Does colour matter? Vein appearance and when to get checked

Spider veins are very common however they can be more prominent in certain individuals. Fortunately, they are simple enough to recognize and with this in mind, we’ve got some practical tips that will assist in checking out your spider veins and advise on what to do next.

What are veins and spider veins?

Spider veins are thought to arise as a result of tiny capillaries following a route of least resistance (which is close to the skin surface) as they grow through the dermis of the skin. They are believed to do this because their walls,which are made largely of collagen, are weakened to the extent that the pressure of blood in them is able to form bulges in the vessel wall and the capillaries basically grow in the direction of the bulge!

Spider veins may appear as a blue, purple or red network of tiny capillaries which are believed to be harmless3,4. They are superficial small blood vessels (capillaries) whose walls which are largely comprised of collagen, have become weakened and visible; they frequently occur on the lower legs3,5,6. They look a bit like spiders webs, hence the name, although their shape can vary from a star shape or a tree-like branching pattern.6 As well as being a distressing cosmetic problem they can sometimes be a sign of developing chronic venous problem3.

Even though spider veins tend to be particularly prevalent in women over the age of fifty, anyone can develop them.2 Risk factors include genetics, standing for long periods of time, wearing high heels or tight undergarments, weight gain, lack of exercise, hormone changes, injury, sun damage and age2,6.

The difference between spider veins and varicose is mostly about size; varicose veins are around 4-5 mm across whereas spider veins are less than 1mm across.2 Varicose veins can also appear more swollen.

Are spider veins a sign of other problems within the body?

Untreated venous problems such as varicose veins are not only about cosmetic appearance. They can lead to persistent pain and discomfort, bleeding of the veins, inflammation in the vein, and skin changes that have the potential to eventually lead to poor wound healing and leg ulcers6. Do not be afraid to see you doctor to answer any questions about their development and if and when they may require treatment.

Additional symptoms to report to your GP

An additional symptom to watch out for is the discolouration of the lower leg. Any changes in the colour of your lower leg and ankle skin, to red-brown, brown, or signs of white or grey scarring should also be reported to your doctor as this may signal underlying problems with the blood flow to your legs7,1,6. Furthermore, eczema appearing on the lower leg which is red, dry or itchy should not be ignored. These changes can be a sign of a circulatory problem characterized by the term ‘chronic venous insufficiency’.

Be aware if the skin is raised or there is an uneven texture underneath the spider veins as some tumours in the skin can take on the appearance of spider veins8. If you notice any changes in the skin around or under the spider veins, you should get them checked by your doctor.

Around half of the people with spider veins may go on to develop varicose veins with symptoms such as pain, cramps, burning, throbbing, itching or leg fatigue3. Treatment for spider veins can improve these symptoms, so you should not suffer in silence. Discuss these symptoms with your doctor in order to check they are not part of a more serious circulation problem.

Most spider veins are harmless but it is important to be aware they can sometimes be a sign of other changes within your body. Speak with your doctor or get a referral to a specialist for more information and an in-depth assessment if you recognize any of the other symptoms. Keeping fit with gentle exercise and maintaining a healthy diet will also help your circulation work effectively but it is important to put your feet up when you get a chance!

For more information on how to improve your vein and blood vessel health and how to avoid circulatory problems or tackling spider veins in general, but for more friendly advice have a look around our website or chat to one of our Nutrition Advisors.


1. Circulation foundation. The Vascular Charity Veins Accessed 05/03/2017 @
2. Goldman 2007 No More “Spider Veins.” Accessed 07/03/2017 @
3. NHS Choices Varicose veins last updated 09/07/2015 accessed 05/03/2017 @
4. Schwartz L. and Maxwell H. 2011 Sclerotherapy for lower limb telangiectasias. Cochrane Database of system reviews 12 : 1-44 accessed 05/03/2017 @
5. Thomson L 2016 Sclerotherapy of telangiectasias or spider veins in the lower limb: A review. Journal of Vascular Nursing p61-62.
6. Nicholls S.C. 2005. Sequelae of Untreated Venous Insufficiency. Seminars in Interventional Radiology 22(3): 162-168 accessed 07/03/2017 @!po=17.8571
7. NICE CG168 July 2013 Varicose veins: diagnosis and management. Information for the public accessed 05/03/2017 @
8. Oakley A 2014 Telangiectasia accessed 06/03/2017 @

Jaqui Walker

Jaqui Walker

She is a a General Practice Nurse with special interests in asthma, COPD, immunisations, cardiovascular disease and with a passion for health promotion and helping patients make positive life style changes.

She set up Vocalcord, my medical writing agency, 7 years ago and has been busy ever since undertaking a variety of projects including market research, meeting reports, landscape reports, articles for publications and patient information booklets