When we talk about varicose veins, we usually refer to enlarged, prominent veins; however, there is another type of varicose vein that is more superficial, often painless, but can be aesthetically disturbing: reticular varices, also known as subcutaneous varicose veins. In this article, we take a closer look at this common but often overlooked type of varicose vein.

What Are Reticular Varicose Veins?
Reticular varices are bluish-green veins, typically 1-3 mm in diameter, located just beneath the skin surface. They are thicker than capillaries but thinner than classic varicose veins. They are commonly seen behind the knees, around the ankles, and on the outer thighs.

What Are the Symptoms?

• Bluish, spider-web-like vein appearance

• Usually painless, but some individuals may experience burning, itching, or a feeling of fullness in the evenings

• Causes aesthetic discomfort

• Visibility increases after prolonged standing

Reticular varices may often indicate deeper venous insufficiency and should not be assessed solely by their appearance.

What Causes Them?

• Genetic predisposition

• Jobs requiring long periods of standing

• Hormonal changes (pregnancy, birth control pills, menopause)

• Excessive heat exposure (sauna, steam bath)

• Sedentary lifestyle

• Excess weight

Reticular varices sometimes appear alongside clusters of spider veins and act as feeder veins supplying them.

What Are the Treatment Methods?

1. Sclerotherapy (Injection Treatment):
   The most common method. A special medication is injected into the vein to close it. Compression stockings are used after the procedure.

2. Foam Sclerotherapy:
   Preferred for larger or more widespread reticular varices. The medication in foam form closes the vein more effectively.

3. Laser Treatment (Surface Laser):
   Laser light applied from the skin surface targets the veins. More suitable for very fine veins.

4. Combination of Transcutaneous Laser and Sclerotherapy:
   For better aesthetic results, laser and injection methods may be applied together.

What Should Be Considered After Treatment?

• Compression stockings should be worn for at least 7-10 days

• Avoid sun exposure (to prevent pigmentation)

• Avoid heavy exercise for the first 24-48 hours

• Walking is recommended after the procedure

Do Reticular Varices Go Away on Their Own?
No. These veins become more visible over time and may progress along with spider veins. Delaying treatment can lead to a more challenging aesthetic condition.

How Long Does Treatment Take?

• Each session lasts approximately 20-30 minutes

• Usually, 2-4 sessions are sufficient

• The treatment plan depends on the density and spread of the veins

Conclusion
Although reticular varices may seem “insignificant,” they can be a sign of a deeper venous problem in addition to aesthetic concerns. Even if painless, they should be treated. Modern sclerotherapy techniques make it possible to eliminate these veins. Remember, not every vein appearance is harmless—timely and proper intervention provides the most effective results.