They creep up and down legs and thighs, around ankles and calves, but most of us think spider veins and varicose veins won't appear — if they appear at all — until we're older.

Much, much older.

Not so.

"It can happen at any age," says Dr. Craig Schwartz, with the Vein Centers for Excellence of Kansas City. "We've seen women in their 20s. I've even seen teenagers."

"Usually starts about age 20," says Dr. Neil Sadick of Sadick Aesthetic Surgery and Dermatology in New York.

But not to worry. asap asked Sadick and Schwartz the difference between spider and varicose veins, what causes them, and how they can be prevented or treated.

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SPIDER VS. VARICOSE

Sunburst or starbust-shaped veins that show over skin and have a purple or blue linear color are spider veins, Schwartz says. They're generally a cosmetic issue, and treatment isn't often considered a medical necessity, he said. They mostly appear on legs, but sometimes show up on the face too.

Large, bulging, dilated, ropey-looking veins are varicose veins, Schwartz says. They can lead to long-term clinical problems, like chronic swelling, skin changes, bleeding, clotting and infection.

The good news: Just because you have spider veins doesn't mean you're definitely going to develop varicose veins, Schwartz said.

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CAUSES

1. Genetics: The top cause, according to Schwartz. "If you've got those genes, you're going to develop them almost no matter what you do," he said.

2. Pregnancy: Hormonal changes, the increase in blood to support the baby causes veins to dilate and the weight of the baby on major blood vessels all contribute to spider and varicose veins, Schwartz says.

3. Trauma: Sometimes factors from years ago, such as sports we played in youth, will traumatize areas that show spider veins 10 years later, Schwartz said.

4. Hormonal influences: Sadick says the hormone estrogen has an effect.

5. Sitting or standing for long periods of time: It's tough on the legs to stand on your feet all day — as it is to sit at a desk the whole day long, Schwartz said.

"Blood tends to pool in your legs and it has a hard time getting out of there," he said. "As that pressure builds up it starts forcing that blood out little side branches and channels because that blood's got to get somewhere; it can't just stay there in your leg. It comes up to the surface it starts appearing as the dilated varicose veins or the superficial spider veins."

Sadick says it's just a myth, however, that crossing your legs causes spider and varicose veins.

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DO MEN GET THEM?

"It's not just a female thing," Schwartz says. "Men can absolutely get varicose veins. Obviously with men pregnancy is not the issue." For them, he says, family history is the first factor, while "occupations and activities" is the second.

Schwartz says about 85 percent of his patients are women; the rest are men. He adds that he doesn't see a lot of men for just spider veins. Sadick says nearly the same proportions of men and women get varicose veins.

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PREVENTION

Dr. Sadick offers three ways to keep spider and varicose veins away:

"Stay off the birth control pill, don't do a tremendous amount of high impact exercise, keep weight at a relatively lean level," Sadick said. "Those are things that can be helpful."

Another tip? Wear compression stockings if you're pregnant or see that you're developing spider or varicose veins.

"Wear support stockings during the day," Sadick says. "That will help decrease the number of veins that will occur. There are newer ones that are more fashionable they're not as thick."

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TREATMENT

Both doctors say there are minimally invasive ways to treat spider and varicose veins. All involve trying to get the veins to collapse and seal closed so the body can reabsorb them.

Spider:

— Laser treatment: A topical or superficial laser heats up and collapses the veins on the surface, Schwartz said.

— Sclerotherapy: A chemical is injected into the vein, creating an inflammation in the lining to get it to collapse, Schwartz said. Treats deeper veins.

Varicose:

Usually there's a bigger problem with the vein. Old-fashioned treatment was called vein stripping. "It was very traumatic. We don't do that anymore," Schwartz said.

Instead, doctors use laser closure, which seals the vein shut. The beam is run into the leg through a catheter to close off the vein.

"We're trying to divert away from this abnormal vein into the normal deep veins of the leg where we want it to go," Schwartz said.

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Caryn Rousseau is an asap reporter, based in Kansas City, Mo. She hopes she doesn't get spider veins.

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