnancy or the menstrual cycle), prolonged periods of standing or sitting, and exposure to the sun. These factors can lead to the development of spider veins. However, in some cases, spider veins can also be caused by underlying chronic venous insufficiency. As such, even if spider veins aren’t dangerous, you should still undergo an evaluation from a vein doctor to rule out the possibility of vein disease.

Varicose Veins

Varicose veins, on the other hand, are typically caused by chronic venous insufficiency. Venous insufficiency occurs when the one-way valves in the veins, which are responsible for preventing the backward flow of blood, weaken or become damaged. This malfunction allows blood to pool in the veins, causing them to enlarge over time. Chronic venous insufficiency progressively worsens with time, so it’s incredibly important to treat it promptly. Addressing the root cause of varicose veins is essential to manage the condition effectively and prevent its progression.

Spider Veins vs. Varicose Veins: Complications

Spider Veins

Spider veins are primarily a cosmetic concern and do not typically lead to severe medical complications if left untreated. However, their appearance can cause emotional distress and affect your self-esteem. In some cases, spider veins may be associated with underlying venous insufficiency, so it’s essential to consult a vein specialist for a thorough evaluation. Spider veins don’t cause direct complications if left untreated. However, if you have underlying venous insufficiency, which you fail to treat, you may eventually suffer from varicose veins, leg ulcers, restless leg syndrome, deep vein thrombosis, and more.

Varicose Veins

Varicose veins are almost always caused by underlying chronic venous insufficiency. As such, if you have varicose veins, you must seek treatment. Failure to seek treatment for varicose veins may lead to complications associated with varicose veins and the underlying vein disease:

  • Chronic Pain: Varicose veins often cause discomfort, pain, and aching in the legs, which can significantly impact your quality of life. The pain often worsens with time, if left untreated.
  • Skin Changes: Prolonged venous insufficiency can result in skin changes, such as darkening, inflammation (dermatitis), or the development of venous eczema. That’s because varicose veins disrupt proper blood flow to the heart, so your skin may change over time.
  • Leg Ulcers: In severe cases, untreated varicose veins can lead to the formation of venous leg ulcers, which are painful, slow-healing wounds that can affect mobility and overall health. Wounds need proper blood flow to heal. Without sufficient blood flow, any wounds in your legs won’t heal properly, eventually leading to ulceration.
  • Bleeding: Varicose veins near the skin’s surface are more susceptible to injury. As blood continues accumulating in the leg veins, the walls of the varicose veins may dilate and weaken, leading to a high risk of burst varicose veins, which can lead to profuse bleeding.
  • Deep Vein Thrombosis: Although less common, untreated varicose veins can increase the risk of deep vein thrombosis, a condition where blood clots form in the deep veins of the legs. DVT can be life-threatening if a clot travels to the lungs, causing a pulmonary embolism.

Spider Veins vs. Varicose Veins: Treatments

Spider Veins

Spider veins are primarily treated for cosmetic reasons, and the treatments include:

  • Sclerotherapy: This procedure involves injecting a special sclerosant solution into the spider veins, causing them to collapse and gradually fade away. Sclerotherapy is highly effective for small to medium-sized spider veins and usually requires multiple sessions.
  • Laser Therapy: Laser treatment uses focused laser energy to target and eliminate spider veins. It is a non-invasive option that is particularly effective for spider veins on the face and legs. Multiple sessions may be necessary for optimal results.
  • Compression Stockings: In some cases, your vein doctor may recommend wearing compression stockings, which improve blood flow in the legs and reduce the appearance of spider veins. They can also help prevent the formation of new spider veins.

Please note that the aforementioned spider vein treatments only work on the spider veins — they can’t address underlying chronic venous insufficiency. If you have spider veins, please visit a vein doctor who can diagnose the underlying vein disease, and then offer comprehensive treatments to address the root cause and the visible spider veins. Treating spider veins without addressing underlying vein disease would lead to an inevitable recurrence.

Varicose Veins

For varicose veins, the treatment approach is more focused on addressing the underlying venous insufficiency and relieving the external symptoms. Treatments include:

  • Endovenous Laser Ablation (EVLA): EVLA is a minimally invasive procedure that uses laser energy to close off the faulty vein. This redirects blood flow to healthier veins, relieving symptoms and improving the appearance of varicose veins.
  • Radiofrequency Ablation (RFA): Similar to EVLA, RFA uses radiofrequency energy to close the diseased vein, providing effective relief from varicose vein symptoms. Radiofrequency ablation causes less post-treatment discomfort than EVLA.
  • VenaSeal: VenaSeal is a relatively new treatment that involves using a medical adhesive to seal the problematic vein. This procedure is less invasive and offers a quick recovery time. Furthermore, since it doesn’t involve thermal energy, the risk of nerve injury is minimal.
  • Ambulatory Phlebectomy: In this procedure, small incisions are made near the varicose veins, and the damaged veins are removed through these incisions. Ambulatory phlebectomy removes the superficial varicose veins, but it doesn’t treat underlying chronic venous insufficiency. As such, it’s often combined with other vein treatments.

Visit Long Island Vein Centers Today

Long Island Vein Centers is led by highly skilled vein doctors who administer advanced ultrasound tests to visualize the root cause of spider veins and varicose veins. We curate personalized treatment plans to address the root cause and the visible symptoms. Whether you’re suffering from spider veins, varicose veins, or other signs and symptoms of chronic venous insufficiency, please schedule an appointment at your nearest vein center in Long Island — we have offices in West Islip, Jericho, Hampton Bays, and Port Jefferson.