Sclerotherapy vs. Endovenous Laser Therapy

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Suffering from spider veins or varicose veins? There are many vein treatments available and two of the most common are sclerotherapy and endovenous laser therapy (EVLT). Understanding the reasons why each may be beneficial for your situation starts with a diagnosis from a vein specialist and staying educated on your options.

What is Endovenous Laser Therapy (EVLT)?

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Endovenous laser therapy is a non-surgical approach to treating superficial venous insufficiency, which often causes varicose veins. Laser vein removal is a preferred treatment method for over 10 years, it’s highly regarded for treating large varicose veins and venous insufficiency.

EVLT involves inserting a laser fiber (which is less than 1mm in diameter) into the diseased vein. This is guided into the exact position by your doctor who uses an ultrasound to perform laser vein removal using real-time images of your vein.

Once in position, laser energy is emitted to heat the area. This action closes the vein so this diseased vein is no longer used to carry blood. Instead, healthy, fully-working veins will take over straight away, while the treated vein(s) is naturally reabsorbed into your body.
The number of treatments required will depend on how many veins need treating, but each procedure typically takes around 15 minutes to complete and only requires local anesthesia. Normal activities can be resumed straight afterward, too.

When is Endovenous Laser Therapy (EVLT) the Best Choice?

Doctors will often choose EVLT over sclerotherapy for:

  • Someone who’s afraid of needles
  • Spider veins that cannot be injected because they’re too small
  • A mass of tiny blood vessels
  • Someone who cannot have sclerotherapy due to the chemicals used

The Advantages of Laser Vein Removal

Sclerotherapy vs. Endovenous Laser Therapy: Everything You Need to Know
In recent years, technology has advanced to offer endovenous therapy for a number of conditions, including spider veins and varicose veins. The advantages this type of treatment offers include:

  • It’s a minimally invasive treatment that can be carried out in your doctor’s office without the need for a general anesthesia or an overnight stay.
  • There are few side effects involved. Some patients may feel a burning sensation on the skin afterward but this eases off gradually over the next day or so. Darker skin tones may notice some skin color changes. Furthermore, the risk of nerve damage or small or large blood clots are far less likely than after vein stripping surgery (another conventional treatment that’s available)
  • There’s no risk of scarring with laser vein removal treatments.
  • You can return to your daily activities quite quickly while avoiding strenuous exercise where possible.
  • Most patients experience instant relief from their symptoms.
  • There’s a high success rate for the procedure. One study even found a 100% success rate for one type of laser therapy treatment using an endovenous laser.

What is Sclerotherapy?

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Sclerotherapy is used as an effective treatment for spider veins and varicose veins, often being the primary choice for small-sized varicose veins.
This minimally invasive procedure involves injecting the vein with a solution (a sclerosant) which causes scarring to the lining of the blood vessel. As blood can no longer flow through this vein due to the clot these scars have created, it’s redirected to healthier veins. Over time, this disused vein is reabsorbed into your body via local tissue and will eventually fade away.

This process tends to take a few weeks, but some patients may need to wait a month or longer to see the best results. And in severe cases, a number of sclerotherapy procedures may need carrying out or a thicker sclerosant may be used.

When is Sclerotherapy Offered?

Sclerotherapy is often recommended for:

  • Someone with darker skin because some discoloration can be caused by lasers that emit light wavelengths
  • Someone with superficial spider veins because this is often a more effective, quicker, and less expensive procedure for small veins that are close to the surface of the skin. That’s why, in most cases, this is preferred for spider veins over varicose veins

This type of treatment is particularly beneficial when treating veins on the legs and hands, and it can also be used in conjunction with other treatments.

Advantages of Sclerotherapy Treatments:


For many years, sclerotherapy has been the go-to treatment for vein specialists, particularly in the treatment of spider veins. That’s because sclerotherapy offers a number of benefits, including:

  • It’s another minimally invasive procedure that requires no general anesthesia or an overnight stay in hospital.
  • It’s relatively safe with few potential side effects. Should a side effect arise, they tend to disappear in a few days or weeks. Rare complications include an allergic reaction to the chemical used, air bubbles, a blood clot, and inflammation.
  • It requires minimal preparation on your behalf. All you need to do is avoid shaving or applying any lotion to your legs a day before your treatment. You just need to wear loose clothing or shorts when you visit your local clinic for the procedure.
  • Little (if any) discomfort or pain during the procedure, which only lasts 30 minutes
  • It allows most patients to return to their everyday activities in less than a day, you only need to avoid strenuous activities for a while.
  • It boasts a great success rate – approximately 80-90%.

Endovenous Laser Therapy for Varicose Veins

As we’ve already seen, varicose veins can be treated with a laser vein removal treatment. And due to the specific approach of this treatment, one EVLT procedure is often more effective than multiple sessions of sclerotherapy. It’s also less painful than vein stripping and litigation and provides you with a shorter recovery time. Only a light sedative or local anesthetic is required to have this treatment.
Studies have demonstrated that this treatment is effective in around 94% of cases.

Sclerotherapy for Varicose Veins

As mentioned previously, in sclerotherapy a sclerosant is injected into your vein to cause scarring and clotting that kills off the vein so healthier veins are utilized instead.

To achieve these results, your doctor will elevate your leg so the blood drains out of the vein. They’ll then inject the chemical into the vein that’s causing problems. Once administered, pressure is applied to prevent any blood from flowing into the veins when you stand (this means you may need to maintain this pressure by wearing compressions stockings for a few days or weeks).

This is all carried out in our clinics, taking approximately 5-30 minutes depending on the size and number of varicose veins. Sometimes, there may be minimal pain when the injection is given, with the chemical causing a cramping or burning sensation for several minutes.

Catheter-Directed Foam Sclerotherapy

Newer techniques have also allowed us to advance this procedure to treat larger veins with a catheter. This involves using an ultrasound to direct the sclerosant and catheter to the target area. It allows specialists to treat larger veins that would have only been treatable with stripping or litigation (both of which involve surgery).

Sclerotherapy vs. Laser Vein Removal

As you can see, there are a lot of considerations to make when choosing the type of treatment you’re going to have for your spider or varicose veins. These considerations are also something you’ll want to discuss with your doctor as they’ll be able to advise whether sclerotherapy or laser therapy will be most effective for you when creating your personalized treatment plan.

Whether it’s varicose veins, spider veins, or venous ulcers, our clinics treat a variety of vein disease conditions. Varicose treatments take between 15-30 minutes depending on the number of veins affected. If you believe you are suffering from vein disease, contact us at 888.768.3467 to learn more about which treatment would work best for you.

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