Varicose and Spider Veins: Causes and Treatments

If you suffer from uncomfortable and unsightly varicose veins or spider veins, Glacial Ridge Health System offers heartfelt treatments from Dr. Billie Jo Grieve, a board-certified general surgeon. She provides a range of safe and minimally invasive procedures that are virtually painless and require little to no downtime.

The Difference Between Varicose and Spider Veins

Varicose veins are bluish and bulge, while spider veins are smaller and colored red, purple, and blue. Spider veins, smaller varicose veins, are much thinner and closer to the surface of the legs, thighs, and face.

If left untreated, varicose veins can lead to severe complications such as inflammation, blood clots, ankle sores, skin ulcers, and bleeding. These symptoms worsen over time.

In addition to the visual appearance of knotted veins, many people experience pain, a burning or tingling sensation, aches, tenderness around the veins, tiredness, and leg heaviness. To ease these symptoms that worsen later in the day, you may need to sit down in the afternoon and elevate your legs to relieve pain.

Spider veins are small, non-bulging, and thin veins visible under the skin. The thighs, lower legs, and face are commonly affected. In addition to their unwanted cosmetic appearance, spider veins may cause aching, burning, or pain.

Causes of Varicose and Spider veins

The causes of varicose and spider veins include a combination of the veins losing their elasticity, genetics, and gravity, which makes blood pool in the legs. To pump this “old” (de-oxygenated) blood back up to the heart and lungs to become rich with oxygen again, a series of valves, like gates, open to move blood forward and close to prevent it from flowing backward into the leg. When the gates don’t close completely, pressure builds behind them, causing varicose and spider veins.

Spider veins do not become varicose over time. The opposite is true: varicose veins can cause spider veins to appear because of the pressure of blood pooling in the legs.

Risk Factors

The following factors don’t directly cause varicose veins; however, they may speed up the development of the disease and make the veins worse.

  • Heredity – A history of varicose veins from your parents or grandparents is a prime factor; nearly 80%
  • Age – Aging vein walls that lose elasticity may cause the valve system to fail.
  • Gender – Women are more prone to varicose veins. Contributing factors include pregnancy and birth control pills, and post-menopausal changes are contributing factors; 70 percent of women and 40 percent of men have varicose veins by age 60.
  • Prolonged Standing – People who stand for long periods because of their occupation have increased blood volume and pressure in their legs due to gravity.
  • Obesity – Abdominal pressure pushing blood down increases when weight increases, which may worsen vein problems.
  • Physical Trauma – Leg injuries can damage underlying blood vessels and make an existing problem worse.
varicose and spider veins on back of woman's legs
Varicose Veins
spider veins on the legs of middle aged woman
Spider Veins

Prevention and Self-Care

Because the underlying causes of varicose and spider veins are due to many uncontrollable factors, such as heredity, gender, and age, it is impossible to cure them.

However, you can help slow their development and prevent others from arising with these tips:

  • Exercise regularly to improve leg strength and circulation. Walking is ideal.
  • Avoid standing for long periods.
  • Avoid sitting for long periods.
  • Take a short walk every 30 minutes, and, if possible, try to elevate your legs.
  • Control your weight to avoid placing undue pressure on leg circulation.
  • Avoid clothing that limits the use of the calf muscles, such as high-heeled shoes or tight pants that restrict blood flow in the groin or calf.

Compression Stockings

  • Compression stockings squeeze the legs to help veins and leg muscles move blood. The amount of pressure varies by type and brand. Most pharmacies and medical supply stores carry various brands of compression stockings.
  • You can also purchase prescription-strength stockings. Insurance may cover the prescription ones if your varicose veins cause symptoms. Home treatments will not change the look of varicose veins.

Spider veins are mainly an aesthetic concern. They don’t usually lead to painful symptoms. Varicose veins can be extremely painful, and they are sometimes linked to circulatory problems.

professional headshot of Dr. Billie Jo Grieve
Dr. Billie Jo Grieve


To diagnose varicose veins, Dr. Grieve will examine your legs while you’re standing to check for swelling. She will also ask you to describe the pain and aching in your legs or other symptoms.

Dr. Grieve may also order a venous Doppler ultrasound of the leg. This painless test uses sound waves to examine blood flow through the valves in the veins. A leg ultrasound can help find a blood clot.

The symptoms of varicose veins may resemble other medical conditions. Always talk with your healthcare provider for a diagnosis.

Surgical Procedures

Glacial Ridge Health System offers safe and minimally invasive procedures to improve circulation and the appearance of varicose veins. These outpatient procedures are virtually painless and require little to no downtime.

Surgery and other procedures also can reduce pain and other symptoms. The size of your varicose veins affects the type of procedure or surgery you might have.


In sclerotherapy, a doctor injects the varicose veins with a solution or foam that scars, collapses, and closes the vein. Blood is then re-routed through healthy vessels.

After the procedure, treated veins tend to fade within a few weeks, although they might not disappear completely. Full results can take a month or more. Some veins need more than one sclerotherapy treatment.

Endovenous Laser Treatment (EVLT)

Endovenous laser treatment shrinks the vein walls, improves circulation, and the blood diverts to normal veins with functional valves. Side effects are minimal, and there’s no scarring. After this outpatient procedure, you’ll be up and walking immediately after the treatment.

Clinical studies show that EVLT has a 98 percent success rate.

Many insurance companies cover EVLT based on medical necessity and symptom relief. Others require conservative treatment measures before approving payment.

Ambulatory Phlebectomy

In an ambulatory phlebectomy, Dr. Grieve removes smaller varicose veins through tiny pricks in the skin. Only the parts of the leg being pricked are numbed in this outpatient procedure, and often, there’s not much scarring.

Psychological Impacts

We understand that living with spider veins can affect your self-esteem. The visibility of these veins, especially in areas like the legs or face, may cause you to avoid certain types of clothing, social situations, and sporting activities. The chronic pain associated with varicose veins can also lead to depression and anxiety. Talk to your doctor about any mental health concerns.

lower legs of a man and woman barefoot on a beach walking away

Choosing the Best Treatment for You

Dr. Grieve will discuss your treatment options based on the severity of your vein’s appearance and your symptoms. In addition to treatment and compression stockings, she may suggest lifestyle changes.

Ask your insurer if varicose vein treatment is a covered cost. If it is done only to make your legs look better, it’s usually considered cosmetic, and your insurance might not cover it. Check with your provider.