Small and very small superficial varicose veins, the so-called broken capillaries of the thighs and legs can be obliterated by the injection of a sclerosing solution through a very fine needle directly into their lumen. Even slightly larger varicose veins can be destroyed in the same manner through the injection of a more concentrated sclerosing solution. Large varicose veins are more difficult to treat with sclerotherapy and sometimes require surgical removal through a procedure called stripping. Lasers can be used for some types of leg veins, but in general they are slower, less effective, more painful, costlier and carry greater risk of scaring than sclerotherapy. We only use the laser in very limited and selected situations. Larger facial capillaries can also be treated with sclerotherapy, but smaller ones are best treated with a low power electric current or with a specialized laser.

Advantages
Injection of sclerosing solution is a quick, relatively inexpensive and virtually painless modality. The stripping operation can also give gratifying results. Lasers are slowly getting better but have a long way to go to replace sclerotherapy as the main treatment modality, especially on legs.

Disadvantages
The injection of the sclerosing solution into the very small capillaries requires great patience and skill on the part of the physician. Rarely, pigment deposition, ulceration and scarring can occur at an injection site. Stripping of the larger veins carries the usual surgical risks of an operation. Lasers can cause the veins to heat up and damages the inner lining, but can also cause skin burns and minor but sometimes unsightly scarring.