How Sclerotherapy Works to Remove Spider Veins

Doctor checking legs for spider veins

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What is sclerotherapy?

Sclerotherapy is an effective, minimally invasive medical procedure used to treat varicose veins and spider veins. It is often considered the treatment of choice for small varicose veins.

After sclerotherapy, treated veins tend to fade within a few weeks, although occasionally it may require a month to see the full results. In some cases, several sclerotherapy treatments may be needed.

How is a sclerotherapy procedure performed?

Sclerotherapy is performed in the doctor’s office and does not require anesthesia. The procedure can take 15 minutes to an hour to complete depending on the extent of the damaged veins.

Patients lie on their back with their legs slightly elevated. After the treatment area is cleaned with alcohol, the doctor uses a very fine needle to inject a solution (generally a salt solution) directly into the vein. There may be some mild discomfort at this point and slight cramping for one or two minutes. The solution causes the treated vein to collapse, forcing blood to be rerouted through healthier veins. The collapsed vein is reabsorbed into local tissue and eventually fades.

Once the needle is withdrawn, compression is applied to the treated area to keep blood out of the injected vessel and to disperse the solution. For larger veins, the compression pad may have to be taped onto the site. The number of injections will depend on the size of the veins being treated.

What are the common uses of this spider vein procedure?

Sclerotherapy is used to improve the cosmetic appearance of spider veins and to relieve some of the symptoms associated with spider veins, including aching, burning, swelling and night cramps. It is the primary treatment for small varicose veins in the leg.

What to do before your spider vein procedure

Prior to the procedure, your doctor will perform a physical exam and gather and review your medical history. During the physical exam, the doctor will examine the veins to be treated and check for any underlying blood vessel disorders.

Your doctor will want to know about your medical history including:

  • Smoking or oral contraceptive use, like these, can increase your risk of blood clots
  • Allergies
  • Medications or supplements you take, especially aspirin, nonsteroidal anti-inflammatory drugs (NSAID), blood thinners or antibiotics
  • Recent illnesses or existing medical conditions, such as heart condition
  • Previous treatment for spider and varicose veins and the results of the treatment

If you take NSAIDs, aspirin or blood thinners, your doctor will instruct you to stop taking the medication for a certain amount of time before the procedure to reduce the chances of bleeding. Tylenol should not affect this procedure.

The day before sclerotherapy

For the 24 hours before the procedure, avoid shaving or applying lotion to your legs. You should wear comfortable, loose-fitting clothing to your exam. You will be given a gown to wear during the procedure, or you can bring a pair of shorts.

What to expect after sclerotherapy

After your procedure, you may be asked to rest on your back for a few minutes. Your doctor will be checking the injection sites for any immediate side effects. You will be up and walking within a few minutes. It is important to move your legs to prevent the formation of blood clots and maximize treatment results. It is required that you do not do any aerobic activity for a few days or one week after the procedure.

You’ll also want to avoid sun exposure to the treated areas during the first few days. The inflammation caused by the injections combined with sun exposure can lead to dark spots on your skin, especially if you already have a dark skin tone.

You will be instructed to wear compression stockings and or bandages over the treatment area for one to three weeks to maintain pressure on the treated veins. Raised red areas may appear at the injection sites and should disappear within a few days. Brown lines or spots on the skin may be seen at the injection sites. In most cases, they disappear within three to six months. Bruising may occur around the injection site and can last several days or weeks.

For more information on what to expect with your spider vein treatment, explore our FAQs.

How will I know my results?

Spider veins will generally respond to sclerotherapy within three to six weeks, and larger veins respond within three to four months. Veins that have responded to treatment will not reappear. However, if new veins appear over time, you may return for additional injections if needed.

You will have a follow-up visit scheduled with your doctor about a month after the procedure to check the procedure’s success and decide whether further sessions are needed. Generally, you need to wait four to six weeks before undergoing another sclerotherapy session.

Studies of vein treatment options for varicose and spider veins have indicated an overall success rate of 50 to 80 percent in eliminating treated veins.

Spider vein treatment insurance coverage

Insurance coverage for sclerotherapy varies. If your varicose veins are causing medical problems such as pain and/or chronic swelling, depending on your plan, your insurance may help cover your treatment at Vein Clinics of America.

During your first visit to Vein Clinics of America, you will meet with one of our expert physicians for a consultation. This appointment is billed to your insurance, and the cost to you is typically your co-pay for visiting a doctor’s office. At this appointment, we will examine you, discuss your diagnosis and treatment options, and review your insurance benefits with you.

Concerned about your vein health?

Medically Reviewed by

Dr. Satish Vayuvegula
Dr. Satish Vayuvegula is the National Medical Director at Vein Clinics of America. Certified by the American Board of Venous & Lymphatic Medicine, Dr. Satish Vayuvegula is recognized as a physician who has met rigorous standards of knowledge and extensive training in phlebology, the diagnosis and treatment of varicose vein disease and related disorders. Dr. Satish also shares his passion and expertise by serving as a board member of the American Vein and Lymphatic Society, the predominant national organization for venous and lymphatic disease.

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