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Veins are compressible structures that return your blood that lacks oxygen to your heart.

In your lower legs, there are several ways your veins can appear atypically — reticular veins are one example. These veins are sized somewhere in the middle between spider and varicose veins.

While reticular veins are mostly a cosmetic concern, they can cause uncomfortable symptoms. Keep reading to find out why reticular veins form and how doctors treat them.

Reticular veins are noticeable veins that appear below your skin, but don’t usually protrude from your skin. Some of the most common characteristics of reticular veins include:

  • Color. Reticular veins are usually blue or purple in their appearance.
  • Location. Reticular veins typically appear on the backs of your knees, on your inner thighs, or near your ankles.
  • Symptoms. Reticular veins can cause pain or other discomforts in your lower legs.

While reticular veins don’t always cause symptoms, their appearance can be a cosmetic concern for some people. As a result, they may seek treatment, so the reticular veins are less noticeable.

Reticular veins come from a condition called vascular or venous insufficiency. Your veins have small “valves” that keep blood from flowing backward as your blood returns to your heart.

However, with vascular insufficiency, your blood leaks backward because of a concern with your valve function. Vascular insufficiency can create several vein types, including:

  • spider
  • varicose
  • reticular

Some risk factors for venous insufficiency include:

  • Family history. If you have a family history of vein concerns, you’re more likely to experience reticular veins and other vein concerns.
  • Occupations. Those who stand often for their job may experience reticular veins in higher percentages, such as teachers, nurses, or factory workers. Prolonged sitting at a computer can also increase the risks for reticular veins behind your knees.
  • Obesity. Obesity can increase abdominal pressure. This places extra pressure on your veins, impacting circulation.
  • Pregnancy. A vagina owner’s growing uterus can affect blood flow, increasing pressure on your veins.
  • Aging. People are more likely to experience venous insufficiency as they age.

Sometimes, you may have reticular veins with no known cause.

Reticular veins can be uncomfortable or painful, but they aren’t usually dangerous. However, they do indicate that blood isn’t flowing through your veins as well as it could be.

If you have reticular veins, you may wish to take steps to improve blood flow to your lower legs. These steps include:

  • elevating your legs, which encourages blood to flow back to your heart
  • not crossing your legs when seated, which can interfere with blood flow
  • wearing compression stockings (especially if you stand a lot for your occupation), which helps to reduce lower leg swelling and improve circulation
  • exercising regularly, which helps you manage your weight and encourages blood flow

If you start developing severe chronic venous insufficiency with many varicose veins and circulation concerns, this can be dangerous.

Isolated areas of reticular veins are not usually a health concern, they’re mostly a cosmetic one. If your reticular veins become especially painful, call your doctor.

Sclerotherapy is one of the most effective treatments for enlarged or painful reticular veins, according to a 2015 research review.

This treatment involves injecting material that destroys your reticular veins by damaging your veins’ lining. This causes your veins to collapse and become blocked.

A doctor will use an imaging tool called an ultrasound to identify which vein to inject. Other treatment options include:

  • Intense pulsed light treatment. Also known as IPL, this therapy is usually most effective on spider veins, but may help reticular veins. The therapy emits light to destroy your affected veins in a way that’s similar to laser therapy.
  • Laser therapy. Doctors use laser therapy in a way that’s similar to sclerotherapy. Laser therapy may be less painful than sclerotherapy. However, according to a 2017 research review, laser therapy can cause more side effects, such as skin spotting. The same research review showed that both IPL and laser therapy are usually more expensive than sclerotherapy.
  • Microphlebectomy. This treatment involves using medical instruments to extract your reticular veins in a minimally invasive way. This approach is more commonly used to remove varicose veins.
  • Thermocoagulation. This treatment involves using radiofrequency energy to damage and destroy your affected veins. A doctor will insert a small, thin needle that emits the radiofrequency that causes thermal damage to your reticular veins.

Sometimes, a doctor may recommend combining treatments for maximal effectiveness. It’s important for your doctor to fully destroy your affected veins. Otherwise, you could be at risk for blood clots.

The most immediate noticeable difference between reticular veins and spider veins are their sizes.

Reticular veins are larger (about 3 millimeters or fewer) than spider veins (usually 1 millimeter or fewer), according to a 2017 research review.

You can have both reticular veins and spider veins. Reticular veins can sometimes serve as “feeder” veins to spider veins.

You may see your reticular vein and several small patterns of spider veins extending from your reticular vein.

Reticular veins are smaller than varicose veins. Reticular veins also appear flatter and less twisted than varicose veins.

Another easy way to tell the difference between varicose and reticular veins is that you usually can’t feel reticular veins. However, varicose veins usually bulge above your skin, and you can feel them.

Here’s a picture gallery showing the difference between reticular veins, spider veins, and varicose veins.

Reticular veins are noticeable veins in your lower legs that you can’t feel. They can cause aching and other discomforts.

Several treatment approaches are available depending on your veins’ sizes and locations. If your veins are uncomfortable or make you feel self-conscious, talk with your doctor about diagnosis and treatment.