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What causes red spider veins on legs?

Spider veins, also known as telangiectasias, are small dilated blood vessels that appear near the surface of the skin. They typically look like red, blue, or purple squiggly lines and are commonly found on the legs and face. While spider veins are harmless, they can cause discomfort, pain, and embarrassment for some people.

What are spider veins?

Spider veins are tiny, thin-walled blood vessels that are close to the surface of the skin. They connect to deeper, larger veins but do not have the same valves that regulate blood flow. As a result, blood can flow backwards and pool inside spider veins, causing them to enlarge and become visible through the skin.

Spider veins are also known as superficial venous insufficiency. They most often appear on the legs as reddish, purplish, or blueish squiggly lines that resemble a spider web. They can range in size from miniscule threads to larger branch-like patterns.

What causes spider veins on the legs?

There are several potential causes and risk factors for developing spider veins on the legs:

  • Genetics – Spider veins can run in families. Having a family member with prominent leg veins puts you at higher risk.
  • Pregnancy – Pregnancy is a common trigger as the weight of the uterus puts pressure on leg veins. Hormone changes also cause veins to relax.
  • Prolonged standing – Jobs or activities that require long periods of standing or sitting can increase leg vein pressure.
  • Obesity – Excess body weight adds pressure on leg veins and can lead to spider veins.
  • Age – Spider veins become more common with age as leg veins weaken over time.
  • Sun exposure – Years of exposure to ultraviolet sunlight may cause spider veins to appear.
  • Hormones – Estrogen and progesterone affect vein walls. Taking birth control pills or hormone therapy can irritate leg veins.
  • Injury – Direct trauma to a leg through surgery, bump, or knock can damage veins and cause spider veins.

Additionally, there are certain lifestyle-related risk factors like smoking, lack of movement, crossed legs, and wearing tight clothing that restrict blood flow in the legs. Chronic conditions such as obesity, hypertension, and diabetes also increase susceptibility.

Who gets spider veins?

Spider veins most commonly affect women. It is estimated that over 40% of women develop some spider veins, compared to just 10-20% of men. The exact reasons are not known, but smaller vein size, hormone changes, and genetics likely play a role.

Spider veins usually begin to appear in adulthood. Though they can develop at any age, women often first notice them during pregnancy and middle age. Other high risk groups include those with a family history, overweight individuals, and people with jobs that require prolonged standing.

Where do spider veins occur?

The legs are the most common place for spider veins to occur. The upper legs, thighs, calves, and ankles are typical problem areas. They frequently form along the back of the calves or on the inside of the legs near the ankles.

Spider veins can also develop on the face, specifically around the nose, chin, and cheeks. Less often, they may appear on the trunk, arms, or other body parts.

Symptoms of spider veins

The most obvious symptom of spider veins is the appearance of squiggly red, blue, or purple veins under the surface of the skin. The veins often look like tree branches or spider webs. In some cases, the veins are very small and only visible on close inspection.

Other possible symptoms include:

  • Aching, throbbing, burning, or heavy feeling in the legs
  • Muscle cramping and swelling in the lower legs and ankles
  • Itching or irritated skin over the veins
  • Discoloration of the skin around spider veins

Spider veins themselves are almost always painless. But if they become inflamed or surrounded by swelling, discomfort and tenderness can result. Noticeable symptoms tend to develop when a significant amount of spider veins are present.

Diagnosing the cause of spider veins

Doctors can often diagnose spider veins by examining the appearance and distribution of the veins. Sometimes, a handheld ultrasound device may be used to see below the surface of the skin and confirm the source.

To help determine the underlying cause, your doctor will ask about risk factors and symptoms. Be prepared to provide information about:

  • Personal and family health history
  • Medications and supplements you take
  • Any recent injuries or traumas
  • Lifestyle factors like exercise, diet, smoking, etc.
  • Jobs or activities that involve prolonged standing

Blood tests or imaging scans are not usually needed unless the doctor suspects an underlying vascular condition. Rarely, a biopsy may be performed if the veins appear abnormal.

Treatments for spider veins

The best treatment approach depends on the location and extent of your spider veins. Very mild cases may not require any treatment if the veins aren’t causing bothersome symptoms.

Here are some options for getting rid of visible leg spider veins:

  • Sclerotherapy – The most common treatment is sclerotherapy, which involves injecting a solution into the vein. This causes it to scar and force blood to redirect into healthier veins. Multiple sessions are usually needed.
  • Laser and IPL – Laser and pulsed light devices can selectively destroy and fade spider veins with heat energy. Like sclerotherapy, several treatments are typically required.
  • Radiofrequency – Radiofrequency devices use heat to collapse the walls of spider veins. The vein eventually gets reabsorbed by the body.
  • Surgery – Rarely, problematic spider veins may need to be removed through micro-phlebectomy (tiny incisions) or ambulatory phlebectomy procedures.

Medical treatments are most effective for small to medium sized spider veins. Larger varicose veins often require additional approaches like endovenous ablation.

Home remedies and natural treatments

While home remedies won’t make spider veins disappear, some lifestyle changes and natural treatments may help reduce discomfort or slow their progression:

  • Wearing compression stockings to improve circulation and vein strength.
  • Elevating the legs while sitting or sleeping to improve blood flow.
  • Doing regular exercise to tone leg muscles.
  • Losing weight to reduce pressure on leg veins.
  • Avoiding extended standing and sitting periods.
  • Applying horse chestnut, witch hazel, arnica, or other herbal extracts.
  • Massaging the legs to stimulate circulation.
  • Taking supplements like vitamin C, rutin, or butcher’s broom.

Preventing new spider veins

While you can’t guarantee spider veins won’t appear, certain preventive measures may help reduce your risks:

  • Maintain a healthy weight through diet and exercise.
  • Avoid crossing your legs for long periods when sitting.
  • Wear sunscreen daily to protect your skin from UV damage.
  • Don’t smoke tobacco products.
  • Limit alcohol intake which can worsen veins.
  • Change positions frequently if you have a standing occupation.
  • Wear loose, comfortable clothing that doesn’t restrict circulation.
  • Do calf muscle stretches, heel lifts, and other simple leg exercises.

When to see a doctor

Consult a dermatologist or vein specialist if you have spider veins that:

  • Are large, dark, or rapidly increasing in number
  • Are swollen, reddened, warm, or tender to the touch
  • Cause pain, aching, burning, throbbing, or cramping
  • Are accompanied by ulcers, sores, or color changes in the surrounding skin
  • Bleed or leak fluid

Getting an evaluation can help identify if an underlying condition needs treatment or if bothersome spider veins should be removed through medical procedures.


Spider veins are very common, especially in women and those with a family history of varicose veins. They appear as squiggly red, blue, or purple veins under the surface of the skin. While usually harmless, they can sometimes cause leg symptoms or cosmetic concerns.

Spider veins form due to weakened valves and blood vessels in the legs. Prolonged standing, pregnancy, aging, sun damage, and genetics can increase susceptibility. Visible leg veins are often effectively treated through methods like sclerotherapy, lasers, or micro-phlebectomy.

Self-care steps like wearing compression stockings, exercising, elevating your legs, and losing excess weight may provide relief from discomfort. See a doctor promptly if you experience pain, swelling, bleeding, or other changes to determine if your spider veins need medical care.