Spider Veins

Spider veins (telangiectasias) are damaged, visible blood vessels just beneath your skin’s surface. They typically look red, blue or purple. They may appear in clusters that look like spider webs or tree branches. Spider veins can form anywhere, but they usually develop on your legs, hands or face.

Despite their name, spider veins aren’t actually veins. They’re small, damaged blood vessels that connect to the veins and arteries in your body (otherwise known as capillaries, venules and arterioles).

Spider veins themselves aren’t dangerous. Having spider veins is mostly a cosmetic issue. That means you might not like their appearance, but they won’t harm you. Sometimes, though, spider veins are an early sign of chronic venous insufficiency (CVI). This is a vein disease that can affect your quality of life and lead to complications.

That’s why it’s important to tell a healthcare provider if you notice spider veins. This can help you catch signs of blood flow problems early and get any treatment you need.

Symptoms of spider veins

Spider veins usually don’t cause symptoms. Even though you can see them on your skin as branch-like clusters of red, blue or purple lines, you probably won’t know that the damaged vessels are there unless you look at them. But it’s common to have spider veins plus varicose veins or other blood flow issues. In those cases, you might experience symptoms, especially after standing for a while. These include: 

• Burning
• Cramping
• Itching
• Pain
• Legs that feel tired
• Bleeding (if a varicose vein close to your skin breaks open)

Treating the spider veins won’t improve these symptoms. Your healthcare provider will discuss treatments for CVI or other blood flow issues that can help you feel better.

Special considerations

In people with darker skin tones, spider veins may look different. The color of the classic blue and red may be more subtle or mistaken for other skin conditions.

Spider vein causes

Spider veins form when small blood vessels just under your skin weaken and expand. It’s not always clear what causes this to happen. Some known causes include:

• Hormonal changes
• Genetic disorders
• Connective tissue diseases
• Injury or trauma

Risk factors

You’re more likely to get spider veins if you:

• Often stand or sit for long amounts of time
• Have close biological family members with spider veins or varicose veins
• Have obesity
• Are pregnant
• Use hormonal birth control
• Use hormone therapy for menopause symptoms
• Spend a lot of time in the sun
• Smoke or used to smoke

Complications of spider veins

Spider veins on their own rarely lead to complications. But if you also have other conditions, like CVI, you may be at risk for:

• Sores that take a long time to heal (venous stasis ulcers)
• Bacterial skin infection (cellulitis)

How doctors diagnose this condition

To diagnose spider veins, a healthcare provider will:

• Perform a physical exam
• Ask about your medical history and biological family history

Your provider will look for signs of CVI to determine if the spider veins signal a more serious blood flow problem. They may run some noninvasive tests, like a vascular ultrasound, to see how blood moves through your legs or other parts of your body.

If you have CVI, your provider may refer you to a vascular surgeon for further evaluation and treatment.

How are spider veins treated?

Spider veins don’t necessarily need treatment. But treatments are available if you don’t like how they look. Procedures can close off or get rid of the damaged blood vessels. Options include:

• Sclerotherapy: Your provider injects a chemical solution into the spider veins to close them off. You should see them go away in about three to six weeks.
• Laser therapy: This is the typical treatment for spider veins on your face. It’s noninvasive (no injection). Instead, your provider uses a laser to create heat and destroy the spider veins. Small ones may disappear right away. Larger ones can take longer.

For either treatment, you might need multiple sessions.

It’s important to know that your healthcare provider will treat more serious issues before treating the spider veins. For example, if you have CVI, they’ll suggest medications, procedures and/or surgeries. These treatments can improve blood flow and prevent complications.

When should I see my healthcare provider?

Call a healthcare provider if:

• A spider vein — or any blood vessel — appears swollen or red/discolored, or it feels warm or tender when you touch it (signs of a blood clot)
• You notice a rash, sores or skin color changes
• You have symptoms, like burning or cramping in your legs

If you have spider veins, it may help to ask:

• Are the spider veins a sign of an underlying issue?
• How can I prevent getting more spider veins?
• Which treatments may help me?
• What can I expect before, during and after treatment?
• What are possible side effects or complications of treatment?

What can I expect if I have this condition?

Spider veins usually don’t lead to serious problems. Treatment can get rid of them and help you feel better about your skin’s appearance. You may need treatment again if new spider veins form.

Talk with your healthcare provider about your prognosis (outlook) if you have CVI. They’ll help you understand which treatments you might need and what you can expect.

Can spider veins be prevented?

Self-care can often improve blood flow and prevent new spider veins from forming. Tips include:

• Avoid sitting or standing for long periods: Try not to sit or stand for longer than 30 minutes at a time. Take breaks. If you’ve been standing, sit down for a few minutes. If you’ve been sitting, get up and move around.
• Flex your feet and ankles: If you need to stay seated or in the same position for a while, move your feet. Flex your ankles up and down. Squeeze and relax your calf muscles to support blood flow in your legs.
• Move around more: Try to increase your level of physical activity each day. This includes planned exercise, plus adding movement to your normal routine. Ask your provider before starting an exercise plan or ramping up your activity level. They’ll make sure it’s safe for you.
• Reach and maintain a weight that’s healthy for you: This can help limit pressure on your blood vessel walls so they work as they should.
• Lift up (elevate) your legs: Try to do this at least twice a day for 30 minutes each time. Your legs should be at least as high as your heart.

What is telangiectasia?

Telangiectasia is the medical term for a small, dilated (widened) blood vessel that can form just beneath the surface of your skin or mucous membranes. When telangiectasias appear on your skin, most people call them “spider veins.” But certain medical conditions can also make telangiectasias appear in other areas, like your tongue or the whites of your eyes.

Telangiectasias are sometimes a main sign of a condition. In those cases, the term is built into the condition’s name. Examples include:

• Ataxia-telangiectasia: A genetic condition that can cause small clusters of dilated blood vessels to form in your eyes and on your skin
• Hereditary hemorrhagic telangiectasia: A genetic condition that can cause telangiectasias on your skin and elsewhere, like the inner surface of your lips
• Macular telangiectasia: An eye condition that involves dilated blood vessels in your macula

What are reticular veins?

Reticular veins, like varicose veins, are actually damaged veins. This makes them different from spider veins. But they’re smaller than varicose veins — around 1 to 3 mm wide. They look bluish in color just beneath your skin. They often twist and turn in different directions or have a zigzag appearance.