Last updated on February 11, 2026 by Giorgia Guazzarotti
When you’re struggling with varicose veins or spider veins that make you think twice before wearing shorts or your legs ache after a long day, you want a solution that actually works, not just temporarily, but for real. The whole Varithena vs. Sclerotherapy debate matters because these are the two biggest treatment options for getting rid of unwanted veins, but they work in completely different ways and give you different results depending on what’s going on with your legs.
If you’re trying to figure out what is the best treatment for your vein, I’ve got the information for you. In this article, you’ll find out what actual studies say about how these treatments go, how many sessions you’ll actually need, what side effects accompany each, and which treatments lead to better long-term results for whatever type of problematic veins you’re dealing with.
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Varithena vs Sclerotherapy: What are they
sclerotherapy Has always existed. Your vein specialist inserts a small needle into the affected vein and injects a solution that irritates the vein wall, causing it to collapse and close. This may be a liquid or foam that the doctor mixes himself in the office by shaking the sclerosant with air. Blood flow is redirected to healthy veins while your body reabsorbs the dead vessel.
Varithena treatment There is also foam, but it is an FDA-approved treatment using specially formulated polidocanol endovenous microfoam that is pre-made rather than hand-mixed. The foam is infused through the catheter with ultrasound guidance so it can treat the vein long term. Research shows that the bubble size and consistency is far more consistent than doctor-mixed foam, which matters for how well it contacts the vein wall.
Benefits of these varicose vein treatments
Sclerotherapy lets you deal with spider veins and small varicose veins without traditional surgery or heat. Because it just uses a tiny needle, there’s no incision, no wound, and you can literally just go out and go about your day. The liquid or foam sclerosant works by chemically irritating the vein wall, meaning it can handle veins that are too small or twisted for laser or heat treatment to reach. You can treat a group of different veins in your legs in a single session, which is great if your spider veins are scattered. It’s been used for decades, so doctors know exactly how to do it and what to expect. For cosmetic concerns like web-like veins on your thighs or ankles, sclerotherapy gets rid of them without the cost or complexity of expensive treatments.
Varithena solves a different problem: It’s designed for those larger, deeper varicose veins that are really making you miserable with symptoms. The specialized microfoam can fill and treat the entire greater saphenous vein or accessory saphenous veins from one access point, which traditional sclerotherapy really can’t do effectively. Research shows that consistent bubble size means better contact with the vein wall and more complete healing.. Because it treats the entire vein system in a single session, you won’t be coming back again and again for months. For people suffering from chronic venous insufficiency where blood pools in poorly drained veins and causes daily discomfort, Varithena addresses the root problem rather than just the superficial veins. Catheter delivery with ultrasound guidance means your vein specialist can see exactly where the vein is going and treat veins deep under the skin that you can’t even see but are causing your symptoms.
Varithena vs. Sclerotherapy: Most Common Side Effects
Sclerotherapy:
- Bruise at injection site (essentially guaranteed)
- Tenderness or itching in the treated area for a few days
- Temporary dark spots on the treated vein that may last for months
- Inflammation of a vein (phlebitis) is less common, requiring anti-inflammatory medications
- Deep vein thrombosis – rare but possible.
- Neurological symptoms from nitrogen bubbles are a concern with room-air mixed foaming
Varithena: :
- Leg pain or discomfort (most common, usually mild)
- Injuries and body aches
difference of? Varithena uses less than 0.8% nitrogen along with oxygen and carbon dioxide that your body naturally processes through breathing, whereas traditional foam mixed with room air contains more nitrogen that sticks around longer. Both require compression stockings afterwards – about a week for sclerotherapy, two weeks for Verithena. Most people return to normal activities the next day.
RELATED: Does Sclerotherapy Hurt?
How many treatments do you need?
Sclerotherapy:
Different:
Designed for single session treatment. The Vanish-1 and Vanish-2 trials on 511 patients revealed:
- 86% achieved a successful response to one treatment
- Only 3.4% required truncal nerve retraction
- Results last up to one year with continued improvement in varicose vein symptoms
For visible varicosities of the greater saphenous vein causing pain and heaviness in the leg, one session is a game changer compared to multiple treatments over months.
Which minimally invasive treatment works better?
- For spider veins: Sclerotherapy wins. These small blood vessels respond very well to liquid or basic foam medication. No need for ultrasound guidance or catheters. Far more practical and cheaper.
- For small varicose veins (less than 3 mm): Sclerotherapy, especially foam, works well. These are too small for heat treatments like endovenous laser ablation, but large enough that foam beats liquid alone.
- For large varicose veins: Verithena is dominant here. It works similar to endovenous thermal ablation to close veins and has about 3 times better chance of closing veins than doctor-mixed foam.
recovery and getting b​return to life
Sclerotherapy: Most people bounce back incredibly fast. There is minimal downtime. You can resume your normal daily activities immediately after a session, which usually takes less than half an hour. You will need to wear compression stockings between treatments to allow your veins to heal and improve results, but other than that, life goes on. Just take it easy for a few days with really intense workouts or heavy lifting, and your body will thank you.
Varithena: Recovery here is absolutely manageable. Most people return to their normal routine the next day. You’ll wear compression socks for about two weeks, and it’s best to stay away from hot baths or very strenuous exercise for the first few weeks. This procedure takes a little longer than sclerotherapy because a catheter is used, but it’s still an outpatient treatment – ​​you’re in and out the same day.
Who is a good candidate for each treatment?
Sclerotherapy works for anyone with spider veins or small varicose veins who is not pregnant and does not have active deep vein thrombosis. Your medical history matters – your vein specialist will investigate.
Varithena is especially for people with problematic veins The greater saphenous vein causes symptoms – pain, heaviness, swelling, visible bulge in the leg. If you have chronic venous insufficiency that is affecting your quality of life, you are probably a good candidate.
bottom line
For spider veins and smaller ones, traditional sclerotherapy is proven, effective, and practical. For larger varicose veins that cause actual symptoms, Varithena gives more consistent results than doctor-mixed foam and matches thermal ablation methods in effectiveness – potentially in one session instead of several. The choice depends on what vein you’re dealing with, what symptoms you have, and what your vein specialist recommends based on an ultrasound-guided evaluation of your specific vein condition. Talk to someone who offers multiple treatment options and can honestly tell you which effective treatments are best suited for your situation.
