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
Although they can appear similar on the surface, spider veins and varicose veins differ in size, depth, symptoms, and underlying vein function.
If you’re unsure whether your veins are spider veins, varicose veins, or both, a vein evaluation can help clarify what’s happening.
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?
Get treated by vein treatment industry leaders
What are spider veins?
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
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
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.
Symptom Checker
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
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.
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.
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.
Get a Peek Inside Your Veins—Book Your Ultrasound Evaluation
Most PPO insurances cover vein treatment!
and 100+ more
Speak with an expert at 844-690-1788
< What Are Varicose Veins?
What Causes Varicose Veins? >
About the Medical Team at Vein Treatment Clinic
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.

See how we change lives
Start Your Journey to Pain-Free Legs
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.
We’ll verify
your insurance
coverage for you
Please fill out the form provided, and one of our dedicated patient coordinators will promptly reach out to you.
During the call, they will assist you in scheduling your visit at a convenient time and will also verify your insurance coverage to ensure a smooth and stress-free experience.
We are here to help guide you through every step of the process!