Difference Between Sclerotherapy and Microsclerotherapy

posted in: Varicose Veins

In the UK, vascular complications, including varicose and thread veins, are common medical concerns.

Sclerotherapy, a treatment with half a century of clinical application, is a primary intervention for more prominent varicose veins. Whilst microsclerotherapy targets smaller spider or thread veins.

Difference Between Sclerotherapy and Microsclerotherapy - Vein Solutions



Sclerotherapy, derived from the Greek word “skleros”, meaning hard, is a medical procedure utilised to treat and eliminate malformation in blood vessels, primarily in the veins. This treatment traces its origins back to the 19th century. Over the decades, with the integration of modern science and refined techniques, its application expanded, cementing its position as a leading intervention for venous disorders.


The sclerosing agent is at the core of sclerotherapy, a solution specifically formulated to irritate the vessel lining. Upon injection into the affected vein, this agent induces an inflammatory response, causing the vein to contract, collapse, and eventually be reabsorbed by the body. This mechanism reroutes blood to healthier veins, leaving the treated vein to fade over time.


The primary target for sclerotherapy has traditionally been varicose veins. These enlarged, twisted veins, often visible under the skin’s surface, not only present cosmetic concerns but can also lead to symptoms like pain, heaviness, and swelling, affecting a patient’s overall health and quality of life. Besides varicose veins, sclerotherapy has successfully addressed other vascular abnormalities, including haemorrhoids and vascular malformations, underscoring its versatility and effectiveness in vascular medicine.



Microsclerotherapy, as the prefix ‘micro-‘ suggests, is a specialised subset of the broader sclerotherapy technique. While it adopts the fundamental principles of its parent procedure, microsclerotherapy distinguishes itself through a precision-focused approach explicitly tailored to treat finer vascular anomalies.


The mechanics of microsclerotherapy involve using finer needles than traditional sclerotherapy, enabling detailed and precise injections. The sclerosing solutions are specifically formulated for smaller veins, ensuring an optimal reaction in these delicate structures. The targeted veins undergo inflammation, collapse, and eventual reabsorption into the body, much like in standard sclerotherapy. However, the focus remains primarily on smaller, superficial veins close to the skin’s surface.


The mainstay of microsclerotherapy’s application is treating thread veins, often called spider veins. These are minute, web-like vascular patterns that frequently appear on the legs but can also manifest in other areas. Given their predominantly cosmetic impact, microsclerotherapy is a vital tool in aesthetic medicine, addressing the appearance and the minor vascular complications these veins might pose.


Sclerotherapy vs. Microsclerotherapy

The primary differentiation between sclerotherapy and microsclerotherapy hinges on the size of the target veins. Traditional sclerotherapy is customarily directed at more prominent, more pronounced varicose veins. In contrast, microsclerotherapy is designed to address smaller, superficial veins, such as spider or thread veins, often present close to the skin’s surface.

Procedure Distinctions:

There are distinct nuances when it comes to the equipment and methodologies employed in these two procedures:

Microsclerotherapy involves finer, more delicate needles that allow precise targeting, while traditional sclerotherapy may use a broader range of needle sizes.

Given the delicate nature of spider veins, the sclerosing solutions used in microsclerotherapy are often of different concentrations than those used for more prominent varicose veins.

While both procedures rely on the principle of causing vein inflammation, the exact technique and depth of injection might vary based on the vein’s size and location.

Recovery and Aftercare:

Post-treatment guidelines predominantly revolve around supporting the treated area, minimising discomfort, and ensuring optimal results:

Given its application on more prominent veins, traditional sclerotherapy may involve a more extended recovery period with pronounced bruising and a recommendation for compression stockings.

Microsclerotherapy usually has a quicker recovery timeframe due to the smaller vein size. However, patients may still be advised to wear compression stockings and avoid certain activities to reduce the risk of complications.


Both sclerotherapy and microsclerotherapy boast high success rates. However, the exact percentage of success might differ based on the severity of venous issues and individual patient factors.

Generally, patients report significant satisfaction with both treatments, mainly when cosmetic concerns are promptly addressed.

The outcomes of both treatments are typically long-lasting. The treated veins usually fade and are reabsorbed by the body. However, new veins may develop over time, requiring subsequent treatments. It’s worth noting that neither treatment halts the natural progression of venous disease or prevents new veins from appearing.


Potential Risks and Side Effects


Common Post-Treatment Effects:

Patients frequently experience some degree of bruising around the treated areas. This is a temporary effect and typically resolves over a few weeks.

The site of the injections can become red and slightly raised, resembling an insect bite. This usually subsides within a day or two.

Some discomfort or tenderness can be felt around the treated area, which typically fades within a few days.

Rare Complications and Their Management:

There’s a slight chance that a treated vein could become hyperpigmented, leaving a brownish stain on the skin. This generally fades over time but can persist in a few cases.

While rare, some patients might have an allergic reaction to the sclerosing agent. It’s crucial to inform the practitioner of known allergies before the procedure.

In very rare instances, the sclerosing agent can cause skin ulcers. These require prompt medical attention and can leave scars.

A rare but severe complication is the formation of a blood clot in the deep veins. This necessitates urgent medical intervention.

For Microsclerotherapy

Common Post-Treatment Effects:

Just like with traditional sclerotherapy, microsclerotherapy can lead to temporary skin darkening.

Matting is where tiny new blood vessels develop around the treated area. While it’s usually temporary, it can persist for a few months.

Small red bumps are expected at the injection sites but generally resolve quickly.

Rare Complications and Their Management:

Necrosis is rare in which skin tissue dies due to the sclerosing solution affecting the surrounding tissue. This needs to be managed by a medical professional and can leave a scar.

While uncommon, some patients might have an allergic reaction to the sclerosing agent used in microsclerotherapy. Immediate management is vital.

Occasionally, blood can become trapped in the treated vein, causing inflammation and discomfort. This might require drainage by a healthcare professional.

In conclusion, while sclerotherapy and microsclerotherapy are generally safe and effective procedures, potential risks and side effects exist. Patients must be informed, choose a reputable practitioner, and promptly address any concerns post-treatment.

Vein Solutions offers a comprehensive range of varicose vein treatment options encompassing both minimally-invasive techniques and conventional vascular surgical procedures to eradicate varicose veins.


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