Spider and Reticular Veins

Do these images look familiar?

Spider veins

Please read on to learn more about spider and reticular veins…

What are spider veins and reticular veins?

Spider veins

Spider veins, which are also called telangiectasia or thread veins, are tiny engorged veins that lie close to the skin surface and measure 0.5 – 1mm in diameter. They may be red, purple or blue in colour.

They commonly occur on the legs, especially the calves, thighs and ankles; but can also appear on the face (e.g. cheeks or nose), or other body areas.

Reticular veins are also commonly found in the presence of spider veins. These slightly larger (1 – 3mm diameter) and deeper veins are usually blue in colour and may also be referred to as ‘feeder’ veins, as when they are incompetent the blood pooling in them can feed back to the smaller surface vessels to create spider veins.

Spider and reticular veins can be quite visible against the skin and sufferers may therefore feel uncomfortable about wearing clothing that reveals them, preferring long pants or long skirts even in summer.

In the CEAP clinical classification system, spider and reticular veins are categorised as C1 and are generally considered as primarily a cosmetic condition at this stage.

How common are they?


Spider and reticular veins are very common. Studies have shown that over 80% of both men and women between the ages of 18 to 64 will have at least mild but visible spider and/or reticular veins. Generally women are effected more commonly than men, and particularly as they get older.

Who is more at risk?


A number of factors make you more likely to develop reticular and spider veins:

  • Age; the elasticity of your veins weakens as you get older
  • Your genes; if you have a family history of spider and reticular veins the chances are that you will have them too
  • Conditions that cause increased abdominal pressure such as chronic constipation, abdominal tumours or wearing tight girdles
  • Injury to the skin and previous vein surgery
  • Excess weight; being obese (and especially belly fat) increases pressure on the leg veins
  • Standing or sitting for long periods of time
  • Immobility, such as being confined to bed
  • Too much sun exposure, especially on very fair skin, can cause spider veins on the face

In addition, simply being female can increase your risk of spider veins:

  • Hormonal changes during puberty, pregnancy and menopause dilate the veins
  • Taking contraceptive pills and hormone replacement therapy have a similar effect in dilating veins
  • Pregnancy; the pressure of the growing uterus and the increased volume of blood causes veins to enlarge

What causes them?


Your veins and arteries are part of your circulatory system. Arteries pump blood around your body. Once oxygen and nutrients are delivered,  your blood  flows into your veins, some of which are just below the skin.  The forward flow of blood is ensured through:

  • One way valves in the veins, preventing back flow
  • Your calf muscles squeezing the  blood toward your heart when you move about
  • Your arteries transmitting energy to the veins to propel blood towards the heart
  • Elasticity, as veins stretch and contract  to help with upward blood flow

However, the effectiveness of these valves and the elasticity of your vein walls can be damaged or reduced, which results in the back flow and pooling of blood in your veins. Your veins then engorge and dilate. This is called venous incompetence. In the larger vessels venous incompetence can lead to varicose veins, whilst in the smaller more superficial vessels and capillaries reticular and spider veins can result.

Commonly, they occur in the legs because the veins in your lower extremities have to overcome gravity and endure the most pressure to move blood back to your heart. If the pressure is stronger than the one-way valves and vein wall tone, varicose and spider veins develop.

What are the signs and symptoms?


Spider veins are typically identified by their visual appearance, which can look like one or more of the following:

  • Red or purple spider web-like tiny veins
  • The ends of jagged tree branches
  • Threads
  • Interconnected hairs

Reticular veins are usually also visually identifiable, although being a little deeper under the skin they may not be quite so obvious as spider veins. They typically appear as blue or purple vessels and are often found in the same area as spider veins. In some cases they may also be slightly ropey like larger varicose veins.

Apart from their visual appearance, both spider and reticular veins may come with physical symptoms such as:

  • Discomfort in your legs
  • Itchiness in the area
  • A burning sensation around them

What are the potential complications?


Mild cases of spider and/or reticular veins are primarily a cosmetic issue, and as such they are more likely to have an impact on your confidence and lifestyle rather than posing an immediate risk to your physical health.

However, even mild spider veins should be taken seriously. If your spider veins are causing you to lose confidence, feel embarrassed or have a diminished lifestyle, this can all have a significant effect on your mental health and quality of life.

More severe cases can involve greater physical discomfort and complications, such as pain, itching, swelling, burning, phlebitis, infection, bleeding and ulceration.  Studies have reported up to 60% of people with spider veins having one or more of these complications.

Also, regardless of whether they are mild or serious, spider and reticular veins can be an important indicator of underlying issues in the deeper veins which if ignored can lead to more serious complications. In a high proportion of spider vein cases there is incompetence in the these deeper veins. This can lead to varicose veins, chronic venous insufficiency, and even the risk of superficial and deep vein thrombosis, ulceration and other serious problems.

It is therefore always wise to have your veins checked by a medical practitioner who specialises in this area.

What treatments are available?


There are relatively safe, painless and minimally invasive treatment options for spider veins. They may help to relieve discomfort or pain, prevent complications, improve appearance and can significantly halt the progression of venous disease.  Your medical practitioner will discuss the treatment options with you to determine which may be appropriate for your situation.