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Spider and Varicose Veins (Telangiectasia)

Spider veins and varicose veins are common conditions that happen when the valves in your veins don’t work properly.

Arteries bring blood out into your body, and veins carry it back to your heart.

Veins have valves, or flaps, that open and close to allow blood to move forward. If the valves become weak or damaged, they can let blood flow backward, which can cause swelling, bulging, and other symptoms.

At the Vein Center at the UPMC Heart and Vascular Institute, our experts specialize in treating spider veins and varicose veins with the latest technology.

Contact the UPMC Heart and Vascular Institute

To request an appointment, contact the UPMC Heart and Vascular Institute:

You can also schedule an appointment online with the Varicose Vein and Spider Vein Virtual Care Center.

Learn More at UPMC Health Beat

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What are Spider Veins?

Spider veins (telangiectasia) are a small type of varicose veins that are cosmetic in nature. They usually appear as red or blue webs close to the skin, but do not cause other physical symptoms.

What are Varicose Veins?

Varicose veins are large, bulging veins that can cause cosmetic changes and physical symptoms in the legs.

What is Pelvic Congestion?

Pelvic congestion is identifiable pain or heaviness in the pelvis or genital area that is caused by varicose veins in the pelvic region. Symptoms are usually chronic and can be worse just before or during menstruation.

Who is at risk?

Varicose veins can affect anyone, but they are more common in women, especially women who have had children. Other risk factors include:

  • Family history of varicose veins
  • Being on your feet a lot
  • Obesity
  • History of a blood clot
  • Trauma to your leg
  • Older age
  • Pregnancy
  • Sitting with your legs in a dependent position (dangling your legs)

Spider and Varicose Veins Symptoms & Diagnosis

Symptoms of spider veins

Spider veins appear closer to the skin, usually on the face or legs, and tend to be red, blue, or purple. They may look like spider webs or tree branches.

Symptoms of varicose veins

Varicose veins are large, swollen, twisted veins that can also cause symptoms like:

  • Aching
  • Swelling
  • Heaviness or tiredness in the legs
  • Itching
  • Tenderness
  • Brown skin discoloration
  • Ulcers or wounds

Symptoms of pelvic congestion

Pelvic congestion can cause:

  • Pain or heaviness in the pelvis and genital area, which can be chronic
  • Symptoms that get worse before or during menstruation

Diagnosing spider and varicose veins

To diagnose spider or varicose veins, your doctor will begin by giving you a physical exam. In some cases, this exam may be all your doctor needs to diagnose your varicose veins.

Your doctor may also use duplex ultrasound to evaluate the size of the vein and how well they are functioning. A duplex ultrasound uses traditional ultrasound images combined with Doppler ultrasound-derived flow information.

  • Traditional ultrasound uses sound waves that bounce off tissues to create images.
  • Doppler ultrasound records sound waves reflecting off moving objects, such as blood, which can be used to measure its speed and flow direction.

Spider and Varicose Vein Treatment

The Vein Center at the UPMC Heart and Vascular Institute offers the latest treatments for spider and varicose veins. Your treatment will depend on the type, symptoms, and severity of your condition.


Compression stockings generally help symptoms from varicose veins and are often required as a first step in the treatment of venous disorders. A short period of compression is usually required after any venous treatment as well.


Anticoagulation (blood thinner) therapy is used to treat blood clots and deep vein thrombosis. The duration of treatment depends on the case.


  • Polidocanol is an FDA-approved medication administered as sclerotherapy — a series of injections. This may help close and remove spider and varicose veins. Performed as an outpatient procedure, doctors use a very small needle to deliver this therapy.
  • Ultrasound-guided sclerotherapy uses injections to close veins that are too large or deep for regular injections.

Endovenous ablation

Endovenous ablation is an outpatient procedure that uses a catheter and thermal (heat) energy to safely close the vein.

Venous recanalization

Venous recanalization is a catheter-based procedure that opens narrow or blocked veins using a balloon and stent.

Venous embolization

Venous embolization is used to treat pelvic congestion and stops blood flow to problematic veins in the pelvis or abdomen. During the procedure, a surgeon inserts a catheter and uses a coil to safely block the flow of blood and close off the vein.


In severe cases, veins may be removed surgically.

Treatment Side Effects

Patients may experience the following side effects from these treatments.

  • With sclerotherapy – tenderness, redness, or hard lumps at the injection site and along the veins.
  • With endovenous ablation – a pulling sensation along the vein, tenderness along the vein.
  • With surgery – superficial nerve damage, which may cause small areas of numbness of the skin; this does not cause any functional impairment.
  • Bruising, scabbing, leg swelling, or rarely, small ulcers.
  • Hemosiderin staining, or a light brown discoloration of the skin over the treated vein that results from iron in the red blood cells moving into the skin as your body resorbs the treated vein. This typically fades over time, but may take several months to a year.
  • Matting, or a small cluster of thin, red spider veins in very close proximity to each sclerotherapy site. This may not completely resolve over time.
  • There is a very small risk of deep vein thrombosis with any vein treatment. 

Learn More at UPMC Health Beat

Follow the beat for a healthier life. Check out these posts from UPMC Health Beat: