Vein problems can affect people differently.

For some, varicose veins are a cosmetic issue. For others, varicose veins may represent a serious medical condition.  Both spider veins and varicose veins can cause symptoms.

In contrast to what most people think, spider veins are not only cosmetic but can actually cause symptoms, including swelling and heaviness of the legs. This may be in part because small spider veins can be a sign of underlying venous insufficiency or venous reflux disease. Symptoms of venous disease include:

Swollen Ankles

Swollen ankles that you and your friends notice?

Achy, tired legs

Achy and tired legs when walking, running or just moving about?


A general feeling of heaviness in the legs?

Pain behind the knee

Pain, burning or throbbing behind the knee or around the abnormal veins?

drawing showing restless leg syndrome

Restless legs or cramps when sleeping? (Some call this RLS)

Noticeable veins

Noticeable veins that you’re finally tired of looking at?

spider veins back thighs

Spider veins

Spider veins may be a sign of an underlying vein condition, not visible to the naked eye. A duplex ultrasound can detect underlying vein issues.

man varicose veins

Bulging varicose veins

leg swelling

Ankle swelling

corona phlebectasia

Corona Phlebectasia (bluish colored veins around the ankle)

sipder veins thigh

Spider veins along the outer thigh

These are almost always associated with ‘feeder veins’ from the anatomic lateral plexus.

Over time, complications can develop from untreated veins. These include:

  • Superficial phlebitis
  • Skin discoloration and eczema around the ankle
  • Skin sores or ulcers usually near the ankle
  • Burst or hemorrhaged vein
  • Chronic venous insufficiency

The Spectrum of Vein Conditions
healthy_and_diseased_valvesThere is a spectrum of vein disorders, ranging from simple spider veins to venous leg ulcers. Venous disease is progressive and worsens over time.  The presence of spider veins and varicose veins may indicate and underlying vein condition called venous insufficiency. Over time, venous insufficiency can cause a worsening appearance of varicose and spider veins, ankle swelling, skin discoloration and eventually in the most severe cases, leg ulceration. The images below show the spectrum of vein disorders affecting the legs.  Many people will have a combination of these types of vein conditions.


Vein Conditions May Not Be Visible to the Naked Eye: Venous ultrasound imaging is important in determining if an underlying vein problem exists. Vein Conditions May Not Be Visible to the Naked Eye: Venous ultrasound imaging is important in determining if an underlying vein problem exists[/caption]

Spider veins are the fine, thread-like reddish veins at the surface of the skin. Spider veins can be associated with underlying feeder veins, not visible to the naked eye.  Feeder veins are the ‘blue veins’ that give rise to spider veins. Spider veins may also be a sign of underlying venous insufficiency. For example, spider veins located in the inner ankles and inner thighs can indicate an underlying problem with the saphenous vein. As a result, an ultrasound examination may be recommended to identify and effectively treat the underlying source of the spider veins.

Varicose veins are the twisted, bulging veins just beneath the surface of the skin. They are a result of leaky vein valves.