Sclerotherapy can be used to treat small spider veins, which look like small red, purple, or blue veins just under the surface of the skin. During sclerotherapy, a solution (the sclerosant) is carefully injected into the veins, which irritates the inner lining of the veins, causing them to close. Over time, the closed veins are gradually reabsorbed by the body and unsightly veins should no longer be visible. Since spider veins are generally not symptomatic, it is considered a cosmetic treatment and insurance carriers do not typically cover this treatment. If you have symptoms associated with your spider veins, there is a reasonable chance that you may have underlying vein problems that may need to be addressed, and an ultrasound consult may be recommended prior to sclerotherapy.
Sclerotherapy is generally well-tolerated by patients. Prior to the procedure, we will clean the treatment area with an antiseptic soap and place you in a comfortable position. During the procedure, you may experience mild stinging or burning from the injections; however, many patients say that the procedure is almost painless. Following the procedure, we ask that you wear compression socks daily for at least 1 week (around the clock for 3 days, then during the day for a total of 7 days) and avoid hot tubs or saunas. You may experience minimal bruising or tenderness. Blisters, sores, or staining of the skin are uncommon; these will usually go away with time. More serious complications, such as deep vein thrombosis (blood clot in the deep vein system), scarring or allergic reactions have been reported in the medical literature, but these are rare.
Frequently Asked Questions
How many treatments are required?
Spider veins often take more than one treatment. Dr. Jensen usually recommends a “watch and wait” approach; if you get the improvement you are looking for after only 1 treatment, then that is all you will need. However, spider veins can sometimes require more than one treatment. Typically, spider veins can be treated in 2 sessions, spaced out 1-2 months apart.
How long does the treatment last?
The answer to this question is patient specific and difficult to predict. Some patients go for years without any new spider veins. Other patients, however, may see new spider veins within 6-12 months of treatment. If you have spider veins that recur quickly, this may be an indication of underlying vein disease. Generally, untreated vein disease will cause sclerotherapy to be less effective and the duration of clearance to be shorter. If you have symptoms in your legs, such as swelling, achiness, heaviness, or brown discoloration, please let us know, as an ultrasound evaluation may indicated.
Does sclerotherapy hurt?
Sclerotherapy is generally well-tolerated by our patients. A small needle is inserted into the very top layer of the skin, which can sometimes cause a mild pricking sensation. By comparison, sclerotherapy is generally much less painful (but more effective) than an external laser or intense pulsed light device, which some clinicians use in place of sclerotherapy.
Do I need antibiotics for this procedure?
Generally, antibiotics are not indicated for sclerotherapy. If you have any specific concerns, please feel free to discuss it with Dr. Jensen at your consultation appointment.
How long does the procedure take?
Sclerotherapy can be as short as a few minutes (for a very localized cluster of spider veins) to as long as 45 minutes. At your consultation appointment, Dr. Jensen will help you decide the length of the appointment that is needed.
How should I prepare for my appointment?
Several easy steps can be taken to ensure a positive experience and an excellent outcome. Make sure to get adequate rest prior to the procedure. Additionally, make sure to drink plenty of fluids on the day of the procedure (as long as there is no restriction on your fluid intake). Do not wear your compression stockings on the day of the procedure, as this can make it more difficult to treat the spider veins. Eat a normal meal (breakfast or lunch) as you would on any other day. Take your prescription medications as per routine.
Please tell us if you have a history of an atrial septal defect (ASD), ventricular septal defect (VSD), patent foramen ovale (PFO), as you should not have this procedure if you have been diagnosed with one of these (untreated) conditions. Please also tell us if you have a history of migraines, blood clots, require antibiotics for regular dental cleaning, are taking any blood thinners, or if you may be pregnant.
We wish to ensure that your questions are answered and that you are comfortable with the procedure. Dr. Jensen is happy to answer your questions at any time, including those that arise during the procedure. He will walk you through the process step by step so that you will feel confident that you are receiving the best care possible.
What should I bring to my appointment?
Compression socks: We recommend that you bring all of your compression socks to your appointment so that we will be able to choose the most appropriate pair for you following your procedure. Generally, we recommend that you wear thigh-high compression socks around the clock for 3 days, followed by wearing them during the day for a total of 1 week following the procedure. If you decide to purchase compression socks somewhere besides Clarity Dermatology, please bring them in to make sure that they will provide adequate compression.
Shorts: If you have spider veins on the thighs, it is often convenient if you bring shorts that can be pulled up high. If you forget/don’t have shorts, we can provide a drape to cover the areas that do not need treatment. We want to make sure you feel comfortable at your appointment.
Should I continue taking my medications on the day of the procedure?
In general, you should continue to take your medications as directed by your prescribing physician. Do not stop your medications unless told otherwise, as it is rare that you would need to change your daily regimen. If you have specific questions, please bring them up at your initial consultation. Dr. Jensen will review your medication list with you and make recommendations based on your particular health history.
What do I do after the procedure?
- Following the procedure, we will help you place an appropriate compression stocking. Keep your compression stocking on around the clock for 3 days, followed by wearing them during the waking hours for a total of at least 7 days.
- We recommend that you walk for one hour immediately after the procedure and prior to leaving in your vehicle. You do not need to report back to us after your walk unless you experience a problem (i.e., severe pain, bleeding, or any other concerning symptom).
- Walk every day for an hour during the week following the procedure.
Are there any limitations following the procedure?
- You may exercise as long as it does not increase your abdominal pressure (such as weight lifting, high impact aerobics, running, horseback riding, etc). These activities may be resumed 2 weeks following the procedure.
- Do not travel (long flights or car trips) for at least 2 weeks following the procedure. If travel is unavoidable, we recommend walking for 10-15 minute for every hour of travel.
- Avoid saunas or hot baths (more than 100° F) to prevent reopening of the vein for at least 2 weeks.
- No heavy lifting (more than 20 lbs) for at least 2 weeks.
- Minimize sun exposure, as sunlight may increase the risk of the skin staining.
What should I expect following sclerotherapy?
Following the procedure, you may experience some bruising or tenderness. This is normal and will resolve. You may take acetaminophen (Tylenol) as directed.
Be patient with your spider veins. Following sclerotherapy, they can often look worse than before. This is completely normal and is often a manifestation of the veins becoming irritated from the medication. Your spider veins will improve their appearance over 2-4 weeks as they heal.