Laser vs. Sclerotherapy: Which Varicose Vein Treatment Works Better?

You’ve been dealing with those bulging veins on your legs for months now. Maybe longer.

They’re not just sitting there looking unsightly. They ache by the end of the day. Your legs feel heavy. You’re tired of hiding them under pants even when it’s warm outside.

So you started researching varicose vein treatment options. Two names keep appearing everywhere: sclerotherapy and laser therapy. Both work. But they work differently.

Here’s what you really need to know. The question isn’t which treatment is universally “better.” It’s which one actually matches your veins, your lifestyle and your situation

Understanding Sclerotherapy

A vascular specialist injects a solution directly into your problem veins. This solution irritates the vein walls. They stick together and seal shut.

Blood reroutes to healthier veins nearby. Over the next few weeks, your body absorbs the closed vein. It gradually fades from view.

The appointment takes 30 to 45 minutes. You might feel slight burning when the solution goes in. Most people tolerate it well.

You’ll wear compression stockings for a while to help healing.

How Laser Treatment Works

Laser therapy uses focused light energy to close veins from inside.

For larger varicose veins, doctors use endovenous laser ablation. A thin laser fiber goes into the vein through a tiny puncture. The laser heats the walls. They collapse and seal shut.

For smaller spider veins, external laser treatment passes light through your skin to close the vein.

Both happen in the office with local anesthesia. Treatment takes 30 to 60 minutes.

Matching Treatment to Vein Size

Small Spider Veins

Sclerotherapy wins for tiny spider veins. Research shows it eliminates these in one or two sessions with less discomfort than laser.

Medium to Large Veins

Both handle medium veins well. Sclerotherapy works great for bulging veins. Laser excels for deeper ones.

The main saphenous vein running up your leg usually needs endovenous laser ablation for consistent results.

Recovery Expectations

Both treatments are minimally invasive with straightforward recovery.

After Sclerotherapy:

• Walk immediately (helps prevent clots)
• Wear compression stockings for 1 to 2 weeks
• Expect bruising and temporary brown spots
• Resume normal activities right away
• Avoid intense exercise for a few days

After Laser Treatment:

• Walk right after the procedure
• Wear compression stockings for about a week
• Some bruising and tightness along the vein
• Back to regular activities in a day or two
• Usually needs just one session

Neither requires bed rest.

Side Effects You Should Know About

Both treatments are safe, but side effects happen.

Sclerotherapy:

• Bruising and brown staining (2-12 weeks)
• Mild itching or swelling
• Small red marks at injection sites
• Allergic reaction 
• Skin sores or matting 
• Surface blood clots

Laser Treatment:

• Bruising and tightness along the vein
• Temporary numbness
• Skin discoloration (especially darker tones)
• Swelling around the treated area
• Nerve injury (rare, usually temporary)
• Deep vein clots (rare)

Most side effects resolve on their own. Serious complications are uncommon with experienced vascular specialists.

Cost and Insurance Coverage

Sclerotherapy costs less per session than laser treatment. But multiple sessions can make total costs similar.

Most insurance covers varicose vein treatment when medically necessary. That means veins causing pain, swelling or health problems.

Purely cosmetic treatment usually means paying out of pocket.

Choosing the Right Treatment for You

Sclerotherapy works better if you have:

• Darker skin (laser can cause discoloration)
• Small to medium veins
• Budget concerns

Laser treatment works better if you have:

• Larger varicose veins
• Needle phobia
• Allergies to sclerotherapy solutions

Pregnant women should wait until after delivery. If you’ve had blood clots before, your doctor needs careful evaluation.

Follow-Up Care

After sclerotherapy, you’ll return to see how veins are fading. With laser, follow-up includes an ultrasound about a week later.

Long-term success depends on compression stockings during long standing periods and adopting lifestyle changes such as regular exercise and a healthy weight.

Common Questions

“Will the veins come back?” Treated veins don’t reopen. But you can develop new ones elsewhere. About 20 to 30% of people see new veins within several years. Varicose vein prevention helps reduce this risk.

“What if I need those veins someday?” Your body has plenty of veins. Closing problem veins actually improves circulation.

“Is treatment worth it if they don’t hurt?” If veins cause pain or swelling, treatment makes medical sense. Cosmetic concerns are valid too.

Getting the Right Diagnosis

Proper evaluation comes before any decision. A good vascular center does a complete ultrasound assessment to see what’s happening below the surface.

At Prime Vascular Care, we offer both treatment options. We walk you through what each would look like for your specific veins.

The goal isn’t just removing visible veins. It’s improving how your legs feel and preventing complications.

Making Your Decision

The best treatment depends on your situation. Size, location and depth all matter.

Talk with a vascular specialist who can assess your case with an ultrasound and medical history. They’ll explain which approach gives you the best results.

Take the Next Step

Your legs deserve proper care when circulation issues develop.

Whether you choose injections, laser or a combination, work with someone who understands vascular conditions.

We’re here to answer questions and help figure out the best path forward. The hardest part is getting started. Once you do, the process is more manageable than you might think.