Spider veins are caused by the widening (dilation) of a small group of veins near the skin's surface. They often occur on the face and legs. They look like red or purple sunbursts or web patterns. They are more common in females.

Varicose veins are swollen or enlarged veins. They most often appear on the thighs, the backs and fronts of the calves, or near the ankles and feet. The veins have enlarged because of the vein valves getting weaker or damaged. They are found deeper in the skin than spider veins. They may be raised, bulging, or twisted. They are often blue, red, or flesh-colored. If you have varicose veins, your legs may feel tired, heavy, or achy after sitting or standing for a long time. They may feel better when you raise your legs.

Varicose veins can be serious because they may be painful. They may also be linked with health problems such as:

• Phlebitis. This is inflammation of the vein.
• Thromboses. This occurs when blood clots form in the enlarged vein.
• Venous stasis ulcers. An ulcer is formed when there isn't normal drainage in the enlarged vein.

The exact causes of varicose and spider veins are unknown. But pregnancy, heredity, obesity, standing for a long time, older age, heavy lifting, and hormonal changes may all be causes. If you are on birth control pills or taking hormonal treatment for menopause, you are also at risk.

Treatment depends on how bad the condition is. It may include one or more of the following options:

• Compression therapy. Wearing compression stockings can help ease symptoms.
• Sclerotherapy. A concentrated saline or specially developed sclerosing solution is injected into the spider or small varicose vein. The solution irritates the inside of the vein. Over time, the vein will collapse and visually fade. Healthier blood vessels located nearby absorb the blood flow of the collapsed vein.
• Ambulatory phlebectomy. The vein is removed using tiny holes (punctures) or cuts (incisions) along the path of the enlarged vein. Through these tiny holes, the surgeon uses a surgical hook to remove the varicose vein.
• Electrodesiccation. The veins are sealed using an electrical current.
• Laser surgery and intense pulsed light therapy (IPL). Abnormal veins are destroyed by high-intensity laser beams or intense pulsating light.
• Surgical ligation and stripping. The surgeon makes an incision in the skin and removes or ties off the blood vessel. This procedure is done for severe cases of varicose veins.
• Intravascular laser or radiofrequency ablation. A laser fiber or radiofrequency catheter is put into the abnormal vein. The vein is then sealed shut by thermal energy.

Possible complications include:

• Changes in skin color. Brownish splotches near the treated area may appear and may take several months (or even up to a year) to fade.
• Allergic reaction and scarring. Allergic reactions from the injected chemical solution, as well as skin injury, wounds, and lasting (permanent) scarring, may result.
• Telangiectatic matting. This reaction involves the appearance of fine, reddish blood vessels near the treated area. Treatment for this condition may require further injections.
• Blood clots. Treatment could cause blood clots in the veins.

People of any age may be candidates for sclerotherapy, but most are 30 to 60 years old. Spider veins are more common in females. Males do have spider veins. But they often don't think they're a cosmetic problem because the veins are often hidden by leg hair.

If you are pregnant or breastfeeding, you should postpone sclerotherapy treatment. It's not known how sclerosing solutions may affect breast milk.

The surgery may be done in any of these places:

• Surgeon's office
• Surgery center as an outpatient
• Hospital as an outpatient or inpatient

You may be given local anesthesia with I.V. (intravenous) sedation. You may have epidural or spinal anesthesia. Or you may have general anesthesia.

A compression bandage may be put on the treated area. You may be advised to wear support stockings for several days or longer. Follow any instructions your doctor gives you after the procedure. Know who to call if you have complications, concerns, or questions after the procedure.