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.