Vein problems are a common occurrence; varicose veins are thought to affect around 3 in 10 of us, while smaller thread and spider veins are even more frequent. But how can you spot the difference between them?

Varicose Veins

Out of the two, varicose veins are probably the more significant medical concern, though the majority of sufferers’ find their main issue in aesthetic appearance more than anything else. They are characterised by bulging (usually) blue veins that protrude out with a ‘bubbly’ appearance when near the surface.  In diameter they are normally around ¼ of an inch or more, and they can grow from their original size – causing pain and itching for sufferers. You might find your legs ache or throb regularly if you have varicose veins, in which circumstance it’s always advisable to speak to an expert.

Spider Veins

Usually less than 1mm in diameter, spider veins are more of a superficial problem. Unlike problematic varicose veins, they normally rest flat against the surface of the skin and very rarely protrude outwards or create a bump. If we think of varicose veins as rope-like, spider veins are more like a piece of thread and usually purple or red in colour.

How do they occur?

Each vein in our body has multiple one-way valves that transport blood to the places it needs to be. Varicose veins occur when one of these valves fails, causing a ‘reflux’ of blood in the channel which in turn renders it unfit for purpose. While you’ll often read multiple causes behind why varicose veins occur, unfortunately the deciding factor is normally genetics with more than half of those suffering noting a family history of the condition.

Spider veins, meanwhile, occur when blood vessels lose their elasticity and widen. Again genetic, there is very little one can do to prevent them appearing bar (rather obviously) keeping healthy and ensuring you look after yourself. Thread veins are normally completely superficial, but it’s important to note that they can sometimes be a sign of a deeper varicose vein causing pressure in your legs. This is why it’s absolutely crucial to work with the right specialists from the start to save yourself time, money and ensure you get the results you want.

What treatment methods are available?

The treatment you require will always depend on your own individual case but, fortunately, the vast majority are minimally-invasive with less downtime than ever before. The ‘Gold Standard’ for varicose veins according to NICE (National Institute for Health and Care Excellence) is an ablation therapy, available via The Private Clinic's website called EVLA, or Endovenous Laser Ablation. The method seals the faulty vein by concentrating laser energy at the problem area which, in turn, closes it and redirects the blood to a fully functioning vein elsewhere.  Varicose veins are damaged and unusable, meaning they no longer serve a purpose and are completely safe to remove (providing you work with a highly-experienced vascular surgeon). Other recommended methods include Sclereotherapy – which involves the injection of a liquid or foam chemical into the vein to destroy it – and Phlebectomy for smaller veins, in which tiny incisions are made through which the problem vein is removed.

Spider veins, meanwhile, are usually even simpler to treat – though again it’s always vital you go with a qualified expert in case they are a sign of anything more serious. Sclereotherapy can also be used for large thread veins, while something called Cutera CoolGlide is the best way for smaller veins. The laser method involves directing intense light directly at problem veins, causing the blood within them to coagulate and divert to healthy veins deeper below the surface.  


50,000 veins were treated in the UK in 2010, however all with varying methods and varying success rates. The key to treating any problem vein is always seeking help from a recognised clinic, regardless of how serious you believe it to be. While they have a lot of differences and certainly aren’t the same issue, even thread veins can be a direct sign of more deep-rooted vein issues, meaning the right experts will be able to tell you what treatment will be best for you. 

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