Microphlebectomy
The vein is removed The skin is numbed, then a series of nicks a few millimetres wide are made along the vein. A small hook lifts it out in short lengths. The nicks are taped, not stitched.
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Microphlebectomy vs Sclerotherapy
Microphlebectomy is better for a bulging vein you can see and feel. The vein is pulled out through nicks so small they need no stitches, and the bulge is gone that day. Sclerotherapy is better for spider veins and small surface veins. It is an injection, repeated over a few visits, and the vein fades over weeks. Vein size decides, and both are usually done after the larger vein feeding them has been closed.
At a glance
| The difference | Microphlebectomy | Sclerotherapy |
|---|---|---|
| What it feels like | Numbing shots, then tugging | Stinging, then a brief cramp |
| How soon you see a result | The same day | Weeks to a few months |
| Downtime | Back to desk work in a day or two | None, and walking is encouraged |
| Cost and insurance | One fee per session, often covered | Priced per session, and it is a course |
Sclerotherapy
Side by side
The differences that matter
What actually happens
Microphlebectomy
The vein is removed
The skin is numbed, then a series of nicks a few millimetres wide are made along the vein. A small hook lifts it out in short lengths. The nicks are taped, not stitched.
Sclerotherapy
The vein is sealed and absorbed
A liquid or foam is injected into the vein. It irritates the lining so the vein swells shut, and your body clears it over the following weeks.
Which veins it is for
Microphlebectomy
Ropey veins standing above the skin
Wide, twisting branch veins on the calf or thigh, roughly the width of a finger or more.
Sclerotherapy
Spider veins and small varicose veins
Fine red and purple lines, and small ropey veins close to the surface.
What it feels like
Microphlebectomy
Numbing shots, then tugging
The numbing stings. After that you feel pulling and pressure rather than pain.
Sclerotherapy
Stinging, then a brief cramp
Each injection stings for a second. Some solutions cause a short cramping ache in the leg.
How soon you see a result
Microphlebectomy
The same day
The bulge is gone as soon as the vein is out. Bruising then hides the result for two to three weeks.
Sclerotherapy
Weeks to a few months
Treated veins darken first, then fade. The final look takes a few months.
How many visits
Microphlebectomy
Usually one per area
Long or widespread veins may be split across two sessions.
Sclerotherapy
Usually two to four
Spaced a few weeks apart. Large clusters take more.
Downtime
Microphlebectomy
Back to desk work in a day or two
Compression stockings for a week or two. Walking is encouraged. No heavy lifting or hard exercise for a few days.
Sclerotherapy
None, and walking is encouraged
Stockings for a week or two. Skip the gym and long standing for a day.
The main downside
Microphlebectomy
Bruising, and tiny dots that fade slowly
Heavy bruising for two to three weeks is normal. Each nick leaves a small pale mark that usually fades to nothing, though skin that scars easily may keep them. A patch of numb skin can last months.
Sclerotherapy
Brown staining and new tiny veins
A brown line along the treated vein can last months. A blush of new tiny vessels can appear nearby. Both usually fade, but not always.
Does the vein come back
Microphlebectomy
Not that vein
It has been removed, so there is nothing left to reopen. New veins can still form elsewhere.
Sclerotherapy
Sometimes
An injected vein can reopen and refill, especially a large one. Touch-up injections are common.
Cost and insurance
Microphlebectomy
One fee per session, often covered
Covered more often when the vein aches, swells or bleeds.
Sclerotherapy
Priced per session, and it is a course
The at-home or drugstore version
Microphlebectomy
There is no home version
Nothing sold to the public removes a vein. Skin is broken and a vessel is taken out, which needs sterile conditions and anaesthetic.
Sclerotherapy
Stockings and vein creams
Compression stockings ease aching and swelling but remove nothing. Creams cannot reach a vein. Handheld "vein removal" pens act on the skin surface only and can leave marks.
Who each suits
Microphlebectomy
- Best for — A vein you can feel, that bulges when you stand.
- The mindset — You want it gone now and will accept a few weeks of bruising.
Sclerotherapy
- Best for — Veins you can see but not feel.
- The mindset — You are treating the look of your legs across a few visits.
What neither one does
How it works, illustrated
Sclerotherapy
Before you book
More photographs
Sclerotherapy
Common questions
Questions Patients Ask
Which is better, microphlebectomy or sclerotherapy?
It depends on the size of the vein. A vein you can feel bulging is better removed. Spider veins and small surface veins are better injected.
Does microphlebectomy leave scars?
The nicks are a few millimetres wide and are taped rather than stitched. Most fade to marks you have to look for. Skin that scars or darkens easily is more likely to keep them.
How long is the bruising after microphlebectomy?
Two to three weeks is typical, and it can look worse before it looks better. The bulge itself is gone from day one.
Can I have both treatments?
Yes, and many people do. Bulging branch veins are hooked out, and the finer surface veins are injected at later visits.
Do I need my main vein treated first?
Usually, if an ultrasound shows blood flowing backwards in the trunk vein. Treating the branches while that pressure remains makes them more likely to return.
Is either covered by insurance?
Treatment of varicose veins that ache, swell, itch or bleed is often covered. Spider vein injections done for appearance usually are not. Insurers commonly ask for an ultrasound and a trial of compression stockings first.