Spider Veins vs Varicose Veins: What’s the Difference?
Medically verified
Last updated on 1/30/2026
By Dr. Michael Nguyen
Vein Doctor at Vein Treatment Clinic
Harvard Medical School
Board Certified by the American Board of Venous and Lymphatic Medicine
Spider veins and varicose veins are both common vein conditions, and many patients are unsure how they differ or whether they represent the same problem.
Although they can appear similar on the surface, spider veins and varicose veins differ in size, depth, symptoms, and underlying vein function.
Understanding the differences helps patients know when veins are cosmetic, when they may signal vein disease, and when evaluation or treatment may be helpful.
If you’re unsure whether your veins are spider veins, varicose veins, or both, a vein evaluation can help clarify what’s happening.
What are spider veins?
Spider veins are small, thin veins that appear close to the surface of the skin. They often look red, blue, or purple and form web-like or branching patterns.
They are most commonly found on the legs and face and are usually considered a cosmetic concern, though some patients experience itching or burning.
Unhappy with the look of your legs? See How to Clear Spider Veins
Spider Vein before and after treatment pictures.
Results may vary according to each case.
Spider Vein before and after treatment pictures.
Results may vary according to each case.
What are varicose veins?
Varicose veins are larger veins that become enlarged, twisted, and raised above the surface of the skin.
They typically occur in the legs and are more likely to be associated with underlying circulation problems and symptoms.
Get the facts on bulging veins. Read the Complete Guide
Varicose Vein before and after treatment pictures.
Results may vary according to each case.
Varicose Vein before and after treatment pictures.
Results may vary according to each case.
How do spider veins and varicose veins differ in appearance?
Varicose veins are usually easier to feel, whereas spider veins are mostly visible rather than palpable.
Which causes more symptoms?
Varicose veins are more likely to cause symptoms such as aching, heaviness, swelling, and fatigue in the legs.
Spider veins often cause few symptoms, but some patients report itching, burning, or mild discomfort.
Legs feeling heavy or tired? Check Your Symptoms for Vein Disease
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Are the causes the same?
Both spider veins and varicose veins are influenced by genetics, hormones, pregnancy, and prolonged standing.
Varicose veins are more strongly associated with valve failure and venous reflux, while spider veins may occur with or without deeper vein disease.
Can spider veins and varicose veins occur together?
Yes. Many patients have both spider veins and varicose veins at the same time.
In these cases, treating the underlying reflux first often improves results and reduces recurrence.
Are spider veins or varicose veins dangerous?
Spider veins are rarely dangerous and are usually cosmetic.
Varicose veins can sometimes indicate chronic venous insufficiency and may lead to complications if left untreated.
Table of contents
1. What are spider veins?
2. What are varicose veins?
3. How do spider veins and varicose veins differ in appearance?
4. Which causes more symptoms?
5. Are the causes the same?
6. Can spider veins and varicose veins occur together?
7. Are spider veins or varicose veins dangerous?
8. How does treatment differ?
9. How do specialists determine which veins need treatment?
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Results that speak for themselves
You can expect results like these with our specialized treatments for spider & varicose veins performed by the best experts in the country.
Before
After
A 37-year-old patient visited our Vein Treatment Clinic, seeking relief from unsightly and painful varicose and spider veins. We performed radiofrequency ablation and sclerotherapy treatments, significantly improving the veins’ appearance and completely eliminating discomfort. The patient is now enjoying a more active and pain-free lifestyle.
Before
After
A 69 year-old patient visited our California Vein Clinic, embarrassed by spider veins that had impacted their self-esteem. We performed radiofrequency ablation and sclerotherapy treatments, leaving their legs smooth and healthy. The patient now feels more confident, thanks to this transformative treatment.
Before
After
This 84 year-old patient at our New Jersey Vein Treatment Clinic came in with spider veins that had affected their daily routine. We used radiofrequency ablation and sclerotherapy treatments to relieve discomfort and restore both their leg health and confidence. The patient now enjoys a more active and fulfilling lifestyle, free from pain.
Before
After
At our Long Island Vein Clinic, we treated this 75 year-old patient with spider veins using radiofrequency ablation and sclerotherapy. These minimally invasive treatments improved both the patient’s appearance and overall well-being, offering transformative results.
Before
After
This 75 year-old patient visited our Long Island Vein Treatment Clinic with painful spider veins. We used radiofrequency ablation and sclerotherapy, minimally invasive treatments, to eliminate the veins and restore comfort and confidence. The patient experienced life-changing results
How does treatment differ?
Spider veins are most commonly treated with sclerotherapy or surface laser treatments.
Varicose veins often require treatment of underlying reflux using minimally invasive procedures, sometimes combined with additional treatments for surface veins.
How do specialists determine which veins need treatment?
A vein evaluation often includes a physical exam and ultrasound to assess blood flow and valve function.
This helps determine whether spider veins are isolated or related to deeper vein disease and guides treatment planning.
Precision Care: Understand Your Veins with an Ultrasound Map
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< What Are Varicose Veins?
What Causes Varicose Veins? >
About the Medical Team at Vein Treatment Clinic
Vein Treatment Clinic is powered by VIP Medical Group and built around a single guiding principle: deliver the highest standard of vein care using an academic, evidence-based approach combined with the most advanced, minimally invasive technology available today.
Clinical leadership at Vein Treatment Clinic is guided by a panel of board-certified vein specialists responsible for establishing and maintaining the clinic’s medical standards. Their approach reflects training and experience developed at nationally recognized academic institutions such as Harvard, Yale, Columbia, and Mount Sinai, with a focus on disciplined evaluation, accuracy, and outcomes-driven care.
All physicians at Vein Treatment Clinic follow a structured, highly standardized clinical model. This includes ongoing training in the latest non-surgical vein treatments, continuous review of emerging research, and strict adherence to proven safety and quality protocols. The approach reflects the values of academic medicine: thoughtful evaluation, disciplined decision-making, and a commitment to outcomes grounded in science.
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At Vein Treatment Clinic, education is considered a core part of treatment. Patients are encouraged to understand their condition, their options, and the reasoning behind each recommendation, so they can move forward with clarity and confidence.
If you’d like clarity about whether your veins are spider veins, varicose veins, or both, a vein evaluation can help guide that decision.
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