How Are Spider Veins Diagnosed?
Medically verified
Last updated on 1/29/2026

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 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.

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.

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 happens during a physical vein exam?
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.
Symptom Checker
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.
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.
Table of contents
1. Is visual examination enough to diagnose spider veins?
2. What happens during a physical vein exam?
3. When is ultrasound used to diagnose spider veins?
4. What does a vein ultrasound show?
5. Is vein ultrasound safe and painless?
6. Do all spider veins require ultrasound?
7. How diagnosis affects treatment planning?
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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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