Which is better, Sclerotherapy or Endovenous Ablation?

Sclerotherapy vs. Endovenous Ablation

Varicose and spider veins aren’t just a cosmetic concern. They can cause discomfort, swelling, and even serious circulatory issues if left untreated. At California Vein & Vascular Centers, we offer advanced treatments, including sclerotherapy treatment and endovenous ablation, to help patients in Los Altos, Los Gatos, Morgan Hill, and Salinas find lasting relief. But which procedure is right for you?

What Is Sclerotherapy?

Sclerotherapy is a minimally invasive procedure designed to treat small varicose and spider veins. It involves injecting a sclerosing solution directly into the affected veins. This solution irritates the vein lining, causing it to collapse and seal shut. Over time, the treated vein is absorbed by the body, improving circulation and eliminating visible veins. This treatment is commonly used for:

• Small varicose veins
• Spider veins
• Cosmetic improvement of leg veins

What Is Endovenous Ablation?

Endovenous ablation, also known as endovenous laser ablation (EVLA) or radiofrequency ablation (RFA), is a more advanced treatment for larger varicose veins. A catheter is inserted into the affected vein, and heat energy (either laser or radiofrequency) is used to close the vein. Once sealed, blood is naturally rerouted to healthier veins, relieving symptoms like pain, swelling, and heaviness. This treatment is best for:

Larger varicose veins
Chronic venous insufficiency
Reducing leg pain and swelling

Side-by-Side Comparison

Not sure which treatment is for you? Here’s a chart to help you decide:

Feature	Sclerotherapy	Endovenous Ablation
Best for	Small varicose & spider veins	Large varicose veins & vein disease
How it works	Injects solution into the vein	Uses heat to close vein
Pain level	Minimal discomfort	Mild discomfort, local anesthesia used
Downtime	None—walk out and go about your day	Short recovery—most normal activities in 24 hours
Effectiveness	Great for small veins (may need multiple sessions)	Highly effective for large veins (usually one session)
Insurance coverage	Often considered cosmetic (self-pay)	Covered if medically necessary

The Pros and Cons of Each

Choosing between sclerotherapy treatment and endovenous ablation depends on several factors, including the severity of your vein condition, your cosmetic goals, and whether you need symptom relief. Each procedure has its own advantages and considerations, so it’s important to understand what to expect before making a decision. Below, we break down the pros and cons of each treatment to help you determine the best option for your needs.

Sclerotherapy Treatment

Why people love it:
- Quick, in-office procedure
- No anesthesia required
- Minimal discomfort and downtime
- Effective for spider veins and small varicose veins
What to consider:
- Might take multiple sessions for full results
- Doesn’t work on larger, deeper veins
- Temporary bruising or mild swelling can happen

Endovenous Ablation

Why people love it:
- Highly effective for large varicose veins
- Treats underlying vein disease, not just the symptoms
- Insurance often covers it if it’s medically necessary
- Minimally invasive with little downtime
What to consider:
- Requires local anesthesia (but still a simple procedure)
- Mild soreness or bruising for a few days afterward
- Not the best choice for spider veins

So, Which One’s Right for You?

It really depends on what you need. The best treatment depends on your vein size, symptoms, and medical history. If you have small spider veins or minor varicose veins, sclerotherapy may be the simplest and most effective solution. However, if you suffer from large, bulging varicose veins or chronic venous insufficiency, endovenous ablation may provide long-term relief.

At the end of the day, the best way to know for sure is to talk to an expert.

Talk to a Vein Specialist in the Bay Area

At California Vein & Vascular Centers, we specialize in cutting-edge vein treatments, providing expert care to patients in Los Altos, Los Gatos, Morgan Hill, and Salinas, CA. Our team, led by Dr. Hardeep S. Ahluwalia, is among the top vascular and endovascular surgeons in the nation. With a reputation for excellence, we rank #1 in California and among the top 5 in the nation for vein procedures.

Take the Next Step

If you’re experiencing vein-related discomfort or aesthetic concerns, schedule a consultation with California Vein & Vascular Centers today. Our board-certified specialists will assess your condition and recommend the best treatment plan for you. Schedule your consultation now!