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How Are Spider Veins Diagnosed?

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Medically verified

Last updated on 1/29/2026

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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 are often easy to see, but proper diagnosis involves more than simply identifying visible veins on the skin.

Many patients are surprised to learn that spider veins can sometimes be linked to deeper vein pressure, even when symptoms are mild or veins appear small.

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Understanding how spider veins are diagnosed helps patients know what to expect during evaluation and whether additional testing is necessary.

If you’re unsure whether your spider veins need evaluation or treatment, a vein assessment can help clarify next steps.

Is visual examination enough to diagnose spider veins?

In many cases, spider veins can be identified through visual examination alone, especially when they are small and not associated with symptoms.

A physical exam helps determine the pattern, location, and extent of visible veins.

Get the Facts on Spider Veins. Read the Complete Guide

Spider vein before and after results from our cutting-edge minimally invasive treatments at the Vein Treatment Clinic.

Spider Vein before and after treatment pictures.
Results may vary according to each case.

Spider vein before and after results from our cutting-edge minimally invasive treatments at the Vein Treatment Clinic.

Spider Vein before and after treatment pictures.
Results may vary according to each case.

What happens during a physical vein exam?

During a physical exam, the legs are evaluated while standing and sitting to assess vein appearance, skin condition, and areas of discomfort.

This exam helps identify signs that may suggest underlying vein pressure or reflux.

When is ultrasound used to diagnose spider veins?

Ultrasound may be recommended when spider veins are associated with symptoms such as aching, swelling, heaviness, or repeated recurrence.

It is also used when larger veins or a history of vein disease is present.

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What does a vein ultrasound show?

Ultrasound shows how blood flows through the veins and whether valves are functioning properly.

This information helps determine whether spider veins are isolated or linked to deeper vein reflux.

Is vein ultrasound safe and painless?

Yes. Vein ultrasound is non-invasive, does not involve radiation, and is generally painless.

Most patients can resume normal activities immediately after the exam.

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Do all spider veins require ultrasound?

No. Many patients with isolated spider veins and no symptoms do not need ultrasound.

Ultrasound is typically reserved for cases where symptoms or recurrence raise concern for underlying vein disease.

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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.

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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.

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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.

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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.

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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.

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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 diagnosis affects treatment planning?

Accurate diagnosis ensures that treatment addresses the correct veins and avoids unnecessary or ineffective procedures.

When underlying reflux is present, treating it first can improve results and reduce recurrence.

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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 board-certified vein specialists, including Dr. Michael Nguyen, whose training and experience help shape the clinic’s rigorous standards of 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.

Patients benefit from a team-based model of care where expertise is shared, best practices are consistently applied, and treatment recommendations are driven by data, experience, and long-term results.

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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 your varicose veins and what treatment options make sense for you, a vein evaluation can help guide that decision. Submit the form below to start your journey!

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How Are Spider Veins Diagnosed? | Exam & UltrasoundCristina Triana