What’s the Difference between Reticular Veins and Spider Veins?

Reticular and spider veins are common. And, under certain conditions, a superficial leg vein can change in appearance. If several veins do so, as with many cases of spider veins and reticular veins, these changes can become even more apparent. Reticular veins (thread veins) and spider veins (telangiectasia) can appear, causing discoloration, and changes in size and shape.

Reticular veins and spider veins can mar even the smoothest, most attractive legs. For this reason, some patients actively take steps to get rid of them, as it frequently limits what they can wear. Additionally, these venous formations are associated with more serious conditions like varicose veins, skin damage and venous insufficiency. In fact, many doctors believe that reticular veins and spider veins are precursors to vein varicosity.

Using the most effective, minimally-invasive ambulatory vein removal techniques Dr. David Naar at Premier Vein Clinic, Westlake helps patients to deal with their reticular veins and telangiectasias once and for all. Get help with your unsightly leg veins by booking a personal consultation with us. Call (440) 641-0433 or complete a form online to get in touch with us.

Before and After Photos

About Reticular Veins & Spider Veins

Spider veins and reticular veins on the lower limbs are very common. They are seen in many vein clinics across the country, and are the bane of many people’s lives. This is because there are very few ways to remove them or improve their appearance. It is estimated that 40% of women over 50 have these venous abnormalities, and that they are more likely to occur with age. (1)


People who wish to treat their veins may do so for cosmetic or medical purposes. But despite their appearance, the majority of reticular veins and spider veins are asymptomatic. In some cases, notable symptoms include the following. (1)

  • Burning
  • Itching
  • Pain

Why Do They Appear?

One of the most frustrating things for medical professionals to deal with is that finding the root cause of these venous abnormalities is elusive.  Nobody really knows the exact reasons why spider veins and reticular veins appear on the legs. They are linked closely to the development of varicose veins, but there is no hard evidence of their root cause

Venous Incompetence

Venous incompetence, also called chronic venous insufficiency (CVI), causes blood to pool in the veins because the inner valves of the veins are not working correctly. And, although there may not be as much of a connection as previously thought. One study revealed that only 22.9% of patients with spider veins had evidence of venous incompetence. (2) Despite their tenuous link to varicose veins, there are a number of similar risk factors for their development. These include the following. (1)\

Risk Factors

  • Being Female
  • Family History
  • Pregnancy
  • Hormonal Imbalance
  • Excess Weight
  • Local Trauma

Research has shown conclusively that women are more likely to get spider veins, reticular veins, and varicose veins. One study indicated that women are up to four times more likely than men to be affected by them. (2) This frustrating fact can restrict a patient’s freedom to wear what they want on their legs, as well as being an annoyance if they have symptoms of discomfort.

Find hassle-free treatments for your spider veins, reticular veins and varicose veins at Premier Vein Clinic in Westlake, OH. Contact us via our online form and someone from our staff will be in touch with you as soon as possible.

Vein Classification

Diagnosis of spider veins and reticular veins use a classification system called the Clinical, Etiological, Anatomical and Pathophysiological (CEAP) scale. (1)

  • C0 ‐ No signs of venous disease
  • C1 ‐ Spider veins or reticular veins
  • C2 ‐ Varicose veins (3.0 mm or more diameter)
  • C3 ‐ Edema (swelling)
  • C4 ‐ Changes in the skin and subcutaneous tissue
  • C5 ‐ Healed venous ulcer
  • C6 ‐ Active venous ulcer

How Can I Tell Them Apart?

Comparisons between these two types of vein are common. In fact, some people often use the terms interchangeably to describe them. However, there are a few small differences between them. Here’s how to recognize which are spider veins and which are reticular veins.

Reticular Veins

  • Color: Greenish-blue, purple
  • Size: Approximately 2 mm diameter
  • Symptoms: May cause itching or burning

Spider Veins

  • Color: Pink, red, or purple
  • Size: 1-1.5 mm (0.04 – 0.06 in) diameter
  • Symptoms: May cause pain and discomfort

Reticular veins and spider veins are both in the C1 stage of the CEAP classification symptoms, which is considered by vascular surgeons to be an early stage of venous disease. Reticular veins are often wider and longer than spider veins but they may share similar symptoms.But what does it mean if the veins look even bigger, and begin to twist and turn under the surface?

Varicose Veins

If you are at the point where visiting a vascular surgeon is necessary, it may be due to the fact that venous disease has progressed past the C1 stage to C2. The condition may have worsened, and may cause more discomfort than before. The signs of varicose veins in the legs are as follows. (3)

  • Thicker, Twisted Appearance
  • “Heavy” Legs
  • Aching
  • Skin Discoloration
  • Throbbing
  • Localized Itching
  • Leg Cramps
  • Skin Tenderness
  • Leg Fatigue
  • Difficulty Exercising

Varicose veins are closely linked to venous reflux, the backflow of blood in the vein. This is a condition that arises as a result of venous insufficiency.

What is Sclerotherapy?

Vascular surgeons frequently use sclerotherapy to treat varicose veins. It can also be used in the treatment of reticular veins and spider veins. But what is it? And how does it destroy troublesome veins?

Sclerotherapy is the targeted elimination of small blood vessels. (4) Using a solution called sclerosant, or sclerosing agent, a vascular surgeon can pinpoint the target veins and reduce their appearance. The sclerosant causes unhealable damage to the vein, from which it does not recover. And, over time the remaining tissue is resorbed by the body as waste. 


One of the reasons for sclerotherapy’s success is the solution used in the procedure. Sclerosant is a substance composed of saline and special irritating agents that work to destroy the veins. Some of these irritants are detergents, while others are hyperosmolar, meaning they actively cause cells to lose hydration. Both cause irreparable damage to vein cells, causing it to disappear over time.

Benefits of Sclerotherapy for Spider and Reticular Veins

  • Minimally-Invasive
  • Improves Leg Appearance
  • Simple to Perform
  • Short Procedure
  • Cost-Effective

Personal Consultation with Dr. Naar

The easiest way to find out if sclerotherapy can help you with your reticular and spider veins is to come to Premier Vein Clinic for a consultation with board-certified vascular surgeon Dr. Naar. He will discuss the issues you are having with your veins, and find out if you are experiencing any discomfort. Many patients come to us to receive purely cosmetic treatment, though some seek treatment because itchiness and burning are becoming troublesome, and interfering with their day-to-day life.

Cost of Vein Treatment in Westlake, OH

Dr. Naar has treated thousands of patients with the goal of restoring comfort and aesthetics to their legs. For a personal consultation to see if sclerotherapy is right for you, contact Premier Vein Clinic for a full evaluation. To book your one-on-one consultation with Dr. Naar, call us at (440) 641-0433 to speak to our scheduling staff.

Read more posts on the Premier Vein Clinic blog, and join Dr. Naar on Facebook to find out more about vein treatments and see real results!


Where do people usually get spider veins?

Spider veins are thin, pinkish-red vein formations, usually found in the legs and face.

Does sclerotherapy hurt?

There is a small pinch at the beginning of the treatment, but most patients experience only brief, mild discomfort. After the treatment, your leg may feel a little sore for a few days.

How many veins can be treated in one sclerotherapy procedure?

It depends on the patient and the nature of the veins. In some cases 2-4 treatment sessions may be necessary if there are multiple problem veins.

How long is recovery after sclerotherapy?

There is no downtime for sclerotherapy, but the procedure may mean your legs feel tender for 1-2 weeks.

How long does it take for veins to disappear after sclerotherapy?

Usually, patients will see changes in the appearance of the treated vein after about 10 days. In a few weeks the vein will fade from sight completely.

What happens to blood flow in sclerotherapy?

Regardless of the size of the vein, the body redirects blood flow around the problem vein, causing no change in blood flow.


  1. Nakano LC, Cacione DG, Baptista-Silva JC, Flumignan RL. Treatment for telangiectasias and reticular veins. Cochrane Database of Systematic Reviews. 2021;2021(10). doi:https://doi.org/10.1002/14651858.cd012723.pub2 
  2. Sandean DP, Winters R. Spider Veins. PubMed. Published 2022. https://www.ncbi.nlm.nih.gov/books/NBK563218/ 
  3. Antani MR, Dattilo JB. Varicose Veins. PubMed. Published 2020. https://www.ncbi.nlm.nih.gov/books/NBK470194/ 
  4. Khunger N, Sacchidanand S. Standard guidelines for care: sclerotherapy in dermatology. Indian Journal of Dermatology, Venereology and Leprology. 2011;77(2):222-231. doi:https://doi.org/10.4103/0378-6323.77478 
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