From prepping the night before to spotting normal bruising versus a warning sign — here’s exactly what the sclerotherapy process looks like, start to finish.
Sclerotherapy is one of the most common treatments for spider veins and smaller varicose veins, and for good reason: it’s quick, requires no downtime, and has decades of safety data behind it. Still, if you’ve never had it done, it’s natural to want a clear picture of what actually happens — from the days before your appointment to the weeks it takes to see final results.
Here’s a full walkthrough of sclerotherapy before and after your procedure, so nothing on treatment day catches you off guard.
How to Prepare: Before Your Appointment
Sclerotherapy is a quick, in-office procedure where a vein specialist injects a solution directly into a problem vein. The solution irritates the vein’s inner lining, causing it to collapse, seal shut, and gradually fade as your body reabsorbs it and reroutes blood flow to healthier veins nearby. It’s most often used for spider veins and smaller varicose veins.
There’s not much required to prep for sclerotherapy, but a few small steps make the appointment go more smoothly:
- Skip the lotion and self-tanner. Avoid applying moisturizer, oil, or self-tanner to your legs on the day of treatment — your provider needs clean skin to see your veins clearly and keep the injection sites sterile.
- Don’t shave your legs right before. Shave the day before rather than the morning of, to avoid any skin irritation at injection sites.
- Check with your provider about medications. Blood thinners, anti-inflammatory medications like ibuprofen, and certain supplements can increase bruising and may need to be paused beforehand — always confirm with your provider first before stopping any prescribed medication.
- Eat a light meal beforehand. Having something in your stomach can help prevent lightheadedness during the appointment.
- Wear or bring shorts. Your provider will need access to the treatment area, and you’ll want loose clothing that fits comfortably over compression stockings afterward.
- Plan to bring compression stockings. Many clinics provide these, but confirm in advance — you’ll wear them immediately after treatment.
What Happens During the Procedure
Sclerotherapy is typically quick and doesn’t require anesthesia. Here’s what to expect step by step:
- Your provider cleans the treatment area and may mark the veins to be treated while you’re standing, since veins are more visible when blood is pooling under gravity.
- Using a very fine needle, the provider injects a small amount of sclerosing solution directly into each targeted vein.
- You may feel a brief stinging, cramping, or burning sensation at each injection site, which usually fades within a minute or two.
- Multiple veins can be treated in a single session, depending on how many spots need attention.
- The entire appointment usually takes 15 to 30 minutes.
- Compression stockings or bandages are applied to the treated area immediately afterward.
Immediately After Treatment
One of the biggest advantages of sclerotherapy is how little it disrupts your day. Right after your appointment:
- You can walk right away — in fact, your provider will likely encourage a short walk to help circulation and reduce the risk of clotting.
- You can drive yourself home. No sedation is used, so there’s no need for someone to pick you up.
- You’ll wear compression stockings for several days to a couple of weeks, depending on your provider’s recommendation and which veins were treated.
- Avoid hot baths, saunas, and direct sun exposure on treated areas for about one to two weeks, since heat and UV exposure can worsen bruising and discoloration.
- Mild bruising, redness, or raised welts at injection sites are normal and typically fade within a few days to a couple of weeks.
Recovery Timeline: What to Expect Week by Week
| Timeframe | What to Expect |
|---|---|
| Day 1 | Mild soreness, redness, or bruising at injection sites. Compression stockings on. Normal activity resumes same day. |
| Days 2–7 | Bruising may darken before fading. Treated veins may appear more visible temporarily before they start to fade. |
| Weeks 1–2 | Most patients discontinue compression stockings per their provider’s guidance. Strenuous exercise typically resumes. |
| Weeks 3–6 | Treated veins continue to fade. Smaller spider veins often show the most noticeable improvement by this point. |
| Weeks 6+ | Final results become clear. Larger veins may take a few months for complete fading. Follow-up sessions may be scheduled if needed. |
Results: What You’ll See and When
Don’t be discouraged if treated veins look slightly worse before they look better — some temporary darkening or visibility is normal in the first couple of weeks as the vein collapses. Smaller spider veins generally show noticeable fading within three to six weeks, while larger varicose veins can take a few months to fully disappear. Many patients need two to four sessions, spaced about four to six weeks apart, to treat all targeted veins and achieve the best results.
When to Call Your Provider
Mild bruising, slight swelling, and small firm lumps along the treated vein (a normal part of the healing process) are expected. Contact your provider if you notice:
- Significant swelling, warmth, or redness spreading beyond the injection site
- Signs of infection, such as pus or fever
- Sudden, severe pain in the leg
- Shortness of breath or chest pain (seek emergency care immediately, as this can signal a rare but serious complication)
Ready to treat your spider or varicose veins? A vein specialist can map out exactly which veins need treatment and how many sessions to expect.
Frequently Asked Questions (FAQs)
How many sclerotherapy sessions will I need? Most patients need two to four sessions spaced four to six weeks apart, though this varies depending on how many veins are being treated and how your body responds to the first round of injections.
Does sclerotherapy hurt? Most patients feel a mild stinging or cramping sensation as the solution is injected, which typically fades within a minute or two. No anesthesia is required.
Can I drive myself home after sclerotherapy? Yes. Sclerotherapy doesn’t require sedation, so you can drive yourself home and resume most normal activities right after your appointment.
When can I exercise after sclerotherapy? Light walking is encouraged the same day, but most providers recommend avoiding intense exercise or heavy lifting for about one to two weeks.
Will treated veins come back after sclerotherapy? Veins that are fully closed by sclerotherapy don’t return, since the vein collapses and is reabsorbed by the body. New veins can still form elsewhere over time, which is why some patients opt for touch-up treatment later on.
