Varicose Veins vs Spider Veins: What’s the Difference?

Spider veins and varicose veins are both types of venous insufficiency, a condition that happens when weak vein valves disrupt healthy blood flow in the legs. When these valves don’t work well, blood can collect in the veins, causing them to stretch and become visible under the skin. 

Spider veins are generally small, thin veins that appear red, blue or purple and sit close to the surface of the skin. They often form web-like or branching patterns and commonly appear on the legs, face or chest. 

Spider veins are often a cosmetic issue. They rarely cause pain, but they can show early changes in vein function. 

Spider veins usually do not cause symptoms. Treatment is often a choice and focuses on appearance. Spider vein treatments today are minimally invasive, typically performed in an outpatient setting. 

Common spider vein treatments include: 

• Laser therapy, which targets visible surface veins using focused light 
• Sclerotherapy, where a solution is injected into the vein, causing it to close and fade 

These outpatient procedures usually need little to no recovery time. Patients are able to go back to their normal activities soon after treatment. 

Varicose veins are swollen, twisted veins that often appear in the legs. They’re larger than spider veins and can bulge above the skin. Varicose veins are also more likely to cause symptoms. 

Varicose veins develop due to long-term pressure and valve failure, which interferes with normal blood flow. Affected veins may appear rope-like, swollen, or dark blue or purple. Symptoms often worsen without treatment. 

Spider veins rarely cause discomfort. Varicose veins, however, can interfere with daily activities and overall comfort. 

Common symptoms include: 

• Aching, heaviness or pressure in the legs 
• Swelling and fatigue 
• Burning, throbbing or itching 
• Restlessness, especially after sitting for long periods of time 

These symptoms are not normal for aging. They should be checked, especially if they impact your quality of life. 

“If you have achiness, swelling and pain, these are actually abnormal signs and symptoms,” Dr. Ross says. “Unfortunately, many women and men think these symptoms are normal, but they’re not.” 

Some factors can raise the chances of getting spider veins or varicose veins, including conditions that affect blood flow or put extra pressure on the veins. 

You may be more likely to develop vein issues if you have: 

• A family history of vein disease 
• Pregnancy or hormonal change 
• Obesity 
• Jobs that require prolonged standing or sitting 
• Previous vein trauma or surgery 

Not all vein problems are cosmetic. People with a history of blood clots could be at a higher risk for more serious conditions, such as deep vein thrombosis. This happens when blood clots form in deeper veins, usually in the legs and requires immediate medical attention. 

Not all vein problems can be avoided, but lifestyle changes can reduce risk and slow down progression. 

Steps that may help include: 

• Avoiding sitting for long periods of time 
• Exercising regularly to improve circulation 
• Elevating legs when resting 
• Maintaining a healthy weight 
• Wearing compression stockings to support vein function 
• Avoiding high heels and tight clothing 
• Protecting skin from sun exposure 

Compression stockings can help improve blood flow and reduce leg swelling, especially for people who stand or sit for long periods. 

Lifestyle changes can help manage symptoms and support healthy circulation. However, they may not stop vein disease from getting worse. When prevention isn’t enough, treatment depends on the type and severity of the vein condition. 

In many cases, especially with spider veins and small varicose veins, treatment is simple and not invasive. Thanks to new advances in vein care, these procedures can often be done comfortably in a dermatology office and usually require little to no recovery time. 

“Most vein problems can be treated easily in the dermatology office with a combination of superficial laser and sclerotherapy interventions,” Dr. Ross says. 

More complex varicose veins may require additional evaluation to determine the most appropriate treatment approach. 

Because varicose veins are larger and more likely to disrupt circulation, they often require a more comprehensive approach to treatment. When symptoms begin to interfere with daily activities, care goes beyond cosmetic concerns and focuses on restoring healthy blood flow and improving overall comfort.

“For varicose veins, treatment can include advanced laser therapy or catheter-based methods,” says Dr. Ross. “These procedures help restore healthy blood flow while relieving symptoms and improving appearance.”