What’s The Difference Between Varicose Veins And Spider Veins?

Written by Daniel Friedmann, MD, Board Certified Dermatologist on March 21, 2016 6 Comments

varicose veins vs. spider veins

If you suffer from visible veins on your legs, you are not alone. It is estimated that over 25 million adults in the U.S. will develop varicose veins in their lifetime. Add in those who suffer from spider veins and the total number of Americans dealing with some form of unwanted veins jumps even higher – nearly 50 percent of all women and 40 percent of all men. It is therefore not surprising that vein removal is among the most requested services we provide.

Although the terms “varicose veins” and “spider veins” are sometimes used interchangeably, and in fact these types of veins are in some ways similar, they are not the same. It’s important to understand how they differ:

Vein Size

Varicose veins are enlarged, bulging veins of 4 or more millimeters in diameter that often have a twisted, cord-like appearance beneath the skin.

In contrast, spider veins are typically much smaller, classified as 1 millimeter or less in diameter. Spider veins often look like spider webbing, or a series of small or fine intertwined short and jagged lines. Spider veins may also be attached to reticular veins, commonly referred to as feeder veins, which have a dull bluish color and are 1 to 3 millimeters in diameter.

Skin Depth

Varicose veins are typically located within deeper layers of the skin while spider veins develop very close to the skin surface. Because of their superficial nature, spider veins tend to be more visible and exhibit and bright red or blue color.

Vein Location

Varicose veins primarily occur on lower extremities (thigh, leg, and foot). Although spider veins commonly occur in these same areas, they may also appear on the face, neck, chest, or back.


Spider veins typically do not cause any negative symptoms, other than being aesthetically unappealing. On the other hand, varicose veins are commonly associated with itching, burning, pain, fatigue, and/or swelling of the surrounding skin and soft tissues. If varicose veins are left untreated, these signs and symptoms progressively worsen with time.

Treating Varicose Veins and Spider Veins

There are several effective treatment options currently available for eliminating unwanted veins:

  • Sclerotherapy is an effective, minimally invasive procedure for removing varicose veins and spider veins of the lower extremities. Targeted injection of a specific liquid or foam medication into an unwanted vein produces immediate and irreversible injury of that vein, without any damage to surrounding skin. Over the next weeks to months after treatment, the treated veins become no longer visible.
  • Laser Treatment is a great option for getting rid of very small spider veins that cannot be addressed with sclerotherapy. Lasers (such as the V-Beam) are typically the best method for treating spider veins of the face, neck, chest, and back.
  • Surgical Vein Removal is a procedure to completely remove very large varicose veins in a single treatment with minimal scarring and little post-procedure discomfort.

Your physician can help determine which treatment will be the most effective for your needs.


Daniel Friedmann, MD

Daniel P. Friedmann, M.D. is a fellowship-trained, board-certified dermatologist and phlebologist at Westlake Dermatology and Clinical Research Director of the Westlake Clinical Research Center. He has presented nationally on photorejuvenation, noninvasive fat reduction, radiofrequency devices, up-to-date techniques in photodynamic therapy, the management of stretch marks, and the treatment of hand, chest, and facial veins.

6 Responses to “What’s The Difference Between Varicose Veins And Spider Veins?”

  1. We’re always looking for new treatment methods and idea to make vein procedures easier for patients. Have you tried suggesting changes in clothing types and diet?

    We would be happy to collaborate on a blog with you if interested.

  2. Avatar michelle says:

    Have you considered getting the cooltouch varia laser for facial veins? Some San Diego doctors on Real Self are getting amazing results with eliminating veins under the eyes in one treatment.

    • WD Staff WD Staff says:

      Hi Michelle, thanks so much for reading our post and for the suggestion! We utilize many Cooltouch lasers with great success. I’ll pass your recommendation on to our physicians board.

      Any new treatment is carefully evaluated in terms of effectiveness compared to our current offerings. At WD, we always strive for safety, value, and the best possible results. If there are significant benefits those new treatments join our offering!

      WD Staff

  3. Avatar Lela says:

    I was wondering if you can undergo vein treatments while pregnant? If so, does it matter what trimester you are in?

    • WD Staff WD Staff says:

      Hi Lela, thanks for submitting your question. We would advise you to wait until post pregnancy to undergo any vein treatments. Please contact us today if you would like to learn more about vein treatments and schedule an appointment!

  4. Avatar Tyler says:

    It’s interesting that the vein location actually determines whether it’s varicose veins or spider veins. My mom has some pretty interesting veins on her face and I’m concerned that they could be a problem. It’s good to know that they’re probably spider veins so we know what to call them when looking to have them treated.

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