Spider Veins and Varicose Veins


Spider veins appear as fine, branching reddish-blue lines that are very close to the surface of the skin. They are a common sign of aging on the legs and face but do not usually cause noticeable discomfort. Varicose veins frequently develop along the knees, calves, ankles, and feet. They may appear as bulging, ropy lines under the skin. The color of the veins may show through the skin as a greenish-blue or purple. Tingling, aching, itching, and burning are common sensations caused by varicose veins.

Both types of unsightly vascular lesions develop when the valves that prevent blood from pooling in the veins fail. Blood accumulates in the vessels making them distended and discolored. There are many causes of spider veins. Trauma to the skin (including sun damage or bruising) and certain medical conditions such as rosacea are sometimes factors. Varicose veins are often associated with pregnancy, weight gain, and sitting or standing for long periods of time.

Potential Treatments

Superficial varicose and spider veins that are near the surface of the skin can generally be addressed by a dermatologist who is skilled in performing the following treatments:

Sclerotherapy – a surfactant (detergent) is injected into the affected veins. The solution irritates the damaged veins and causes the cell walls to change texture and become fibrous. This closes the blood vessel so blood no longer pools in the vein. The vein itself disintegrates over time and is replaced with other tissues. Read more about sclerotherapy here.

Laser Therapy – Ablative lasers cause tiny bubbles of steam to form in the hemoglobin in the vein. This damages the walls of the blood vessels and causes them to close. The type of laser used varies depending on the severity and location of varicose veins and spider veins. Radio frequency ablation (RF) is a therapy that works in a similar way by targeting collagen in the blood vessel walls. It is a newer treatment that is still being evaluated.

Intense Pulsed Light (IPL) – This is a less invasive procedure that is sometimes used for treating spider veins on the face. It may reduce the appearance of inflamed blood vessels while evening out skin tone at the same time. Read more about IPL here.