Should I be worried about the spider veins in my ankle ? I'm a 18 year old boy. (photos)

If you are concerned about family history, consider a visit to  a vein specialist who you can trust to determine if venous reflux is present. Healthy leg veins contain valves that open and close to help the blood return back to the heart. Using ultrasound to scan your legs, your physician will determine if venous reflux is present. Signs and symptoms of venous reflux are varicose veins, leg or ankle swelling, leg heaviness and fatigue, leg pain, aching or cramping, burning or itching of the skin among others. Best,

Thank you for the question! It's rather difficult to fully assess your situation based on the photo alone. I'd advise scheduling an in-person consultation with a vein specialist to determine whether you have vein insufficiency. You may have this condition if you happen to experience the following symptoms: cramps, swelling, itchy or burning sensation, heaviness in the legs. 
An in-person exam with a board-certified plastic surgeon is the best way to assess your needs and obtain expert medical advice. Best of luck!

The veins in the gaiter areas of the legs (iner leg, above ankle) indicate venous insufficiency and warrant Dopple ultrasound investigation. The least you can do is wear compression stockings and also use an aescin based topical (Omega Vein Cream) and an oral venotropic agent containing citrus bioflavonoids and Diosmin (Varicosmain) to promote vein health. This is a vein valve leakage problem, also known as venous insufficiency. In the U.S. we treat it with endovenous ablation procedures such as EVLT or RF Closure. 

Spider veins on the inside ankle (also called the medial malleolus) can come from a vein which is not working properly, also on the inside of the leg. This condition is called venous insufficiency and results in blood flowing backwards, settling around the ankle, causing spider veins. You should talk to your doctor about a trusted vein specialist of check out the American Board of Venous and Lymphatic Medicine to find someone. Treatment is typically with compression socks until such point as you have pain, swelling, cramping or discoloration.