Varicose veins and spider veins: causes and prevention

Varicose veins and spider veins are common conditions and tend to become more common with age. It’s estimated that up to 20% of men and up to a third of women develop varicose veins in the UK, although most people don’t have any major health symptoms associated with them.

What are varicose veins and spider veins?

Varicose veins are enlarged veins, which usually occur in your legs. They appear as swollen, twisted veins and are usually dark blue or purple in colour. You may find that they look like a rope and cause your skin to bulge slightly around them. 

Spider veins, also known as thread veins, are damaged small veins, called capillaries, near the surface of your skin. As the name suggests, they tend to appear in a spider web pattern. They are less likely to bulge outwards as varicose veins do. Spider veins are most common on the legs and face and can be red, blue or purple in colour. 

You can have varicose veins without developing spider veins and vice versa.

What are the symptoms of varicose veins?

Severe pain is very uncommon with varicose veins but they can be uncomfortable, with the discomfort increasing as the day wears on and easing overnight while you sleep. Typical symptoms of varicose veins can include:

• Burning or itching of the skin
• Darkening of the skin 
• Fatigued leg muscles
• Night cramps
• Swelling in your ankles and feet

Women may find that the symptoms of varicose veins get worse during some parts of their menstrual cycle, as well as during pregnancy. 

Other symptoms that you may experience include restlessness, heaviness and throbbing in your legs. In most cases, symptoms can be reduced by elevating your legs or wearing compression stockings — speak to your doctor to ensure you are wearing the appropriate size of stockings. 

If you experience any of the following symptoms around your varicose veins, you should see your doctor:

• Bleeding veins
• Painful veins that feel hot
• Persistent pain and swelling
• Skin sores or ulcers

What causes varicose veins?

Varicose veins occur when the valves in your veins stop working properly. This disrupts blood flow through the veins. There are several risk factors for developing varicose veins, including: 

• Ageing or being overweight
• A history of blood clots or a family history of varicose veins
• Conditions that cause increased pressure in the abdomen eg constipation or tumours
• Hormone changes such as during puberty, pregnancy and menopause
• Medications containing high levels of oestrogen eg certain types of birth control
• Occupations that require a lot of standing

You may also develop varicose veins if you have had previous surgery on your veins. 

What are the symptoms of spider veins?

The main symptom of spider veins is the appearance of small red, blue or purple veins in a web-like pattern on your legs, chest, face or hands. They are not painful. If you start to experience symptoms such as discomfort, pain or swelling, you may have another underlying condition, such as venous insufficiency. You should, therefore, speak to your doctor.

What causes spider veins?

There are several risk factors for spider veins. As with varicose veins, spider veins can run in families. Being overweight, getting older and sun damage also increases your risk of developing spider veins.

Are varicose veins dangerous and should you be concerned if you have them?

Most of the time, varicose veins are not dangerous. However, in rare cases, they can lead to some serious complications. Complications include:

• Bleeding 
• Blood clots
• Skin ulcers 

If you are concerned about your varicose veins or have noticed a change in their appearance or symptoms, you should make an appointment with your GP. 

There is a very small risk of developing a deep vein thrombosis (DVT) if you have varicose veins and subsequently develop a condition called thrombophlebitis. Thrombophlebitis occurs when a blood clot forms and gets stuck in the vein and causes it to become inflamed. Although most of the time the blood clot is cleared, if it dislodges and passes into deeper veins, it can cause a DVT.

How can you prevent varicose veins and spider veins?

There are some steps you can take to reduce your risk of both varicose veins and spider veins. You can: 

• Avoid standing for long periods of time
• Exercise regularly to help improve your circulation
• Elevate your legs when you’re sitting down and avoid crossing them
• Lose excess weight and maintain a healthy weight to reduce pressure on your legs
• Wear compression socks, after seeking medical advice, especially if you are often on your feet

To avoid spider veins on your face and chest, make sure you wear adequate sun protection to prevent UV damage to your skin.

Varicose vein and spider vein treatments

Both spider veins and varicose veins can be treated with minimally invasive procedures, such as sclerotherapy or micro-sclerotherapy in the case of spider veins, and endovenous ablation. Open surgery is also an option for varicose veins. So make sure you speak to your GP about your different treatment options.