Spider & Reticular Veins: Causes, Treatment Options, and Cosmetic Solutions

What Are Spider and Reticular Veins?

Most of us will notice our veins become more visible over time, especially on our legs or face. These visible veins often fall into two categories: spider veins and reticular veins. While harmless in many cases, they can impact our confidence, especially when shorts season rolls around in South Florida.

Spider veins are the smaller of the two. Think of them as delicate networks of red, blue, or purple lines just beneath the skin. They frequently resemble spider webs (hence the name) or thin branches and tend to appear on the thighs, calves, or around the nose and cheeks.

Reticular veins, on the other hand, are slightly larger and usually bluish or greenish. These veins often form a net-like (or reticular) pattern just under the skin and may serve as a feeder network to spider veins. In short, both are visible signs of vascular change and are treatable, especially when addressed early.

The Difference Between Spider Veins and Reticular Veins

The key difference lies in size, depth, and coloration.

• Spider veins: Smaller (less than 1mm), found close to the skin surface, and may look red or purplish.
• Reticular veins: Larger (1 to 3mm), deeper under the skin, typically blue or green, and sometimes cause spider veins to branch outward from them.

Understanding this distinction helps determine the right treatment approach. For example, spider veins typically respond well to surface laser treatments, while reticular veins often require sclerotherapy.

Causes and Risk Factors

Why do these veins appear? While genetics play a major role, several lifestyle and physiological factors can also contribute:

• Family history: If your parents had visible veins, you’re more likely to develop them too.
• Hormonal changes: Pregnancy, menopause, and hormone therapy can relax vein walls.
• Prolonged standing or sitting: Occupations like teaching, nursing, or retail can increase vein pressure.
• Injury or trauma: Bruises or deep skin injuries may trigger vein changes.
• Sun exposure: Particularly contributes to spider veins on the face.
• Obesity and inactivity: These increase strain on the circulatory system.
• Age: Vein elasticity declines over time, increasing susceptibility.

In women especially, hormonal fluctuations are significant contributors. Pregnancy can increase blood volume, placing more pressure on the veins and weakening their walls. Weight gain and restricted movement during pregnancy, typically in later trimesters, exacerbate the issue.

How Common Are These Veins?

Spider and reticular veins are more than just common, they’re prevalent.

Up to 60 percent of women and nearly 40 percent of men will develop visible veins at some point in their lives. Age plays a role, but we’ve seen patients in their 20s and 30s seek treatment driven by occupation, family history, or early hormonal changes.

While largely cosmetic, their presence can signal an underlying issue like chronic venous insufficiency in some cases. That’s why evaluation by a qualified vein specialist is so important: it ensures we’re not just treating what’s visible on the surface, but also assessing what might be happening beneath it.

Signs, Symptoms, and Diagnosis

Most spider and reticular veins don’t cause pain and are noticed only because of their appearance. However, some people experience symptoms including:

• Aching or heaviness in the legs
• Burning or tingling sensations
• Swelling or cramping after long periods of standing
• Restlessness in the legs at night

Signs can worsen with hormonal shifts, heat, or extended activity. Although these veins are surface-level, their symptoms may overlap with those of deeper venous issues like varicose veins. That’s why, beyond a physical exam, we often recommend a duplex ultrasound to examine vein flow and valve function beneath the skin.

Cosmetic Treatment Options: Sclerotherapy and Laser Therapy

Once we’ve ruled out deeper concerns, treatment becomes a personal decision based on aesthetics and comfort.

Sclerotherapy remains the gold standard. This involves injecting a specially formulated solution (or foam) directly into the vein. The solution irritates the vein lining, prompting it to collapse and reabsorb into the body over time. It’s quick, minimally invasive, and requires no anesthesia—perfect for spider and reticular veins.

Laser vein therapy is another excellent option, especially for delicate or facial veins. It uses light energy to target and fade small veins without needles. Results appear in a few weeks, and multiple sessions may be necessary.

Both treatments are:

• Performed as outpatient procedures
• Require minimal downtime
• Often completed in under 30 minutes
• Most effective when combined with post-treatment care like compression stockings

Advanced Treatments for Underlying Venous Issues

If reticular or spider veins are tied to venous insufficiency, addressing the underlying issue is critical. In these cases, we recommend minimally invasive procedures like:

• Radiofrequency ablation (RFA): Uses thermal energy to close unhealthy veins
• Endovenous laser treatment (EVLT): Similar to RFA but utilizes laser energy
• Ambulatory phlebectomy: Surgically removes larger superficial veins through micro-incisions

These procedures restore proper blood flow through healthier veins and prevent worsening of surface symptoms. They also enhance the results of cosmetic therapies by preventing reoccurrence.

Patient Expectations and Recovery Process

Setting the right expectations is just as important as the procedure itself.

While both sclerotherapy and laser treatments offer high efficacy, results typically unfold over several weeks. Some patients need two to three sessions for optimal outcomes. Mild bruising and redness are common but short-lived.

After treatment, we recommend:

• Wearing compression stockings for one to two weeks
• Avoiding direct sun exposure or tanning beds
• Skipping high-impact activities for a few days

Most of our patients value not just the cosmetic improvement, but also the renewed sense of freedom—whether that’s wearing a dress, swimsuit, or even just feeling confident again.

Preventive Measures and Lifestyle Modifications

Even after successful treatment, veins can return if we don’t address contributing lifestyle factors. Here’s what we advise:

• Keep moving: Take walking breaks, even at a desk job
• Maintain a healthy weight to reduce vein pressure
• Elevate your legs when resting
• Avoid prolonged sun exposure
• Use compression stockings on long flights or car rides
• Perform leg stretches regularly
• Focus on cardiovascular health—strong veins start with a strong circulatory system

Think of prevention as ongoing vein wellness. It’s about treating your veins like the vital pathways they are, long after the aesthetic concern fades.

If you’re seeing visible veins or experiencing leg discomfort, the vascular specialists at South Florida Multispecialty Hospital are here to help. Let’s create a customized treatment plan that restores comfort, confidence, and long-term vein wellness. Book your consultation today.