Tiny veins (less than 1mm in diameter) visible on the skin surface are commonly called “spider veins”. The name “spider vein“ refers to the web-like appearance of these veins when clustered together.
Most of the time spider veins are asymptomatic (or minimally symptomatic) and are primarily of cosmetic concern.
Typically patients with spider veins can be reassured that their problem is not limb-threatening. Consideration can be given to cosmetic therapies such as injection sclerotherapy or transcutaneous laser.
Not infrequently, patients with spider veins will report localized symptoms of pain, itching, burning, or tenderness.
Isolated (or scattered) spider veins typically represent a localized problem at the level of the skin. In this situation underlying structural vein problems are unlikely, and it is not necessary to perform additional diagnostic testing.
In patients with extensive symptomatic spider veins (especially if larger varicose veins are also present) it is not unreasonable to perform duplex ultrasound testing on the leg(s) to evaluate for underlying structural vein problems, that may be the nidus of the patient’s symptoms.