Spider veins

    Spider veins are tiny, widened blood vessels visible near the skin surface, commonly on the legs. They are usually flat and differ from bulging varicose veins. Many cause only an appearance concern, although discomfort or underlying venous problems can occur.

    Last reviewed: November 20264 sources

    What you may notice

    • Fine red, blue or purple lines
    • Branching or web-like clusters
    • Vessels on the thighs, calves or ankles
    • Occasional local itching or burning

    Why it can happen

    Family tendency, pregnancy, hormonal factors, ageing and previous local injury may contribute. Spider veins can occur alone or alongside larger veins and venous reflux. Their appearance alone does not establish whether deeper veins are affected.

    What may help

    Treatment is optional when there are no symptoms or other concerning findings. Sclerotherapy or vascular laser can reduce selected vessels, sometimes over several sessions. Results vary, and new vessels may develop. Risks include pigment changes, new fine vessels, burns or ulceration, and uncommon serious complications.

    When to consult

    Seek assessment for associated swelling, persistent pain, skin changes, ulcers or bleeding. Sudden swelling or pain in one leg needs urgent assessment. Associated breathlessness or chest pain requires emergency care; these symptoms should not be attributed to spider veins.

    Related options

    3 options

    Treatments

    Evidence and sources

    1. Guy’s and St Thomas’ NHS Foundation Trust. Varicose veins: overview [Internet]. London: Guy’s and St Thomas’ NHS Foundation Trust; [cited 2026 Nov 7]. Available from: https://www.guysandstthomas.nhs.uk/health-information/varicose-veins
    2. DermNet. Sclerotherapy [Internet]. Auckland: DermNet; 2023 [cited 2026 Nov 7]. Available from: https://dermnetnz.org/topics/sclerotherapy
    3. Nakano LCU, Cacione DG, Baptista-Silva JCC, Flumignan RLG. Treatment for telangiectasias and reticular veins. Cochrane Database Syst Rev. 2021;10(10):CD012723. doi: 10.1002/14651858.CD012723.pub2.
    4. National Health Service. DVT (deep vein thrombosis) [Internet]. London: National Health Service; [cited 2026 Nov 7]. Available from: https://www.nhs.uk/conditions/deep-vein-thrombosis-dvt/