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Nd:YAG Laser vs Sclerotherapy

Nd:YAG Laser: A laser that reaches deeper than most and is absorbed least by skin pigment. At 1064 nanometers it is the wavelength that makes hair removal and vessel treatment safer on deeper skin tones.

Sclerotherapy: A solution injected with a fine needle into spider veins on the legs, which irritates the vein lining so the vein closes and is absorbed. It takes several sessions, and a brown line often marks the treated vein for months afterward.

Reviewed by Dr. Schwarz, Board-Certified Dermatologist
Last updated: 10/22/2026
Editorial illustration for Nd:YAG Laser, based on the entry’s treatment or equipment reference.Editorial illustration for Sclerotherapy, based on the entry’s treatment or equipment reference.
Choose ifKey differencesWhat is it?What it treatsTreatment areasSkin tonesHow it worksBefore your treatmentDay of treatmentAfter your treatmentRisksCostQuestionsRelated

Choose Nd:YAG Laser if…

Choose for laser hair removal or vessel treatment on deeper skin tones — the wavelength that makes them safer.

  • Deeper skin tone with dark hair
  • Leg or facial vessels
  • Razor bumps

Choose Sclerotherapy if…

Choose for spider veins on the legs — several sessions, and brown marks along treated veins can last months.

  • Spider veins on the legs
  • You can wear compression stockings
  • You'll avoid sun on the legs afterward
Often combined

Can you have both?

For leg veins, sclerotherapy treats larger veins and Nd:YAG laser treats fine ones. They are often used together, spaced weeks apart.

Key differences

● Nd:YAG Laser
● Sclerotherapy
DowntimeNone → 2+ weeks
1–2 days
1–2 days
PainMinimal → Needs anesthesia or sedation
Moderate
Mild
Results showImmediately → 3+ months
1–4 weeks
1–3 months
How long it lastsWeeks → Years or permanent
Years or permanent
Years or permanent
Visits neededOne → Every few months
A longer series (4–6+)
A short series (2–3)
Cost per visit$ → $$$$$
$
$$
ReversibleYes, can be undone → No, permanent
No, permanent
No, permanent

What is it?

Nd:YAG Laser

Sclerotherapy

What is it?

It is a family of lasers.

Nd:YAG devices commonly deliver 1064-nm light.

Pulse modes differ.

Long-pulsed, Q-switched and picosecond modes have different effects.

It can suit darker skin.

Its wavelength is often used in darker skin types.

It still carries risk.

Inappropriate use can cause burns or pigment injury.

It closes veins.

A sclerosant injected into a vein damages its lining.

The vein fades over time.

It is gradually replaced by fibrous tissue.

Assessment guides treatment.

Small visible veins and underlying reflux are treated differently.

History matters.

Previous clots, circulation problems and pregnancy should be discussed.

What it treats

Evidence level
Nd:YAG Laser
Sclerotherapy
Strong evidenceMost established uses
Unwanted Hair on light skin.

Unwanted Hair

Safe hair removal on darker skin.

Unwanted Tattoos on light skin.

Unwanted Tattoos

Q-switched versions clear dark ink.

Fine branching superficial spider veins on the lower leg.

Spider Veins

Clears leg veins.

Moderate evidenceSome supportive research
Fine branching superficial spider veins on the lower leg.

Spider Veins

Treats leg and facial veins.

Varicose Veins on light skin.

Varicose Veins

Treats small varicose veins.

Little evidence
Ice Pick Scars on light skin.

Ice Pick Scars

Other resurfacing works better.

—
Not effective
—
Redness and fine superficial vessels across a light-skinned cheek and nose.

Rosacea

Not used on the face.

Port-Wine Stains, representative educational image.

Port-Wine Stains

Lasers are used instead.

Can make it worse
Flat tan patches with soft irregular edges across the forehead and upper cheek of an adult with light skin, the surface completely smooth.

Melasma

Heat can darken patches.

—

Treatment areas

Treatment areas

Upper lip, legs and back; the target and pulse mode determine the treatment.

Leg veins.

Skin tones

Skin tone
● Nd:YAG Laser
● Sclerotherapy
Lighter skin
Low risk
Works best with dark hair.
Some risk
Brown lines along veins for months.
Medium skin
Low risk
A safe choice for most.
Some risk
Brown staining more visible.
Deeper skin
Low risk
The safest laser wavelength for deeper skin; burns still possible with poor technique.
Some risk
Staining can last longer; usually fades.

How it works

Nd:YAG Laser

Sclerotherapy

How it works
Nd:YAG Laser mechanism diagram. A target and pulse mode are selected: Long-pulse and short-pulse treatments have different uses. The chosen target absorbs energy: Pigment or blood can absorb 1064 nm laser energy. The tissue response depends on mode: Uses can include hair reduction, vessels, or selected tattoo pigment.
Sclerotherapy mechanism diagram. Solution enters a selected vein: A clinician injects a sclerosant into the target vessel. The vein lining is injured: The treated vessel closes through a controlled local response. The vein gradually fades: Scar tissue replaces the treated vein as blood uses other pathways.
Diagram explanation

A target and pulse mode are selected: Long-pulse and short-pulse treatments have different uses. The chosen target absorbs energy: Pigment or blood can absorb 1064 nm laser energy. The tissue response depends on mode: Uses can include hair reduction, vessels, or selected tattoo pigment.

Schematic illustration. Technique and response vary. This explains a mechanism and does not specify treatment settings.

Solution enters a selected vein: A clinician injects a sclerosant into the target vessel. The vein lining is injured: The treated vessel closes through a controlled local response. The vein gradually fades: Scar tissue replaces the treated vein as blood uses other pathways.

Schematic illustration. Technique and response vary. This explains a mechanism and does not specify treatment settings.

Before your treatment

Nd:YAG Laser
Sclerotherapy
2–4 weeks before

4 weeks before: Sun and tanning: Avoid sun, sunbeds and self-tanner on the area.

4 weeks before: Hair removal: Do not wax, pluck, thread or use an epilator.

2 weeks before: Sun: Avoid sun and sunbeds on your legs for a couple of weeks before and after.

The week before

3 to 5 days before: Actives and shaving: Stop retinoids and exfoliating acids.

1 to 2 days before: Shaving: Shave your legs a day or two before, if you shave.

Day of treatment

Nd:YAG Laser
Sclerotherapy
Before you arrive
Not specified

Clean, dry skin: Tape and dressings need clean, dry skin.

What to bring: Stockings and clothes: Buy the compression stockings your provider recommends beforehand.

Arrival & prep

Test spot: On a deeper skin tone, ask for a test spot.

Skin is examined, photographed and cleaned, and hair areas shaved again if needed.

Your legs are examined standing up, when veins fill, and photographs are usually taken.

Treatment

Everyone wears eye protection — 1064 nm light is invisible and can injure the eye without warning.

Cool gel or cold air goes on and the handpiece moves in overlapping passes. An upper lip takes a minute or two, a back or legs 30 to 60 minutes. Each pulse is a deep hot snap that lingers a second. Say if it is too much; settings and cooling can be adjusted.

You lie down, the skin is cleaned, and the provider works along the leg injecting small amounts into each vein, often using magnifying glasses or a vein light.

A session runs about 15 to 45 minutes. Each injection stings for a second or two, sometimes with brief cramping along the vein.

Before you leave

Pink, warm, and often with a small raised bump around each treated follicle, like goosebumps or a mild rash.

Stockings or wraps go on before you stand, and you walk for fifteen or twenty minutes.

After your treatment

Nd:YAG Laser
Sclerotherapy
First 24 hours

Days 1 to 3: Redness and swelling fade.

Days 1 to 14: Small red welts, itching and mild aching along the treated veins.

Weeks 2–4

Weeks 1 to 3: Treated hairs push out and fall away over one to three weeks.

Weeks 4 to 8: Fewer hairs return, finer and slower.

Weeks 3 to 8: The veins fade and most bruising resolves.

Beyond 1 month
Not specified

Months 2 to 12: Brown staining fades slowly, and most clears within six to twelve months.

Time to results

1–4 weeks per session

1–3 months

How long results last

Long-term for hair; vessels can recur

Treated veins are gone; new ones can appear

Risks

Risks
  • Dark patches
  • Light patches
  • Blistering or crusting
  • Spots and folliculitis
  • More hair, not less
  • Most of what happens is expected
  • Brown staining along the vein
  • Matting
  • A firm, tender lump along a vein
  • A vein that has not responded
  • Itching or a rash over the treated area

Cost

Per session

In the US, small areas such as the upper lip, chin or underarms usually run about $100 to $250 a session.

In the US a session usually runs about $300 to $600, priced per leg or per block of time rather than per vein.

Insurance

Insurance rarely covers any of this.

Ask what a session includes, whether the price covers both legs, and whether a follow-up visit to release trapped blood costs extra.

Questions

Nd:YAG Laser

Sclerotherapy

Individual Questions
Is Nd:YAG safe for deeper skin tones?

It is the wavelength usually chosen for them. At 1064 nanometers surface pigment absorbs very little of the light, so the pulse passes through rather than heating the skin. It still needs conservative settings, good cooling, a test spot and a provider who treats deeper skin tones regularly. Safer than the alternatives is not risk-free.

Is laser hair removal permanent?

It is permanent reduction. Hair comes back finer, sparser and slower, and most people need a top-up once or twice a year. Anyone promising permanent removal is overstating what these devices are cleared to claim.

Why does it hurt more than other lasers?

The target absorbs this wavelength weakly, so more energy has to be delivered, and deeper. That is the trade you accept for the pigment safety. Numbing cream, cold air and slower passes help, and settings can be adjusted if it is too much.

Why can I not wax between sessions?

The laser aims at pigment in the hair sitting in the follicle. Waxing, plucking and threading pull that hair out, so the next session has nothing to find. Shaving cuts at the surface and leaves the follicle full.

Will it work on my blond or gray hair?

No. Lasers find melanin and light hair does not have enough of it. This is not a settings problem and more sessions will not fix it. Electrolysis works regardless of hair color.

How many sessions before I see anything?

Treated hairs shed over one to three weeks after each session, which looks like regrowth and is not. Most people notice genuine thinning after three or four sessions, and the plan is usually six to eight before maintenance.

How many sessions will I need?

Usually two to four per leg, four to six weeks apart, and stubborn veins sometimes need injecting more than once. Extensive veins need more. Expect a course, plus touch-ups every year or two as new veins appear.

Why is there a brown line where my vein was?

Blood trapped in the closed vein breaks down and leaves iron in the skin. Most fades over six to twelve months, and sun makes it darker and slower to clear. It is more visible and slower to fade on deeper skin tones. If a firm tender lump forms, having it released in the office speeds the fading.

What is matting?

A patch of very fine new red vessels where a vein was treated, usually within a few months. It happens to a minority, often fades on its own over months, and occasionally needs further injections or laser.

Will it work on my bulging varicose veins?

No. Ropey bulging veins need a vein specialist, an ultrasound to find the source, and usually a procedure that closes the larger vein with heat, glue or ultrasound-guided foam. Treating the spider veins on top is why some people see them return quickly.

Does it hurt?

Each injection stings for a second or two, sometimes with brief cramping along the vein. Dozens in a session make it repetitive rather than severe. Afterward, aching and itching for a few days.

Will my legs look worse before they look better?

Usually yes, for the first week or two. Bruising, raised red lines and brownish streaks are the normal middle stage. Judge the result months after the course finishes.

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