Sclerotherapy vs Laser Vein Therapy - Which is Best?

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 pool in the veins under pressure and create "varicose veins" and "spider veins."

Therefore, the optimal treatment for the different types of veins that form on your legs depends on the diagnosis or evaluation of the deeper veins (with a duplex ultrasound), to evaluate the health of the deeper veins which give rise to the smaller veins (varicose and spider veins). If this is not done, and the root cause of your veins are not treated appropriately, you are destined to have failure of therapy.

Far too often, I have seen patients have multiple treatments of sclero or laser, etc. If you want to avoid having the same treatment over and over, my advice is to see someone who uses all of the available technology that treat your veins appropriately and effectively.

First and foremost, see a vein specialist for an evaluation to best answer your question specifically for you. If you have spider veins and varicose veins showing, you will most likely require sclerotherapy, a laser or radiofrequency ablation and possibly a ambulatory phlebectomy for best results. The evaluation should determine if your situation is medical or cosmetic, and you and your doctor can develop a plan from there. Best of luck!

For Spider veins below the knee sclerotherapy injection is recommended and also for varicose veins regardless of location. For Spider veins from the knee to the waist either sclerotherapy or Laser works well, above the waist I prefer the laser. For extensive vericose veins with reflux (diagnosed on ultrasound) there are several ways to treat including intravascular laser. All of these procedures can be performed in the office.

Without examining you in person, it is difficult to say which treatment is best as they both work exceptionally well in different situations. I would suggest that you visit a board certified dermatologist who has special training in vein treatments. I would advise that you visit an expert to ensure a safe and effective treatment. In many cases, a combination of sclerotherapy and laser treatments may be used for the best possible results.

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.

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.

Hello,
Thank you for your kind question.
When speaking about venous problems, there is a whole plan that should be respected to establish the treatment plan. This includes, first of all and the most important, a thorough and detailed Doppler-ultrasound scan performed by a highly specialised and experienced ultrasonographer to chace each vein and establish its root, content (if there are clots or not), diameter, the venous wall size and the veins relation to the skin and the deep venous system. Based on these criterias we may establish yhe best treatment plan and the best combination of methods to treat your case, do it is a plan that is tailored according to each case apart. The treatments could vary, from endovenous lasers used to treat main trunks and perforators, micro-phlebectomies used to treat big bramches, ultrasound-guided foam sclerotherapy used to treat the smaller branches (that foes not deserve to be treated with the phlebectomies), and microsclerotherapy for cosmetic spider veins anly after treating the main roots in the order I mentioned before. So there is no GOLDEN CHOICE that works for all cases, but there is a plan dobe for each case apart.
Once varicose veins are CORRECTLY TREATED, the recurrence rate is no more tgan 3%, but if the treatment is done without the correct and deep understanding of the disease and the deep understanding of each treatment method then the recurrence could be as high as 85%.
Hope I answered your question.
With kind regards:
Dr. Omar Abu-Bakr
Consultant Venous Surgeon and Consultant Phlebologist - Whitele Clinics London

Thank you for the question! In my practice, I offer sclerotherapy, endovenous laser ablation, Clariven treatment, and microphlebectomy to treat varicose and spider veins. It's not a matter of one treatment being better than the other. Rather, the choice of treatment will depend on a size and location of your veins.  
In recent years, endovenous laser ablation (EVLA) has replaced traditional surgical method of treating varicose veins. This procedure uses laser to heat the veins instead of surgically removing them. The heat produces a steam bubble inside the vein, which destroys the vein walls, causing the affected vein to collapse. The body, in turn, naturally absorbs the dead tissue. 
Sclerotherapy tends to be one of the most popular and widely-used treatments these days. It uses a sclerosing solution that causes the vein to shrink. Usually, sclerotherapy takes only 1 to 2 sessions to achieve fading of the undesirable veins.  
Microphlebectomy is ideally suited to treat superficial bulging veins that are too large for sclerotherapy.  In the course of this treatment, I will make tiny incisions as small as 1mm to remove an undesirable vein.  He will then insert a small phlebectomy hook to extract the vein through the puncture.  Only a small section of the vein needs to be eliminated because the remaining portion of the vein will clot off and gradually fade from view. 
Clarivein is a minimally-invasive procedure that utilizes a thin infusion catheter clinically proven to deliver faster results and guarantee up to 74% less pain than most other peripheral vascular treatments. 
An in-person exam with a board-certified plastic surgeon would be the best way to assess your needs and obtain expert medical advice. Best of luck! 

Generally speaking leg veins are best treated with sclerotherapy or injections of Asclera.  Some fine tiny veins may need the V-Beam laser as well.  Whichever veins I can inject with a tiny needle usually do better with injections but the laser may be needed for areas of matting. Please consult an expert in leg veins for the best cosmetic treatment results.  Best. Dr. Green

Unsightly veins on the legs or on face can be easily treated—and eliminated. These blood vessels are triggered over time by a number of factors: Genetics, hormonal changes(as during pregnancy or menopause—or if you’re taking birth control pills or other hormones), excess weight, pressure and repetition associated with crossing legs when sitting and aging. We can treat these veins with one, or a mix, of these treatments—based on what’s right for your particular veins.Sclerotherapy: We will inject a liquid solution directly into the vein. The solution irritates the lining of the veins, causing them to seal shut. This stops the flow of blood, forcing blood to be rerouted to healthier veins. The result: the vein is reabsorbed into the body and fades within several weeks.Typically 10 to 40 veins can be treated in one session and sometimes the same vein needs to be treated more than once to get long-term results. Follow-up sessions are required to treat additional veins.Laser treatment: A laser beam is targeted at the blood vessel and the heat from the laser coagulates the blood inside, causing it to collapse and seal up—without damaging nearby skin, vessels, or tissue. Over several weeks, the vein will shrink and disappear. One to five sessions, spaced four weeks apart, is typically required.