Spider veins or varicose veins: what is the difference?

Both are veins you can see, but they differ in size, symptoms and treatment.

Spider veins are fine red, blue or purple lines just under the skin, often on the thighs and around the ankles. They are usually harmless and treated mainly for appearance.

Varicose veins are larger, bulging and twisted veins, 3 mm or more across. They come from weak valves in the vein and can cause heaviness, aching, itching, night cramps and ankle swelling. Over years, untreated varicose veins can lead to skin changes and, in some people, ulcers near the ankle.

A Doppler scan shows whether the visible veins are fed by a leaking vein deeper down. Spider veins usually respond to sclerotherapy, small injections that close them. Varicose veins are now mostly treated from the inside with heat or medical glue through a needle, and you walk out the same day.