Sclerotherapy is the injection of a solution into the vein (we use Sotradecol which is an FDA approved drug for this therapy) that causes the vein to “sclerose” or clot off, becoming permanently occluded.  In our practice this therapy is used for veins too small to remove by phlebectomy and too large to treat comfortably with the topical laser.  The procedure is associated with minimal discomfort as a very small needle is used and the sclerosing solution injection is painless.  We prefer not to use this technique for treating “spider veins” as there is risk of developing hyperpigmentation at the treatment site.

Topical or superficial laser therapy uses a special laser (different from the laser used for saphenous vein ablation) to treat small superficial veins called telangiectatic varices, better known as “spider veins”.  A special, safely formulated, anesthetic cream is applied to the skin an hour or so before the treatment.  The laser is then aimed at the lesions and the small veins are coagulated beneath the skin.  The laser we use for this delivers almost all of its energy beneath the skin and there is little risk of depigmentation even in deeply pigmented individuals as the laser energy is not absorbed by the skin pigment.