Sclerotherapy vs Laser Vein Therapy - Which is Best?

We are often asked by patients this type of question during the consultation - what is better, sclerotherapy or laser vein therapy? I turn the question around and ask my patient the following question: what is better, an SUV or a sports car? The typical response is, "it depends" on what you want to do with it. You don't drive a Corvette when its snowing and you don't taunt a Ferrari when you're in your SUV. Each vehicle serves its purpose. So is the case with... more

Most patients have a combination of spider veins, reticular veins, and varicose veins. The reason that patients develop these types of "extra" veins is that there is likely venous reflux of some sort. What is venous reflux? It means that the veins that usually let blood flow in one direction (back to the heart), are malfunctioning because the valves that allow blood to flow toward the heart, are actually allowing the blood to flow back down to the feet. This causes blood to... more

Sclerotherapy is considered the gold standard for the treatment of telangiectasias, the small spider veins visible in patients with leg vein disease.  Larger blue veins, and even varicose veins, may be amenable to treatment with sclerotherapy, but this often requires treatment with foamed solutions, and sometimes with the aide of ultrasound guidance.  Rarely, the very smallest veins are unsuccessfully treated with sclerotherapy and an Nd:YAG laser may be used to treat them. ... more

Often times this is not an either/or decision. These two modalities can be complementary. Furthermore, the use of surgery is still occasionally required. In any event, maintenance therapy will be required and it is important to understand and be prepared for this.

Vnus or evlt ( radiofrequency ablation or laser)  work best on varicose vein tributaries including the greater saphenous and lesser saphenous veins. if these dont completely shut down the varicosities then sclero therapy using a 1 to 3 % strength sotradecol foam therapy vis ultrasound guidance or microphlebectomy.

Treatment of spider, reticular, and varicose veins begins with a complete mapping of the vein network and evaluation of venous reflux. This should be done by a surgeon who is board certified in phlebology. I perform a combination of reticular, spider sclerotherapy and selective photothermolysis with laser.

Sclerotherapy is the injection of a solution into the vein to cause it to get irritated and turn into a tiny scar that is invisible and cannot carry blood. Sclerotherapy is the best way to treat most leg veins. However, the smallest, thinnest veins may be too small to treat with sclerotherapy. The only method to treat these little veins is with laser, which doesn't work for all vessels. Blood vessels on the legs are much more resistant to laser treatment that vessels on the face or... more

As stated by some of my colleagues, sclerotherapy is technically much more difficult but yields better, more reliable results for leg veins. Over the years, there have been many lasers and IPL devices that have been developed to try to compete with the efficacy of sclerotherapy...but to date, none have succeeded. Lasers are great for facial telangiectases (small dilated vessels) but due to several different reasons, they are not as effective for leg vessels. I hope you find this helpful. more

Sclerotherapy has a lot of advantages to laser vein treatments. It is more effective and cheaper. However, it is quite technique dependent. I have attended laser "courses" which are really courses masquarading as sales sessions. When they get to the vascular part when they are touting their laser, they seem to skip the sclerotherpy. When I query the physician about sclerotherapy , they will often mutter that the patient (client sometimes) should be referred to a dermatologist... more

Sclerotherapy is still considered the gold standard for vein treatments. Sclerotherapy is effective on small veins that are red called spider veins, on the green veins that are called reticular veins and the large veins called varicose veins. Lasers are effective on the tiny red veins and are an excellent choice on matting. Matting is a grouping of tiny veins sometimes caused by overzealous sclerotherapy. Generally speaking it takes more treatments with the laser than with... more

In an very independent study performed by one of this country's leading laser surgeons, Dr Tina Alster, she found in most patients that sclerotherapy was more efficient and less expensive than laser. Of course, very tiny matted vessels that are too small for the needle may respond just fine to certain long pulsed vascular lasers such as the NdYag. It is important to get global treeatment of any feeder vessels and not just spider veins. Some patients with severe disease may need ambulatory... more