If you have unwanted spider veins or visible small bluish veins or small varicose veins in the legs, you may be a good candidate for sclerotherapy to improve the aesthetic appearance of your legs. Sclerotherapy is an injectable medication that is used to treat uncomplicated small varicose veins. This treatment is an FDA-approved agent and works by damaging the inner wall of the vein. With time and possibly multiple sclerotherapy treatments, the damaged vein is replaced with fibrous connective tissue and prevents blood flow through the vessel.

Sclerotherapy: Before and After

Questions and Answers

I have a lot of small spider veins and small bluish veins. How long will it take for them to improve?

This depends on how many there are and how you respond to the therapy. Only a certain amount of the Asclera can be used in one treatment session. If you have extensive spider veins and varicose veins over the majority of the legs, this may take many sessions to have them all treated. Multiple sessions may also be needed for veins to close completely, therefore, it may take 3-4 sessions or more. For most, I like to focus on the areas that are the most bothersome first.

How should I prepare for a sclerotherapy procedure?

It is best to have graduated compression stockings purchased before your first treatment session. These should be medium-grade, 20-30 mmHg2, to be worn for compression on the injected veins for 3 weeks for best results. The first 2-3 days, you will wear them continuously (even to shower), thereafter, you will wear them during the day, and remove them to sleep.

Why do I have spider veins and varicose veins?

There are risk factors associated with this. This is often hereditary, so you may want to look to your parents to see if either your mother or father have these, too. But many other factors can contribute as well, such as prolonged standing, aging, pregnancy, and obesity. If you are someone who has to stand for your job, then move as much as you can and wear compression socks to keep the veins compressed as much as you can. Lose weight if your are overweight or obese. We can’t do much about aging or our genes. If you are sitting, put your legs up and don’t cross them.

How is sclerotherapy performed?

The legs and skin are examined, photographed, treatment areas determined, and areas cleansed. Alcohol is used to prep the skin at each injection site. A very fine needle is used to inject the sterile medication (Aclera) into the veins. You may feel a slight stinging sensation. Once completed, a pressure dressing is applied.

What do I need to avoid after having sclerotherapy done?

For 2-3 days, you will need to avoid heavy exercise (but you will need to walk regularly), hot baths, saunas, and extended periods of sitting or standing (ex: long plane flights, etc). In addition, you cannot swim or use hot tubs/spas for 1 week after the procedure. For a minimum of 2 weeks, you should not expose the treated area to any sun or tanning beds. If this is unavoidable, clothing coverage and broad-spectrum sunscreen SPF 30+ should be worn at all times to prevent hyperpigmentation.

When will I see the results of my sclerotherapy sessions?

It can take several weeks to see final results. In addition, you may need multiple sessions to treat the veins for closure to occur.

Can sclerotherapy treat all types of varicose veins?

No, not all varicosities are able to be treated. If you have large bulging varicose veins, then this is not the treatment for you. You should see a vein specialist to evaluate you for a different procedure, as you may need a more intensive procedure. Once that is completed, then I can certainly treat smaller vessels that linger.

Once I have these spider veins treated, will I need to have sclerotherapy done again?

Sclerotherapy does not prevent the development of new spider veins or varicose veins from developing. This is common to recur as we age. Many individuals will come in after having initial treatments done for a quick touch-up on a yearly basis.


More information about sclerotherapy and other aesthetic treatments can be found on our Blog

Post-Treatment Skin Care for Sclerotherapy

To minimize the appearance and severity of post-treatment bruising, our Clinicians Complex Bruise Cream is highly recommended for sclerotherapy patients. 

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