Sclerotherapy

How does sclerotherapy work?

The injected solution irritates the inner lining of the targeted vein, causing the vessel to close. Blood is naturally redirected through healthier veins, while the treated vessel is gradually broken down and absorbed by the body.

The vein fades progressively rather than disappearing immediately. Smaller spider veins may respond more quickly, while larger or deeper veins may require additional healing time and treatment sessions.

What types of veins can be treated?

Sclerotherapy may be recommended for:

• Small red, blue or purple spider veins
• Reticular veins beneath the skin
• Selected small varicose veins
• Clusters of visible veins on the thighs or lower legs
• Veins that have not responded adequately to conservative measures

Asclera is specifically indicated for uncomplicated spider veins and small reticular veins in the lower extremities. Larger, bulging, painful or symptomatic varicose veins may require ultrasound evaluation or another type of vein treatment.

What happens during treatment?

Before treatment, your provider will examine the visible veins and review your medical history. You may be asked to stand briefly so the veins can be evaluated and marked before lying down for the procedure.

The skin is cleansed and a very fine needle is used to inject small amounts of sclerosant into the targeted vessels. The number of injections depends on the size and number of veins being treated.

After the injections, pressure may be applied to the area and compression stockings or a bandage may be placed over the treated veins.

Is sclerotherapy painful?

Most patients tolerate sclerotherapy well. You may feel a quick needle prick followed by mild stinging, burning, warmth or cramping as the solution enters the vein.

These sensations are generally brief. Tell your provider immediately if you experience significant pain during an injection so the area can be evaluated.

How long does treatment take?

A sclerotherapy appointment commonly takes approximately 15 to 45 minutes. The exact treatment time depends on the number, size and location of the veins being addressed.

Larger treatment areas may need to be divided across multiple appointments to limit the total amount of medication used during a single session.

How many treatments will I need?

Some small veins may improve after one treatment, but multiple sessions are often necessary to achieve the desired result.

The number of treatments needed depends on:

• The number of visible veins
• The size and depth of the vessels
• The amount of blood flowing through them
• Previous vein treatments
• Your body’s response to the injections
• The degree of improvement you want to achieve

Your provider will evaluate your progress before recommending another session. Treatments are generally spaced several weeks apart to allow the veins time to respond and the skin to recover.

When will I see results?

Small spider veins may begin fading within approximately three to six weeks. Larger treated veins may require several months to show their full response.

The veins may temporarily appear darker, more noticeable or slightly raised before they begin to fade. Results develop gradually as the body clears the closed vessels.

Are the results permanent?

Veins that respond successfully to sclerotherapy generally remain closed. However, treatment cannot prevent new spider or varicose veins from developing in the future.

Genetics, pregnancy, hormonal changes, aging, prolonged standing, weight changes and underlying circulation problems may contribute to the formation of new veins. Periodic maintenance treatments may be recommended.

Is there any downtime?

Most patients can return to work and resume light daily activities on the same day. Walking is generally encouraged shortly after treatment to support healthy circulation.

Temporary effects may include:

• Redness
• Mild swelling
• Bruising
• Tenderness
• Itching
• Small raised areas at the injection sites
• Firm or lumpy areas along the treated vein
• Temporary brown discoloration
• Fine new blood vessels near the treatment area

These effects usually improve gradually, although discoloration or firmness may take several weeks or months to resolve.

Why are compression stockings recommended?

Compression stockings place gentle pressure on the treated veins, helping keep them closed while they heal. Compression may also reduce swelling, discomfort and the risk of blood becoming trapped within a treated vessel.

The Dermatology Clinic generally recommends wearing support or compression stockings for a period after treatment. The type of stocking and length of use will depend on the veins treated and your provider’s instructions.

Because compression stockings can feel warm, many patients prefer scheduling sclerotherapy during the fall or winter months.

How should I prepare for treatment?

Before your appointment:

• Tell your provider about all medications and supplements you take
• Report aspirin, blood thinners, hormone therapy or medications that affect clotting
• Discuss any history of blood clots, vein inflammation, circulation problems or bleeding disorders
• Tell your provider about previous vein procedures
• Report any allergy to polidocanol or another sclerosant
• Tell your provider if you are pregnant, planning a pregnancy or breastfeeding
• Avoid applying lotion, oil or self-tanning products to the legs on the day of treatment
• Wear loose, comfortable clothing
• Bring your recommended compression stockings to the appointment

Do not stop a prescribed medication unless the healthcare professional who prescribed it tells you to do so.

How should I care for my legs afterward?

Follow the personalized instructions provided by your treatment team.

You may be advised to:

• Walk shortly after the procedure
• Continue taking short walks during the following days
• Wear compression stockings as directed
• Avoid prolonged sitting or standing
• Avoid strenuous exercise temporarily
• Avoid hot tubs, saunas, hot baths and excessive heat
• Avoid tanning and direct sunlight on the treated areas
• Use broad-spectrum sunscreen on exposed skin
• Avoid shaving or applying irritating products until the injection sites have healed
• Avoid long-distance travel for the period recommended by your provider

Walking is encouraged, but vigorous exercise and activities that place significant pressure on the treated veins may need to be postponed.

What are the possible risks?

Common side effects include bruising, swelling, tenderness, itching, temporary pigmentation and firmness along the treated vein.

Less common complications may include:

• Trapped blood within a treated vein
• Inflammation of a superficial vein
• Persistent discoloration
• Fine new blood vessels around the treatment area
• Skin ulceration or tissue injury
• Infection
• Allergic reaction
• Blood clot formation
• Incomplete improvement
• Recurrence or development of new veins

Careful injection technique, appropriate patient selection, compression and following aftercare instructions can help reduce these risks.

What symptoms require prompt medical attention?

Contact the clinic promptly if you develop increasing pain, significant swelling, worsening redness, drainage, an open sore or darkening of the skin near an injection site.

Seek immediate medical attention for symptoms such as:

• Sudden shortness of breath
• Chest pain
• Coughing up blood
• New swelling or severe pain in one leg
• Sudden weakness or numbness
• Difficulty speaking
• New vision changes
• Symptoms of a serious allergic reaction

Although serious complications are uncommon, these symptoms require urgent evaluation.

Who is a good candidate for sclerotherapy?

Sclerotherapy may be appropriate for adults who are bothered by visible spider or small reticular veins and want a nonsurgical treatment with minimal downtime.

Good candidates generally:

• Have small veins that can be treated with an injectable sclerosant
• Are in good overall health
• Have realistic expectations
• Can wear compression stockings after treatment
• Can remain active and walk regularly during recovery
• Have no active infection in the treatment area

A consultation is necessary to determine whether sclerotherapy or another vein treatment is the safest and most effective option.

Who may need to postpone treatment?

Sclerotherapy may need to be postponed or avoided if you:

• Are pregnant
• Have an active blood clot or clotting disorder
• Have inflammation within a vein
• Have a known allergy to the proposed sclerosant
• Have an active infection, rash or open wound
• Have significant arterial circulation problems
• Have severe uncontrolled medical conditions
• Are unable to walk after treatment
• Recently underwent surgery or experienced prolonged immobility
• Have large or symptomatic varicose veins that require additional evaluation

Tell your provider if you take hormonal medications, have recently traveled for an extended period or have a personal or family history of blood clots.

Can sclerotherapy treat painful varicose veins?

Sclerotherapy may treat certain small varicose veins, but symptoms such as aching, heaviness, swelling, cramping, skin discoloration or open sores may indicate underlying venous insufficiency.

Patients with these symptoms may need a medical vein evaluation or ultrasound before cosmetic treatment. Larger veins may respond better to catheter-based treatment, phlebectomy or another vascular procedure.

Schedule a sclerotherapy consultation

Sclerotherapy provides an effective, minimally invasive way to reduce spider veins and selected small varicose veins of the legs. The Dermatology Clinic can evaluate your veins, determine whether injectable treatment is appropriate and develop a personalized plan based on your circulation, medical history and cosmetic goals. Contact us today to get scheduled.