What is a spider vein?

A spider vein is a small blood vessel just under the surface of the skin which can indicate an underlying disease.

Remove Las Vegas Spider Veins

A Spider vein is a thin, red vessel that commonly  you can see just under the surface of your skin are not truly veins, but rather dilated capillaries.

They’re named spider veins because they remind us of spider webs, and are also sometimes described as looking like marble. Spider vein, as well as varicose vein, are symptoms of vein disease.



Spider veins usually take on one of three basic patterns:

A. Thin separate lines

B. Tiny branchlike shapes

C. A true spiderlike shape radiating outward from a dark center

Linear spider veins are commonly seen on the inner knee, whereas the arborizing (branch- or spiderlike) patterns often appear on the outer thigh in the form of a sunburst or cartwheel.


What causes spider veins?

Malfunctioning valves in feeder veins are the underlying cause.

Spider veins in the leg, hand, and face are caused by unhealthy valves inside feeder veins, allowing blood to flow backwards instead of upwards toward the heart. Some of this backed-up blood can lead to non-functional, “dead end” veins that appear underneath the surface of the skin as unsightly spider veins.

Who Gets Spider Veins?

Men and women of all ages develop spider veins.

Many of us will eventually encounter vein health issues. It’s usually hereditary, so if your parents or grandparents have or had spider veins, you are more likely to develop them as well.

Contributing Factors For Spider Veins:

Aging: As you age, your veins grow weaker and more susceptible to vein disease..

Gender: Women are more likely to develop vein disease than men.

Heredity: Genetics is the number one contributing factor for developing vein disease.

Lifestyle: Sitting or standing for long periods of time can cause varicose veins.

Obesity: Obesity puts excessive pressure on the veins and can cause vein disease.

Pregnancy: Changes from pregnancy increase your risk for developing varicose veins.


Doctors often diagnose spider veins based on a physical exam alone. Sometimes tests or procedures are used to find out the extent of the problem or to rule out other condition

Symptoms associated with spider veins include:

There typically aren’t significant symptoms of spider veins. They may cause minor aching or discomfort, and some people have complained of a heavy feeling in their legs or legs that tire easily.

All these symptoms generally worsen later in the day. Relief comes from walking or elevating the legs. Still, many patients say they have no symptoms at all.

  • Throbbing pain
  • Dull, generalized aching (especially after standing for a long time)
  • Night cramps
  • Tiredness
  • Burning
  • Tingling
  • Heaviness in the legs

Test & Diagnosis

Spider veins are diagnosed visually. The small red and blue vein tangles located just under the skin do not cause physical symptoms, but some physicians observing spider veins prefer to conduct ultrasound exams to determine the extent of the problem and the underlying causes of the condition.

Treatment Options for Spider Veins

Spider Vein Treatment

Quick, effective outpatient visits treat the root cause of spider veins.

Some of our patients seek treatment for cosmetic improvement, and others are looking for relief from pain. The good news is that spider veins and their underlying cause are quite treatable, and Dr. Carullo’s comprehensive approach handles the entirety of vein disease–not just the symptoms of it.

Dr. Carullo uses advanced imaging ultrasound to identify hidden varicose veins, which feed the small veins on the surface.

Furthermore, when located on the inside of the ankle, spider veins are not merely a cosmetic issue, but rather can be a sign of a more serious, internal derangement. A cluster of spider veins at the ankle is called corona phlebectasia and requires a special ultrasound study to identify the root cause before treatment will be effective. Typically, a leaking saphenous vein or incompetent perforating vein is the cause of ankle spider veins.

Do spider veins disappear if the underlying varicose veins are treated?

Spider veins have a distinct treatment of their own. Endovenous laser and ultrasound-guided sclerotherapy treat varicose veins and not spider veins. However, because varicose veins often “feed” the spider veins, the best time to treat spider veins is after eliminating these underlying, high-pressure varicose veins.  Dr. Carullo does not treat spider veins without eliminating the underlying high-pressured varicose veins.

Once the underlying issue addressed, there are two main spider vein treatment procedures–Sclerotherapy and Surface Laser Therapy –both are quick, minimally invasive, and require no hospitalization. Treatment is designed to seal off any feeder veins with unhealthy valves. Once those veins are sealed, blood circulation returns to veins with properly working valves, and dead-end spider veins are eventually absorbed back into the body.

Dr.  Ralph Carullo is a ABVLM certified vein specialist with years of experience performing sclerotherapy and provides treatments that are safe and effective.

Previous sclerotherapy procedures using hypertonic saline were painful and often left permanent brown spotting behind from the vein destruction.

Dr. Carullo’s advanced procedures does not have these side effects.

Dr. Carullo personally performs sclerotherapy. He has never delegated this responsibility to any assistant and this fact is important to the integrity of his practice and to his patients’ consistent care and his high patient return rate. 

Sclerotherapy is performed by injecting an irritant solution, either concentrated saline or a specialized detergent solution, directly into the spider veins themselves. The irritant damages the spider vein walls of the spider veins, causing them to swell, adhere and seal shut. The vein then slowly turns into scar tissue and gradually disappears over a period of weeks. Sclerotherapy (“sclero”), which was first developed in the 1930s, sclerotherapy is generally performed in the doctor’s office in less than 30 minutes and is considered highly effective when properly done, although the same vein may require multiple injections and repeat treatments over time. The treatment can be painful, with a burning or stinging sensation common, but the discomfort usually passes in a few minutes. Side affects are generally mild and temporary, and can include skin sores, superficial phlebitis, bruises and discoloration around the treatment site.

  • Laser and Intense Pulsed Light

Laser and Intense Pulsed Light devices treat spider veins non-invasively by delivering heat through the surface of the skin to the vein, sealing the vein walls.

Laser energy can be directed with a high degree of accuracy to minimize the damage to the tissues adjoining the treated vein.

The patient will frequently feel a painful burning sensation during the vein treatment and depending on the severity of the vein condition, two to five treatments lasting 15 to 20 minutes a piece may be required to eliminate spider veins in the legs. Facial vein procedures require less time for treatment. Side effects of laser vein treatment can include postoperative redness or swelling and discoloration of the skin, which will disappear within days or weeks.

Before and After Examples

Typical results after 4 treatments

Typical results after 3 treatments

Typical results after 3 treatments


The sooner the treatment, the quicker to overall better health.

Vein conditions that are seemingly cosmetic are often caused by a progressive underlying vein disease that could lead to more serious vein conditions if left untreated. The more quickly people seek treatment, the lesser the chance of developing more symptoms and of needing even more extensive treatment. So once you understand the root cause of your vein condition, the next step is finding the right vein disease treatment plan.

*Management of Varicose Veins and Venous Insufficiency, 2012 American Medical Association and Chronic Venous Disease in an Ethically Diverse Population, American Journal of Epidemiology.

Do's and Don'ts Spider Veins
  • Listen to your body. Both spider and varicose veins tend to be a cosmetic concern; however, they can lead to serious health complications such as fatigue, night cramps, leg swelling or itching around certain veins. If you are experiencing any of these symptoms, an ABVLM physician should be contacted for further assistance. 
  • Keep active. Activities such as walking, cycling and swimming all help to keep up blood circulation in the legs and will reduce pressure and blood pooling. 
  • Maintain a healthy weight. Reducing body weight will eliminate excess pressure on the legs that causes veins to surface.
  • Wear compression stockings. Properly fitted graduated support hose ensures that pressure is properly distributed on legs so that blood is directed toward the heart. Be careful, however, not to restrict blood circulation.
  • Sit or stand for long periods of time. Being in one position for an extended period of time can place pressure on veins. Change positions every 30 minutes to increase blood flow. Flex calf muscles frequently to keep up circulation while sitting at a desk or during long car or plane trips.
  • Assume all treatments will work. Speak to an ABVLM physician about a variety of treatment options available, such as lasers or injections. Depending on the severity of vein damage, experts can determine the best treatment option for you.
  • Subject legs to excessive heat. The heat associated with long hot baths and hot tubs will actually increase vein swelling and lead to blood pooling.
  • Fall for bogus advertisements. While tempting, such treatments may not be legitimate. It’s best to consult with an ABVLM physician to explore treatment options.
  • Wear overly restrictive clothing. Clothing around specific body parts – including waist, legs and the groin area – can restrict circulation and lead to spider and varicose veins.

Non and minimally invasive treatments for spider veins are frequently and readily available in a doctor’s office. Both kinds of procedures are considered safe and allow the patient to return to normal activity immediately following vein treatment.

Spider veins treatment questions to ask a ABVLM Physician

  1. Which spider veins procedure is the correct one for me? (What are the options?)
  2. What is the estimated cost of the procedure?
  3. How long is one appointment?
  4. How often will I need to receive treatment to treat my spider veins?
  5. How far apart are the treatments?
  6. What are the common side effects or complications associated with the procedure?
  7. How can I prepare for the treatment/procedure?
  8. Does the treatment hurt?
  9. What are my pain management and anesthesia options?
  10. Do you have before-and-after patient images to help prepare me for what to expect?
  11. Will someone walk me through the process before going in for treatment?
  12. What are the risks?
  13. What should I expect after the procedure is performed? (i.e. short-term and long-term effects; activity restrictions; expected recovery period)

General questions to ask before spider veins procedures

  1. Is a doctor on site?
  2. Is the doctor board-certified in Venous and Lymphatic Medicine?
  3. Was my medical history taken?
  4. Was I given an initial evaluation to determine if the technique or procedure is appropriate for my skin type?
  5. Did the doctor show me before-and-after photos?

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