Choosing the Best Vein Treatment: Is VenaSeal or Sclerotherapy More Effective?

Choosing the right non-surgical treatment for varicose or spider veins isn’t always straightforward. At Charm Vascular Clinic, we often meet patients who are unsure which option fits their condition and lifestyle best. While both VenaSeal and sclerotherapy offer effective, minimally invasive solutions, their mechanisms, ideal candidates, and recovery profiles differ in key ways.

If you’ve ever looked down at your legs and wondered whether those veins are “just cosmetic” or something more — you’re not alone. The truth is, varicose veins often go deeper than they appear. Let’s break down the what, why, and how behind these two treatments so you can make an informed, confident decision.

What They Are & How They Work

Sclerotherapy

Sclerotherapy has long been a trusted method for treating spider veins, reticular veins, and small-to-medium varicose veins. It involves injecting a specialized solution, known as a sclerosant, directly into the targeted vein. The solution irritates the inner lining of the vein, causing it to collapse and seal shut. Over time, the body naturally absorbs the closed vein, rerouting blood through healthier vessels nearby.

There are two common forms:

• Liquid Sclerotherapy: Best suited for small spider veins.

• Foam Sclerotherapy: Mixed with air or gas to create a frothy texture, foam is better at filling larger vein segments and is often used under ultrasound guidance for enhanced precision.

What many people appreciate is its simplicity: no incisions, no anesthesia, and usually no downtime. But it's not just a cosmetic fix — sclerotherapy can also relieve symptoms like burning, itching, and aching in the legs, especially when spider veins are a sign of underlying venous insufficiency.

VenaSeal

VenaSeal represents a newer generation of treatment, using a medical-grade cyanoacrylate glue to seal varicose veins. Introduced as an alternative to heat-based techniques like Endovenous Laser Ablation (EVLA) and Radiofrequency Ablation (RFA), VenaSeal requires no thermal energy and no tumescent anesthesia, which makes it more comfortable for many patients.

The procedure is straightforward:

1. A tiny catheter is inserted into the target vein.

2. Small amounts of adhesive are dispensed along the length of the vein.

3. The vein seals shut almost immediately, and the catheter is removed.

Because VenaSeal works without heat, there’s minimal tissue trauma and virtually no bruising. For patients who fear needles or heat, this glue-based approach is often a game-changer.

Recovery & Convenience

One of the top reasons patients choose non-surgical vein treatments is convenience — and both options deliver, but in slightly different ways.

Sclerotherapy Recovery

After sclerotherapy, compression stockings are typically worn for 7 to 14 days, depending on the vein size and the doctor’s guidance. You can resume most normal activities the same day, including walking, working, and light household chores. However, it’s best to avoid:

• Heavy lifting

• Hot baths or saunas

• Direct sun exposure (to reduce pigmentation risk)

Some patients experience mild bruising, itching, or brownish discoloration, especially if veins are closer to the skin. These usually fade within weeks.

VenaSeal Recovery

VenaSeal requires no compression stockings, and most patients walk out of the clinic and continue with their day — whether it’s a business meeting, grocery shopping, or even light exercise. That’s why it’s a favorite among busy professionals, parents, and patients who can't afford downtime.

In clinical studies, VenaSeal patients reported less post-procedure pain and fewer activity limitations compared to those undergoing thermal ablation or foam sclerotherapy.

Effectiveness & Safety

When it comes to closing diseased veins, both treatments are highly effective — but again, in slightly different contexts.

Sclerotherapy Success

Sclerotherapy boasts a success rate of 50–80% per treated vein, with multiple sessions often needed to fully resolve spider vein clusters. It’s important to note that sclerotherapy treats the visible veins but does not always address deeper truncal reflux (blood flowing backward in major veins like the great saphenous vein), which may require more advanced interventions.

Side effects can include:

• Temporary discoloration or brown staining

• Matting (tiny new vessels forming at injection sites)

• Allergic reactions (rare)

• Inflammation or superficial phlebitis

It remains one of the most studied and trusted vein procedures worldwide.

VenaSeal Success

VenaSeal has shown a vein closure rate of over 94–99% at 6–12 months in major clinical trials. What’s more, the five-year data looks promising — with recanalization (re-opening of the vein) staying low, around 7–9%. That puts VenaSeal on par with thermal techniques like RFA and laser, but without the heat, pain, or multiple needle sticks.

Complications are rare but can include:

• Mild inflammation or phlebitis

• Hypersensitivity to the adhesive

• Deep vein thrombosis (extremely rare with proper screening)

For patients with significant truncal vein disease, VenaSeal provides a durable, long-lasting solution — and many of them report feeling better almost immediately.

Which Veins Are Ideal?

This is where the distinction matters most — because while both treatments are non-surgical, they’re optimized for different types of veins.

• Sclerotherapy is best for:

  • Spider veins (telangiectasias)

  • Reticular veins (blue-green veins beneath the skin)

  • Mild varicosities without reflux

  • Post-procedure clean-up after EVLA or RFA

• VenaSeal is best for:

  • Great or small saphenous veins with documented reflux

  • Large, rope-like varicose veins

  • Patients who can’t tolerate compression

  • Those seeking a “one-and-done” treatment option

At Charm Vascular Clinic, we often combine therapies — for example, using VenaSeal to close a main saphenous vein, followed by sclerotherapy weeks later to treat residual spider veins for a clean cosmetic finish.

Cost & Insurance

Let’s talk frankly about cost — because it’s often a deciding factor.

• Sclerotherapy is usually covered by insurance if the veins are causing pain, swelling, or other symptoms. However, purely cosmetic sclerotherapy is often paid out of pocket.

• VenaSeal, being newer and glue-based, is not always covered by Korean or international insurance plans. Patients may need to pay privately, though some plans have begun offering partial reimbursement when the treatment is medically necessary.

That said, VenaSeal’s long-term durability may make it more cost-effective in the long run, especially if it prevents repeat procedures.

Side-by-Side Summary

Choosing What’s Right for You

So how do you choose? Start with your clinical diagnosis, which includes an ultrasound scan to assess the extent and source of venous disease. At Charm Vascular Clinic, we always begin with this — because treating visible veins without understanding the root cause is like painting over a water stain without fixing the leak.

Here’s how we guide decisions:

• Have mostly cosmetic spider veins with no leg pain? → Sclerotherapy is likely ideal.

• Suffering from aching, swelling, heaviness, or visible bulging veins? → Consider VenaSeal with a duplex scan first.

• Have trouble tolerating compression or time off work? → VenaSeal offers quicker recovery.

• On a tight budget or cosmetic goal only? → Start with sclerotherapy and reassess.

Sometimes, we even recommend a combination approach — starting with VenaSeal for major veins, then fine-tuning the surface with sclerotherapy a few weeks later. Think of it as treating both the "root and the branches."

Final Take

To be honest, many patients don’t need to choose just one. What’s important is treating the right veins in the right way. At Charm Vascular Clinic, we believe in thorough diagnosis, clear communication, and tailoring each treatment to your personal lifestyle — not just your symptoms.

If you’re tired of hiding your legs, dealing with discomfort after long days, or unsure if those visible veins are “just cosmetic,” we’re here to help you get answers — and results.

Ready to Take the First Step?

• Schedule a vein consultation and ultrasound at Charm Vascular Clinic

• Get a personalized treatment plan from Dr. Insoo Park and our experienced vascular team

• Explore both VenaSeal and sclerotherapy as safe, minimally invasive options — with expert guidance every step of the way

You don’t need surgery to feel better — just the right plan, from the right clinic.

Let us help you get your legs, and your confidence, back.