A member asked:

Is evlt or sclerotherapy better for the treatment ofvaricose/spider veins?

12 doctors weighed in across 5 answers
Dr. Ted King answered

Different things: Endovenous thermal ablation (evlt, rf) have become the standard of care for treatment of straight veins below the surface of the skin. We call these the saphenous trunks. Most of varicose vein trouble comes from these veins not working. But for more visible, squiggley, and smaller veins, sclerotherapy is a better choice. Often the best treatment is a combination of the two.

Answered 12/9/2013

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RFa and EVLT: Sclerotherapy of spider veins using detergents polidocanol and sotradecol works well. The superficial axial veins gsv and ssv can be ablated using rfa and evlt. The ropy varicose veins can be removed with microphlebectomy methods, and all of the above can be completed as an office based procedure, without any sedation, under local anesthesia.

Answered 3/26/2013

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Dr. Steven Zimmet answered

Specializes in Aesthetic Medicine

Usually both: Spider veins are typically treated with sclerotherapy. If there are varicose veins, an ultrasound should be done to determine if poorly functioning underlying veins are present. If so, often evlt (endogenous laser) is used to treat them. In some cases ultrsound-guided sclerotherapy is done to the underlying veins. Surface varicose veins are treated with ambulatory phlebecomty and/or sclerotherapy.

Answered 2/16/2015

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Yes, kind of: Evlt, laser treatment, is generally used to treat the source or cause of the varicose veins....The vein with malfunctioning valves which leads to the formation of varicose vein. Sclerotherapy, the injection of a substance to close the vein, is used to treat both varicose veins and spider veins.

Answered 8/17/2013

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Dr. Joel Gotvald answered

Specializes in Vascular Surgery

May need both: Depends on your anatomy. If you have varicose veins, then u often also have venous insufficiency (will need ultrasound to prove) & this will might require a ELVT or radiofrequency ablation if a saphenous vein in your leg has failed. If you have no saphenous failure then EVLT not needed. Sclerotherapy is useful for spider veins & many cases of varicose, & can be useful for perforator reflux as well

Answered 5/6/2016

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