Should I Have Sclerotherapy Or Laser Treatment for Spider Veins?


We often see patients in our clinic who are wondering what is the best treatment for spider veins?  Inevitably, this is a question about whether sclerotherapy or laser therapy for spider veins is best.  As you might expect, the answer isn’t so simple and the answer lies in the individual assessment of each patient.

To begin with, vein treatment is influenced by multiple factors, including what you are treating, the location, and how large the veins are.  However, before beginning any treatment, our vein doctors want to know if there is an underlying venous disorder.

Venous insufficiency is the number one cause of varicose and spider veins.  It is when the veins below the surface of our skin can no longer perform their circulatory duties well.  This can be due to several factors, however, the most important considerations are family history, age, and lifestyles that require longer periods of standing or sitting.  When symptoms are present including leg pain, swelling or heaviness, our vein specialists recommend a diagnostic ultrasound evaluation to rule out unhealthy circulation. In the presence of venous insufficiency, surface cosmetic treatments with either sclerotherapy or laser treatments are unlikely to be successful.  Instead, the vein specialists may recommend one of several minimally-invasive treatments to correct the underlying circulation first.

Treatment with Sclerotherapy: Sclerotherapy is a procedure that uses a medication, called a sclerosant, to collapse the targeted veins. This sclerosant can vary, however, reputable vein clinics will use polidocanol–the safest and effective choice at 0.25%-1% concentration depending on the size of the targeted vein.  The medication is injected into the unhealthy veins with direct visualization or in some cases with ultrasound or infra-red light. Over the next couple weeks (or months for larger veins) the veins will slowly be broken down and absorbed by your body. One treatment is expected to produce 50-60% improvement and many patients will require two or three sessions for complete elimination.

Treatment with Laser: Laser technology focuses a beam of energy on unhealthy spider veins that are absorbed by the blood vessel. This causes the vein to close down through heat and is gradually removed by the body over the course of several weeks.

Sclerotherapy vs Laser treatment

In general, our vein doctors prefer sclerotherapy for the treatment of spider veins due to the increased number of vein types that can be treated with sclerosant injections.  Sclerotherapy is effective in both small and larger sized veins, including reticular and varicose veins. Laser therapy is not as effective as sclerotherapy with larger reticular or varicose veins.  However, there are some situations where laser therapy is preferred. This includes spider veins on the face or feet where injection can be contra-indicated. Additionally, very fine veins that are difficult to inject will be suitable for laser treatment.  Ultimately, your vein doctor will plan treatments according to your individual anatomy and in some cases, both forms of treatment may be required.

How effective is Spider Vein treatment?
Spider vein treatment is quite effective with either sclerotherapy or laser treatment.  However, in patients with symptoms or rapidly evolving spider veins, a qualified vein specialist will consider underlying venous insufficiency before any cosmetic treatment.   We can think of venous insufficiency as being a leaky pipe underneath the surface of the skin. The overflow on this vein turns up on the skin as spider and varicose veins. Treating venous insufficiency first will help not only alleviate symptoms but also improve cosmetic results with sclerotherapy. Venous insufficiency is treated in modern vein clinics with minimally-invasive procedures.

Your vein doctor may recommend:

To schedule a consultation with an experienced spider vein specialist, get in touch with the Princeton Vascular Center today.  Our vein doctors are recognized leaders in the field of diagnosing and treating vein disease. For your convenience, the Princeton Vascular Center has multiple state-of-the-art facilities across NJ for the treatment of spider veins.

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