What are spider veins?
Spider veins, also known as thread veins, are tiny, dilated, damaged veins that appear on the surface of the skin. Unlike varicose veins, they are usually flat and do not bulge. They often resemble a spider’s web, spreading out in clusters, and can vary in colour from red to dark purple.
These veins develop when the wall of the vein weakens causing it to dilate. When they weaken or fail, blood can back up and pool in the vein, causing it to swell and become visible through the skin. Spider veins are most common on the thighs, calves, ankles, and face, particularly around the nose and cheeks.
How spider veins develop
Spider veins form when the wall of the small veins weaken. This can be due to back pressure from larger veins, sometimes these larger veins are visible as bulging blue veins, but they can be hidden varicose veins which are not visible at the skin surface. Other factors that can be important are genetic factors.
When they become weak or damaged, blood can flow backwards and collect in the vein. This extra pressure causes the vein walls to expand and become visible through the skin. Factors like hormonal changes, prolonged standing, injury, or excess pressure can speed up this process.
On the face, spider veins often result from tiny blood vessels becoming weakened due to sun exposure, extreme weather, or certain skin conditions like rosacea. Over time, these weakened veins become permanent unless treated. This process is slow and can begin long before the veins become visible.
Who is affected?
Spider veins can affect many people, but certain groups are more likely to develop them:
- Women, especially during pregnancy or hormonal changes such as puberty or menopause
- Older adults, as veins weaken naturally with age
- People with a family history of spider or varicose veins
- Those in sedentary or standing professions like teachers, healthcare workers, or office staff
- Individuals who are overweight or obese, which places more pressure on veins
- People with light skin, particularly those who have frequent sun exposure
- Those with certain skin conditions, such as rosacea, which increase facial spider vein risk
While spider veins are often a cosmetic concern, for some, they can lead to discomfort or indicate a more serious underlying vein condition.
Signs and symptoms of spider veins
Common signs and symptoms
The most obvious sign of spider veins is the appearance of thin, web-like veins on the skin's surface. These veins are typically red, purple, or blue and may form clusters or spread out like branches. While spider veins are usually painless, occasionally people report:
- Mild burning or itching in the area
- Tingling sensations around the veins
- A feeling of heaviness or tiredness in the legs
- Aching or discomfort, especially after standing or sitting for long periods
Symptoms tend to be more noticeable by the end of the day or in warmer weather. Although mainly cosmetic, spider veins can sometimes signal deeper vein problems, especially when accompanied by swelling or pain.
When symptoms may worsen
Spider vein symptoms can vary from mild to bothersome depending on your lifestyle, overall vein health, and daily habits. You may notice symptoms becoming worse:
- After standing or sitting for long periods, such as during work or travel
- At the end of the day, particularly if you've been on your feet a lot
- During hot weather, which causes veins to expand and can increase discomfort
- During hormonal changes (e.g., pregnancy or menstrual cycle)
- After intense exercise or strain on the legs
If you find that symptoms like aching, burning, or leg heaviness are getting worse over time, it could be a sign of an underlying vein condition. Keeping an eye on these changes and seeking help early can prevent further discomfort or complications.
Causes and risk factors of spider veins
Common causes
Spider veins develop for a variety of reasons, and often there is more than one contributing factor. The most common causes include:
- Valve weakness or failure – when the valves in the larger veins don't work properly, blood can back up and create pressure that causes smaller spider veins to expand
- Hormonal changes – fluctuations in hormones, such as during pregnancy or menopause, can affect vein strength and blood flow
- Sun exposure – UV rays can damage skin and small blood vessels, especially on the face
- Injury or trauma – previous injuries to the skin or veins may lead to spider vein formation in the affected area
- Pressure increases – anything that increases pressure in the veins, such as straining, prolonged standing, or obesity, can contribute
Identifying the cause helps guide treatment and may prevent new spider veins from developing in the future.
Risk factors you should know
While spider veins can happen to anyone, certain factors make them more likely to appear. These risk factors either weaken the vein walls or increase the pressure in your veins, making it harder for blood to flow properly. Over time, this can lead to visible spider veins—especially in the legs or face. Understanding what might put you at greater risk can help you take steps to prevent or manage them earlier.
Common risk factors include:
- Family history of spider or varicose veins – genetics plays a strong role
- Use of hormonal treatments – like birth control pills or hormone therapy
- Getting older – veins naturally weaken with age
- Prolonged standing or sitting – especially for work
- Excess body weight – which increases pressure on your leg veins
- Sun damage – a common cause of facial spider veins
Being mindful of these risk factors can help you manage any symptoms that you have, or prevent further veins developing.
“Understanding your personal risk factors for spider veins is key to taking control of your vein health. Genetics, hormone changes, and lifestyle habits all play a part. By recognising these early, we can help patients make informed choices to prevent symptoms from worsening or new veins from developing.”
Dr Deborah Marsh
Vascular Doctor, UK Vein Clinic
How spider veins are diagnosed
Diagnostic tests
While spider veins are visible on the skin’s surface and can often be diagnosed by sight alone, however, it’s important to check for any underlying vein issues. Your doctor may use a duplex ultrasound scan to assess the deeper veins in your legs.
This test uses sound waves to create images of the blood flow and detect any valve problems or blockages. The scan is painless, non-invasive, and helps determine if there’s a condition like chronic venous insufficiency that needs treatment. If no deeper issues are found, your spider veins may be considered cosmetic. However, this diagnostic step ensures you receive the most appropriate care and avoid missing a more serious vein condition that could be feeding into your spider veins.
Clinical examination
During your consultation, a healthcare professional will examine the areas affected by spider veins. This involves looking at the size, location, and pattern of the veins and asking questions about your symptoms, medical history, and lifestyle.
If you experience any pain, swelling, or leg fatigue, these may indicate a need for further investigation. The clinician may also check for signs of underlying vein disease, such as varicose veins or poor circulation. This step helps determine whether your spider veins are simply a cosmetic issue or if further imaging is needed.
Treatment options for spider veins
Conservative management (lifestyle changes, compression stockings)
For those with mild or non-bothersome spider veins, conservative approaches can help improve symptoms and prevent new veins from forming. These options don’t remove existing spider veins but are helpful for managing discomfort and reducing further development:
- Exercise regularly – Low-impact activities like walking, swimming, or cycling help improve circulation and lower pressure in the leg veins. Aim for at least 30 minutes a day, most days of the week.
- Elevate your legs – Resting with your legs raised above heart level for 15–20 minutes at a time can reduce swelling and help blood flow return more easily to the heart.
- Avoid long periods of standing or sitting – Change positions frequently throughout the day to keep blood moving. Take walking breaks or shift your weight from leg to leg if standing for long periods.
- Wear compression stockings – These gently squeeze the legs to support blood flow and reduce aching, swelling, and fatigue. Put them on in the morning before swelling starts and wear them during the day.
- Maintain a healthy weight – Reducing extra pressure on your veins helps lower the risk of spider veins forming or worsening.
- Protect your skin from sun exposure – Especially important for the face, using sunscreen can prevent spider veins caused by UV damage.
These habits are easy to build into your routine and can make a noticeable difference in how your legs feel over time.
Minimally invasive treatments
If moderate methods don’t offer enough relief or if you’re looking to reduce the appearance of spider veins, several minimally invasive treatments can help. These procedures are generally quick, low-risk, and performed in outpatient settings without the need for general anaesthetic. They work by closing off the affected veins, allowing blood to reroute through healthier vessels. Over time, the treated veins are absorbed by the body and fade from view.
Common treatment options include:
- Sclerotherapy – This is the most commonly used treatment for spider veins on the legs. A specialist injects a clear solution (usually a type of salt solution) directly into the affected veins using a fine needle. This irritates the vein lining, causing it to collapse and seal shut. The body gradually absorbs the treated vein over several weeks. Multiple sessions may be needed for best results.
- Laser therapy – Often used for facial spider veins or smaller veins in the legs. This treatment uses a focused beam of light to heat and destroy the affected vein without damaging nearby skin. It’s particularly helpful for people who are allergic to sclerosing agents or have very small, fine veins. No needles are used, and recovery is usually fast. There is a risk of scarring with laser treatment.
- Intense Pulsed Light (IPL) – A non-invasive option typically used for facial thread veins. IPL delivers broad-spectrum light that targets blood vessels beneath the skin’s surface. While similar to laser therapy, IPL is better suited for wider areas and less targeted treatment. Scarring is a risk of treatment with IPL.
- Veinwave or Thermocoagulation – This treatment uses a very fine filament which directs radiofrequency energy to the vein wall to seal off tiny veins, mostly on the face. It uses less energy than laser and IPL and as such has virtually no risk of scarring.
Each method has its own benefits and limitations depending on your skin type, vein location, and personal preferences. Your vascular specialist will guide you on which option is most suitable for your needs.
What to expect during and after spider vein treatment
Before your treatment
Before your treatment, you’ll typically have a consultation with a vascular specialist to assess your veins and discuss your goals. This may include an ultrasound scan to check for underlying vein problems. You’ll also be given instructions on how to prepare – this might include avoiding certain skincare products, not shaving the area, or wearing loose clothing.
Some patients feel nervous before treatment, which is completely normal. Your clinical team will explain everything clearly, answer your questions, and help you feel at ease. Planning ahead, like bringing someone with you or wearing comfortable clothes, can make the experience feel more relaxed.
During your treatment
Spider vein treatments are typically quick and minimally invasive. For sclerotherapy, you’ll lie down while a clinician gently injects a solution into each spider vein using a very fine needle. You may feel a slight sting or tingling, but this is generally well tolerated.
Thermocoagulation uses a very fine, insulated needle, to deliver controlled bursts of radiofrequency energy directly into each spider vein. You might feel a mild pricking or heating sensation. The procedure is quick and well suited for small veins, especially on delicate facial areas like the nose and cheeks.
Aftercare and recovery
Proper aftercare is an important part of ensuring successful results and a smooth recovery after spider vein treatment. While most procedures are minimally invasive and low risk, following the right steps can make a significant difference to how well your skin heals and how long the results last.
After treatment, it’s common to notice some mild:
- Redness or bruising at the treatment sites
- Swelling or firmness around the veins
- Discolouration that may fade over several weeks
To support healing and reduce side effects, you’ll usually be advised to:
- Walk regularly to keep blood flowing and reduce the risk of blood clots
- Avoid strenuous activity such as running, weightlifting, or high-impact workouts for at least 48 hours
- Stay out of hot baths, saunas, and pools for about a week as it can dilate blood vessels and slow healing
- Keep the treated area clean and dry, especially for the first 24 hours
- Avoid using harsh skincare, particularly on the face to avoid a reaction
If you experience increasing pain, warmth, or redness at the site, or signs of infection, contact your clinician promptly. Your care team may arrange a follow-up appointment to assess progress and decide if additional sessions are needed.
When to resume normal activities
Most people can return to normal activities straight after their spider vein treatment.
Wear compression stockings during the day for the recommended time. If your work is physically demanding, consider taking it easy for a few days or modifying duties as advised by your clinician.
Follow-up appointments and long-term care
Follow-up appointments help monitor your recovery and assess how well your spider veins have responded. At these visits, your clinician will:
- Review your healing
- Check for any side effects
- Plan further treatment if needed
- Offer advice for ongoing care
It’s common to require around 2-4 treatments for spider veins on the face of 4-6 for spider veins on the legs.
Long-term care tips include staying active, wearing compression if advised, and addressing new veins early. These steps help maintain your results and support healthy veins.
Can spider veins come back after treatment?
Spider vein recurrence
Spider veins can return even after successful treatment. This is not usually due to treatment failure, but rather because the underlying factors that contribute to spider veins—such as genetics, ageing, or lifestyle habits—are still present.
Recurrence may happen due to:
- New veins developing in the same or different areas
- Feeder veins not being fully treated, allowing new spider veins to form
- Progression of venous disease, which may not have been fully visible at the time of initial treatment
If spider veins do reappear, further treatment may be needed. Regular follow-ups, wearing compression stockings, and adopting healthy habits like staying active and avoiding long periods of standing can help minimise the risk of recurrence.
Treating any deeper venous problems early on can also prevent future outbreaks of spider veins.
Can spider veins be prevented?
Lifestyle tips
While it may not be possible to completely prevent spider veins—especially if you have a strong family history—there are steps you can take to reduce your risk and delay their development:
- Stay active – Regular movement improves circulation and helps prevent blood from pooling in the legs. Walking, swimming, and stretching throughout the day can all help.
- Avoid prolonged sitting or standing – Change positions frequently to support better blood flow. If you stand for long periods, shift your weight between legs. If you sit a lot, take walking breaks.
- Maintain a healthy weight – Extra weight puts pressure on your veins. A balanced diet and regular activity can help reduce the strain.
- Protect your skin from sun exposure – Especially on your face, use sunscreen to prevent damage that can lead to broken capillaries and visible veins.
- Elevate your legs – When resting, raise your legs above the level of your heart to encourage better blood return.
Taking these simple steps daily can go a long way in protecting your vein health and minimising the likelihood of spider veins developing or worsening.
Early intervention
Spotting spider veins early can make a big difference in managing them effectively and preventing them from becoming more widespread. Many people ignore the first signs, such as small red or purple lines on the legs or face, thinking they are just cosmetic. However, these visible veins may be an early sign of underlying vein weakness or poor circulation.
Here’s why early action matters:
- It allows you to adopt lifestyle changes before veins worsen
- Minimally invasive treatments are more effective when spider veins are small and localised
- It helps reduce the risk of developing more visible veins or associated symptoms like aching or swelling
If you notice new or spreading spider veins, or if you’re experiencing discomfort, it’s worth speaking to a vascular specialist. They can assess your vein health, rule out deeper issues, and guide you toward the most effective next steps.
When to seek medical advice
Signs you shouldn’t ignore
Although spider veins are often harmless, there are times when they may signal something more serious. You should seek medical advice if you notice:
- Pain or aching in the legs, especially after standing or sitting for long periods
- Swelling in the legs, ankles, or feet that doesn’t go away
- Skin changes such as redness, dryness, or thickening near the affected veins
- New or spreading spider veins, especially if they appear quickly
- A history of blood clots or vein problems in your family
- Bleeding from a spider vein, which, while rare, should always be assessed
- Restless or heavy legs that interfere with sleep or daily activities
If any of these symptoms apply to you, it’s a good idea to get a professional evaluation. A vascular specialist can check for underlying vein issues and recommend the best course of action.
Doctors who treat this condition
Related
Chronic Venous Insufficiency
Sclerotherapy
Veinwave Treatment
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