Varicose, Spider and Reticular Veins

Some people with vein conditions like spider or varicose veins may find it hard to enjoy activities or focus because of leg pain, swelling, heaviness and other discomfort. Depending on each person’s case, a range of nonsurgical or surgical treatments may be recommended to help ease symptoms from these conditions. Learning about these conditions can help ease your worries about your treatment options and help you be more educated about managing your condition. 

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Understanding Veins 

Healthy veins have valves that ensure blood flows in one direction. A diseased vein valve cannot close properly, making blood reflux (flow backward) and pool. If left untreated, this condition may worsen over time and develop into chronic venous insufficiency (CVI), a more serious form of venous disease. CVI symptoms in the legs or ankles may include:

  • Cramping and swelling
  • Discoloration or other skin changes
  • Itching
  • Pain or aching
  • Restlessness
  • Tiredness or heaviness
  • Ulcers or open sores
  • Varicose veins, spider veins or reticular veins

Some people may not experience symptoms from varicose and spider veins. Those who do have symptoms will experience leg tiredness, heaviness or achiness. Symptoms may worsen when standing or sitting for long periods and ease during rest or when elevating the legs. Consult a doctor if you experience these symptoms, especially if they are already affecting your daily activities. Your healthcare provider will perform a physical exam and ask about your symptoms, lifestyle, activity level and personal and family medical history. An imaging test such as a duplex ultrasound (DUS) may be used to examine blood flow in your legs’ blood vessels. Other tests may be performed to confirm whether you have varicose veins or other conditions.

What Are Varicose Veins? 

Varicose veins are enlarged, twisted veins visible under the skin, often in blue, red or skin colors. Larger varicose veins have a rope-like appearance and bulge out of the skin. They often appear on the thighs, calves, near the feet and ankles. Some pregnant women may experience symptoms of varicose veins appearing in the buttocks, lower pelvic area and inner thigh.

What Are Spider Veins? 

Spider veins are smaller than varicose veins and usually red in color. They do not bulge out like varicose veins but look like spider webs or tree branches on the skin. They are usually found on the face or legs.

What Is a Reticular Vein? 

Reticular veins are more prominent than spider veins but smaller than varicose veins. Reticular veins are thin, bluish or purplish lines that you can see under your skin, especially on the inner thighs, behind the knees and around the ankles. These veins do not usually bulge out like some other veins. 

What Causes Visible Veins?

The following factors may increase a person’s risk for varicose or spider veins:

  • Aging – as a person ages, the valves in their veins may weaken.
  • Medical history – people born with weakened veins or have a family member with vein problems have an increased risk of developing varicose.
  • Hormonal changes – puberty, menopause, pregnancy or taking birth control pills may contribute to risk of developing enlarged veins.
  • Obesity – being obese or overweight can put extra pressure on the veins.
  • Lack of movement – sitting or standing too long may force the veins to work harder.

How Are Vein Conditions Treated 

Depending on your symptoms, existing conditions, overall health and other factors, your doctor may prescribe any of the following treatment options:

  • Compression stockings
  • Diseased vein removal
  • Closing diseased vein through:
    • Thermal energy – involves using heat to close the vein. The patient is required to wear compression stockings afterward.
    • Nonthermal procedure – such as VenaSeal treatment involves using a special adhesive to seal the vein. The patient may not have to wear compression stockings after the procedure.

The following are procedures for varicose vein surgery that may be recommended for severe cases:

  • Miniphlebectomy – aims to remove varicose veins just beneath the skin's surface through small incisions.
  • Surgical ligation – aim to treat larger varicose veins by tying them shut or completely removing them.
  • Endovenous ablation – using laser or radiofrequency energy to heat and close a varicose vein.
  • Sclerotherapy – involves injecting a chemical solution directly into the affected veins to seal the vein shut, stopping blood flow. As a result, the visible vein fades within a few weeks.
  • VenaSeal - an FDA-approved nonthermal procedure for sealing diseased veins to redirect blood flow to nearby healthy veins.

Spider and reticular veins treatment and management may include:

  • Sclerotherapy – injecting veins with a solution that causes them to close, often guided by ultrasound.
  • Laser and IPL treatments – noninvasive treatment option to target spider veins with light energy absorbed by hemoglobin, causing the veins to close.
  • Miniphlebectomy – removes spider veins through small skin incisions, offering a low-risk alternative with minimal scarring or pigmentation issues.

Find a Vascular Surgeon 

Vein disease like varicose veins is not just a cosmetic issue. It can also cause uncomfortable symptoms that affect your life. Schedule a consultation with one of our vascular surgeons to learn more about your treatment options.

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