Varicose and spider veins are related. They both result from weak or damaged vein valves. Vein valves inside veins help direct blood back to your heart. When they don’t function anymore, blood can pool in the veins causing varicose and spider veins. The smallest vessels are affected first. You can usually tell by looking at your skin which of these vein problems you have. Spider Veins Spider veins are small veins close to your skin surface. They look like small, jagged lines or starbursts. Spider veins can be red, blue or purple in appearance, but rarely bulge out from the skin’s surface. They also do not tend to cause discomfort or other symptoms. For the most part, these veins are a cosmetic concern. Spider veins tend to occur most commonly on the legs. The veins in the legs have to work against the pressure of your body weight and gravity to return blood to the heart. This makes them prone to weakness and damage. But spider veins can also occur other places, such as the face. This is especially common in people with fair complexions. Varicose Veins Varicose veins are larger than spider veins and can look blue, twisted and bulging. They are usually visible on the skin and may appear as cords or knots under the skin. While some people may have basically no other symptoms, it’s common to feel discomfort with varicose veins. Symptoms can include: Achiness, soreness or cramping Burning, tingling or itching Skin discoloration or changes in texture Skin ulcers Throbbing Tiredness or heaviness in the legs You can also have a duplex ultrasound to see how blood is moving through your veins. This is a special type of ultrasound doctors use to diagnose varicose veins and other blood vessel problems. Like spider veins, varicose veins most often occur on the legs and for the same reason. But varicose veins can also occur other places. Talk with your doctor if you are having symptoms or the appearance of your spider or varicose veins bothers you. There is no cure for the weak vein valves that lead to varicose and spider veins. But there are a variety of treatments available to correct both types of vein problems.