Spider veins are small, thread-like veins that appear near the surface of the skin, often resembling red, blue, or purple webs. In some cases, yes they can hurt and spider veins can be more than just a visual nuisance. Let’s take a closer look at what causes spider veins, when they might become spider veins on legs painful, and what treatment options are available. Spider veins can appear on any part of the body, including hands and face, but they most commonly appear in the legs from increased pressure and decreased blood flow. If you have noticed tiny, colorful, red veins on your legs, they are probably spider veins or telangiectasia.