Spider Veins vs. Varicose Veins: What's the Difference?

Spider veins and varicose veins are both visible vein problems, but they differ in size, depth, and what they mean for your health. Knowing which you have helps you choose the right next step.

Spider veins: small and superficial

Spider veins (telangiectasias) are thin, web-like clusters of red, blue, or purple lines sitting just beneath the skin's surface. They are usually 1 millimeter or less in diameter, flat, and painless. Most people seek treatment for cosmetic reasons rather than symptoms.

Varicose veins: larger and deeper

Varicose veins are bigger — typically 3 millimeters or more — and bulge above the skin in a twisted, rope-like pattern. Because they involve larger veins with failed valves, they more often cause aching, heaviness, swelling, and other symptoms.

Unlike spider veins, varicose veins can point to chronic venous insufficiency, a deeper circulation issue.

How to tell them apart

A simple rule of thumb: if the vein is flat, fine, and web-shaped, it is likely a spider vein. If it is raised, thick, and twisting, it is likely varicose. Our visual vein checker walks you through the visual cues, and a clinician can confirm with a quick ultrasound.

Do they need different treatments?

Spider veins respond well to sclerotherapy or surface laser. Varicose veins usually need a procedure that closes the underlying feeder vein — such as ablation or a non-thermal closure. Treating only the surface without addressing the source often leads to recurrence.