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Spider veins and varicose veins, what are the differences?
Spider veins and varicose veins look different and are treated differently. Here is how to tell them apart, and when the smaller ones are an early warning.
- Spider veins are tiny surface vessels; varicose veins are larger, deeper veins.
- Both come from venous reflux, but they are not the same condition.
- Spider veins are usually cosmetic; varicose veins can need treatment.
- Spider veins can be an early sign of underlying venous insufficiency.
- Varicose veins can be treated without surgery, unlike spider veins.
Varicose veins are veins that struggle to carry blood back up to the heart. Blood pools, and over time the vein walls stretch and bulge under the skin. But how do they differ from the finer spider veins? Although both share similar causes, they are not the same condition and are not treated the same way.
Varicose veins: what they are
The visible varicose vein is usually only part of the problem: deeper veins, the so-called hidden varicose veins, are often affected too. The cause is venous reflux, when the valves inside the vein stop closing properly and blood flows back down. Twisted and bulging, varicose veins are often a cosmetic concern, and if they cause no discomfort there is no immediate need to treat them. But as the disease worsens, pain, irritated skin and disturbed sleep can appear, and it is then worth discussing treatment options with a doctor.
Spider veins: an early sign of venous insufficiency?
Spider veins, or thread veins, are tiny blood vessels in the top layer of the skin, usually on the legs or face. When they dilate they show as thin red or blue lines, like a spider web. They are not the same as varicose veins, but they can be a first sign of underlying venous insufficiency.
| Feature | Spider veins | Varicose veins |
|---|---|---|
| Where | Tiny vessels in the top layer of the skin (legs or face). | Larger superficial veins, deeper under the skin. |
| Appearance | Thin red or blue lines, like a spider web. | Twisted, swollen, bulging veins. |
| Medical concern | Mostly cosmetic; rarely need treatment. | Can cause pain and complications and may need treatment. |
| Reimbursement | Usually not covered (cosmetic). | Often covered when medically justified. |
If the underlying vein is faulty, it can be treated without surgery: focused ultrasound (echotherapy) closes it with no incision.
Spider veins are more common than varicose veins
Studies have found a link between the extent of spider veins and the severity of varicose veins. Even so, spider veins are far more common, so not everyone who has them will go on to develop venous insufficiency that needs treatment.
Treating spider veins and varicose veins
Spider veins are usually treated for cosmetic reasons only, as they are no medical concern, so treatment is typically not reimbursed. Varicose veins, on the other hand, may need medical treatment when they cause pain, and are often covered by insurance. Options include laser or radiofrequency ablation with a catheter, sclerotherapy and surgical stripping. Echotherapy, a newer thermal method, uses therapeutic ultrasound and, unlike catheter-based methods, needs no catheter or surgery at all, so it is completely incision-free.
Wondering whether echotherapy is available near you? A growing network of centres is already equipped with the SONOVEIN.
Questions fréquentes
What is the difference between spider veins and varicose veins?
Spider veins are tiny vessels in the top layer of skin, appearing as thin red or blue lines. Varicose veins are larger, deeper veins that look twisted and bulging.
Are spider veins a sign of varicose veins?
They can be an early sign of underlying venous insufficiency, but many people with spider veins never develop varicose veins that need treatment.
Are spider veins dangerous?
No, they are almost always a purely cosmetic concern and rarely need medical treatment.
Do spider veins and varicose veins need the same treatment?
No. Spider veins are treated for cosmetic reasons and usually not reimbursed. Varicose veins may need medical treatment, often covered by insurance.
How are varicose veins treated?
Options include sclerotherapy, laser, radiofrequency and surgery. Echotherapy is a newer, fully non-invasive method that uses focused ultrasound, with no catheter or incision.