What are the symptoms of reticular varicose veins?

Varicose veins in the legs are a common vascular condition caused by dysfunction in blood flow through veins and blood pooling. Many assume varicose veins appear in one form, but this isn’t true. While the common perception is of large, bulging veins visible under the skin, the condition, especially in early stages, may present other symptoms. Varicose veins can be classified based on appearance and size, location, extent of involvement or symptom severity. Reticular (or network) varicose veins are one type, categorized by appearance and size.

Types of Varicose Veins by Appearance and Size

Varicose veins are classified based on the appearance and size of affected veins as follows:

• Spider Veins: The mildest form of varicose veins, appearing as web-like, blue, red or purple veins with a diameter less than 1 mm visible under the skin. They are usually painless with possible mild symptoms like burning or itching around the veins and are primarily noted for the aesthetic issue they cause in the legs.

• Reticular (Network) Veins: Also called blue veins in a comprehensive review article reticular veins are more common in women and linked to aging, hormonal changes and genetic predisposition. They may have moderate severity and symptoms, appearing as branched or network-like veins in green, red or purple, slightly swollen and more prominent than spider veins with a diameter of 1–3 mm. Symptoms include heaviness, fatigue or muscle cramps in the calves.

• Trunk Veins: These exhibit more severe symptoms with bulging, prominent veins larger than 3 mm in diameter. Symptoms include pain, discomfort and risks of ulcers, bleeding, infection and embolism.

Differences Between Reticular and Spider Veins

Reticular veins, one type of varicose veins appear as small, raised, blue veins under the skin primarily in the legs. Approximately 80% of men and women aged 18–64 experience this type in their lifetime. Reticular veins are often confused with spider veins due to similarities but key differences help distinguish them:

• Vein Size: Reticular veins have a larger diameter (1–3 mm) compared to the very small, delicate spider veins (less than 1 mm).

• Color: Spider veins are typically red, blue or purple while reticular veins are usually blue or green.

• Prominence: Reticular veins are slightly raised and palpable under the skin, unlike the flat, non-prominent spider veins.

• Depth: Reticular veins are deeper than spider veins.

• Appearance: Spider veins resemble a spider web while reticular veins form a network or branched pattern.

• Location: Spider veins often appear on the face, thighs or ankles while reticular veins are commonly seen behind the legs around the thighs or knees and may connect to spider veins.

Causes of Reticular Varicose Veins

Although reticular veins are not fully understood the following factors likely contribute:

• Genetics: A family history of varicose veins is a significant factor.

• Gender: Women are more prone due to hormonal changes and pregnancy.

• Pregnancy: Hormonal changes and increased blood volume/pressure on veins during pregnancy can trigger varicose veins.

• Prolonged Standing or Sitting: Daily prolonged standing or sitting especially due to occupation causes blood pooling in leg veins leading to varicosity.

• Obesity and Overweight: Excess weight increases pressure on leg veins, predisposing them to varicosity. For more see How Are Obesity and Varicose Veins Related?

• Age: Aging weakens vein walls and valves, impairing blood flow and increasing inflammation and venous swelling.

• Chronic Constipation: Constipation and varicose veins are linked in two ways. Untreated chronic constipation besides causing hemorrhoids, increases pressure on leg veins leading to varicose veins.

Diagnosis of Reticular Varicose Veins

Reticular veins are typically diagnosed through a physical examination by a specialist. In some cases additional diagnostic methods like ultrasound may be needed. For more details see Methods for Diagnosing Varicose Veins.

Symptoms of Reticular Varicose Veins

Reticular veins may initially be asymptomatic. As vein diameter increases over time symptoms may include:

• Visible, raised blue veins under the skin.

• Heaviness and fatigue in the legs.

• Swelling and pain in the legs.

• Itching around varicose veins.

Treatment of Reticular Varicose Veins

Key treatments for reticular veins include:

• Laser Therapy

Uses laser beams to close and eliminate varicose veins, effective for reticular veins.

• Sclerotherapy

A chemical sclerosant is injected to block and eliminate varicose veins.

• Micro-Phlebectomy

Varicose veins are removed through tiny incisions, less invasive than surgery with fewer complications.

• Lifestyle Changes

Wearing compression stockings, regular exercise, a healthy diet, elevating legs several times daily and weight control significantly aid in prevention and symptom relief.

Conclusion

Reticular (network) varicose veins typically appearing as raised blue veins in the legs are accompanied by symptoms like pain, heaviness, swelling or itching. They differ from spider veins in color, vein diameter, prominence, depth and appearance. Various treatments exist, performed based on a varicose vein specialist’s diagnosis.

FAQs

What are reticular or network varicose veins?

They are visible veins under the skin, appearing blue or purple, less prominent than other varicose veins but potentially causing pain and discomfort.

Are reticular varicose veins dangerous?

They typically pose no significant risk but progression can lead to more severe varicose veins or blood clots increasing the risk of pulmonary embolism.

What is the diameter of reticular veins?

The diameter is usually between 1 and 4 mm.

Are reticular varicose veins painful?

They often cause no pain or issues but can be cosmetically unappealing and may occasionally bleed around the leg or ankle.