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What's the Difference Between Varicose and Spider Veins?

Varicose veins and spider veins are two results of a faulty circulatory system. These twisted, colored, and ropy bulges in the former, and more delicate, reddish, spiderweb-patterned blemishes in the latter, can result when blood doesn’t flow properly as it returns from the body’s tissues to the heart. Though the two may resemble each other in the broad strokes, they’re actually different conditions, and they’re treated in different ways.

The expert team of vein specialists, including double-board certified Dr. Mark Kim, at Eterna Vein & Medical Aesthetics in Puyallup, Washington, is well versed in the characteristics of each of these problems, as well as in their treatment. We believe an informed patient can more effectively participate in managing their health, so we’ve put together this guide so you can better understand the different characteristics, symptoms, and treatments of varicose veins and spider veins.

Chronic venous insufficiency (CVI)

The veins are the part of your circulatory system that return deoxygenated blood from the tissues back to the heart. That means the blood has to flow against the pull of gravity. To force the blood upward, veins contain one-way valves that close once the blood has passed through, preventing backflow.

If the valves are damaged, though, they won’t snap shut completely. Blood flow in the area becomes sluggish and pools around the valves. This condition is known as chronic venous insufficiency (CVI), and the increased blood pressure against the vein walls results in colored, visible swellings — varicose veins.

Any vein in the body can become varicose, but it’s most common in the legs and feet, especially in the calves, because walking, standing, and even your body’s weight puts pressure on the veins in the lower body.

If spider veins occur in the legs, they also arise from CVI. If they occur on the face, they most often are the result of broken blood vessels near the surface.

CVI may affect up to 40% of US adults. It’s more common in women, especially after pregnancy, and in people 50 and older.

Symptoms of varicose veins and spider veins

Spider veins are located close to the skin’s surface, and are most often small, thin, red lines that are flat or only slightly raised. While they can cause discomfort, most of the time they’re painless and are more of a cosmetic than a health issue.

Varicose veins are larger and deeper than spider veins and bulge significantly. Depending on their severity, they may cause:

  • Pain

  • Itching

  • Bleeding

  • Swelling in the legs and ankles

  • A “heaviness” in the legs

Beyond their discomfort, varicose veins may also cause a number of serious health problems, including:

  • Skin ulcers: pooled blood can cause open wounds that are painful, heal slowly, and risk becoming infected

  • Vein damage and bleeding: thinning of the skin over the vein can turn a scratch or a bump into a rupture that causes significant bleeding

  • Superficial thrombophlebitis: small blood clots close to the surface make the area feel hot, swollen, hard, and tender

  • Deep vein thrombosis (DVT): larger clots in deep veins can break off and travel to the lungs, causing a pulmonary embolism (PE), a life-threatening emergency

As a result, you should always seek medical attention for your varicose veins.

Treatments for varicose veins and spider veins

Here at Eterna Vein & Medical Aesthetics, we offer a number of different treatments to alleviate pain and improve the appearance of both varicose and spider veins.

Varicose vein treatments

Treatments include:

  • VenaSeal™: a medical adhesive closes the vein; blood is rerouted to healthier veins

  • Venefit™ (formerly called the VNUS closure): uses radiofrequency (RF) ablation to heat the vein from within; the vein collapses and seals shut

  • Asclera: an FDA-approved injection that causes veins to collapse and seal

Spider vein treatments

Treatments include:

  • Asclera: an FDA-approved injection that causes veins to collapse and seal

  • Veinwave™: thermocoagulation to safely heat spider veins, closing them instantly

  • Laser sclerotherapy (aka laser vein therapy): a focused beam of light irritates vein walls, causing them to collapse

While facial veins may be spider veins, they could also be blood vessels inflamed due to rosacea, sun exposure, and other factors. We use Veinwave and laser sclerotherapy to treat these veins.

Visible veins on the hands aren’t necessarily dysfunctional; hand veins naturally become more obvious as you age. Asclera is an option for reducing their appearance, or you can try filling out the skin volume with injectable dermal fillers.

If you’re noticing colored veins snaking across your legs or face, it’s best to get them checked out to ensure they’re not harmful, and to have them treated if they are. Give Eterna Vein & Medical Aesthetics a call at 253-268-3400 to set up a consultation, or request an appointment online now.


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