Leg Veins: spider veins & small vascular changes

Leg Varicose Veins.jpg

Visible leg veins, often appearing as red, blue, or purple thread-like lines, are a common cosmetic concern for many adults. These small veins—known as spider veins (telangiectasias) and reticular veins—are typically less than 3 mm in diameter and most often appear on the thighs, calves, or ankles.

what causes small leg veins?

Several factors can contribute to the development of spider veins and reticular veins:

  • Genetics: Family history of visible veins or varicose veins increases your risk.

  • Hormonal changes: Pregnancy, menopause, or oral contraceptive use can promote vein dilation, making spider veins more common in women.

  • Prolonged standing or sitting: Occupations or lifestyles that keep you on your feet or seated for long periods can increase venous pressure in the legs.

  • Sun exposure: Chronic sun damage can thin the skin and make blood vessels more fragile, especially near the ankles.

  • Trauma or surgery: Local injury or previous surgical procedures may trigger new vessel formation.

  • Venous hypertension: Deeper, unseen veins can increase pressure and contribute to the appearance of spider veins.

Vascular matting

Fine pink or red networks of tiny vessels—can also develop spontaneously or after treatments like sclerotherapy or laser, influenced by hormones, local inflammation, or incomplete treatment of feeder veins.

when should you seek further assessment?

While most small leg veins are harmless and mainly a cosmetic issue, extensive matting or symptoms such as aching, swelling, or the presence of larger varicose veins may indicate underlying venous insufficiency. In these cases, further assessment with ultrasound and referral to a vascular surgeon may be recommended.

laser TREATMENT for small LEG VEINS 

For small, superficial leg veins, dermatologists commonly use the longer wavelength Nd:YAG laser (1064 nm)—such as the GentleMax Pro®—to target and treat visible vessels. This vascular laser penetrates deeply enough to treat both red and blue veins up to 3 mm in diameter.

Treatment with a Long-Pulsed Nd:YAG laser can be uncomfortable but with the GentleMax® Laser a cryogen (cold) spray is incorporated into the device to increase patient comfort. 

For redder looking vessels that are more ‘matted’ then a vascular laser may be used such as the V-Beam Perfecta.

What to Expect?

  • Sessions last 15–30 minutes and use a cooling system to protect your skin.

  • You may feel a mild snapping or warmth during treatment.

  • Some redness, swelling, or bruising is common and usually settles within days.

  • Treated veins may darken before fading over several weeks.

Most patients require 2–4 sessions for optimal results. Sun protection before and after treatment is important to minimise the risk of pigmentation changes.

 

Why see Dr Liz dawes-higgs for leg vein treatment? 

Dermatologists are trained to assess the type and depth of your leg veins, select the safest and most effective treatment, and manage any side effects. If larger veins or symptoms are present, they can recommend further investigation or referral to a vascular specialist.

Book a consultation with Dr Liz at Northern Sydney Dermatology & Laser (or ring (02) 9958 1555) for a personalised assessment and treatment plan tailored to your skin and vein type. 

This page is for general information only and does not replace individual medical advice. For personalised care, please book a consultation.