Washington Vein & Body

Varicose Veins vs. Spider Veins

What is the Difference Between Varicose Veins and Spider Veins

beautiful legs with no varicose or spider veins


Although patients often use the terms Spider Veins and Varicose Veins interchangeably, these are two separate, albeit often related, issues with the health of your venous system. Spider Veins and Varicose Veins are similar in that they are both unsightly, but easily treatable. However this is where their similarities end.

Spider Veins

  • Cosmetic in nature, even though they can be symptomatic and, even, an indicator of more severe underlying vein problems.
  • Typically measure less than one millimeter in diameter, and unless clustered together, are typically not as noticeable to the naked eye as bulging varicose veins.
  • Thread-like, red, blue or purplish lines on the skin surface, often times resembling a bruise when they do occur in clusters together.
  • Treated primarily with sclerotherapy injections, the "gold standard" of care in the treatment of spider veins. A series of 3-6 treatments is typically required spaced 4-6 weeks apart.
  • Treatment considered cosmetic and not covered by insurance.
painful varicose and spider veins

Varicose Veins

  • Medical in nature, generally a symptom of a deeper, underlying issue in the venous system.
  • Large, dilated, bulging veins protruding above the level of the skin, often looking like bluish rope underneath the skin. These bulging veins tend to be associated with symptoms of pain, heaviness, swelling and aching in the leg.
  • Treated, after an initial consultation and ultrasound, via in-office endovenous radiofrequency ablation, sometimes in conjunction with ambulatory phlebectomy and endovenous chemical ablation, depending on the severity and source of the diseased veins.
  • Treatment is covered by insurance if the patient is symptomatic or had had complications, and the ultrasound shows venous reflux (backwards flow of blood in veins).

If you want to learn more about Spider Vein or Varicose Vein Treatment, Dr. Rothstein can provide you with additional information during your complimentary consultation. Contact us by calling our office or by filling out the form below.

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3 Convenient Locations:

2440 M St NW Suite 200 Washington, DC 20037
8200 Greensboro Dr Suite 210 McLean, VA 22102
850 E. Main Street Purcellville, VA 20132


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