Sclerotherapy for Spider Veins

Sclerotherapy involves injecting a solution directly into the vein that causes it to scar and collapse, forcing blood to reroute through healthier veins. The collapsed vein is reabsorbed into local tissue and eventually fades.

Sclerotherapy: before and two months after treatment with Asclera

Sclerotherapy: before (left) and two months after treatment with Asclera (polidocanol).

Photo courtesy of Jennifer Peterson, MD, of Houston, Texas

Why choose sclerotherapy for spider veins?

Sclerotherapy is considered the treatment of choice for spider leg veins. The treatment is minimally invasive. The procedure also can improve related symptoms such as aching, swelling, burning and night cramps. Treated veins tend to fade within a few weeks, although occasionally it may take up to two months to see the full results. In some instances, several sclerotherapy treatments may be needed.

Possible Risks

As with any treatment, there are risks associated with it, though they are minimized in the hands of a qualified ASDS dermatologist. These include:

  • Bruising
  • Raised red areas
  • Small skin sores
  • Darkened skin in the form of lines or spots
  • Multiple tiny red blood vessels

More severe complications rarely occur, including inflammation, blod clots, allergic, reaction to treatment solutions and side effects caused by tiny air bubbles in the bloodstream, including nausea, headaches, coughing and visual disturbances.

What you should know about sclerotherapy for spider veins

The procedure is typically performed in the doctor’s office. It does not require anesthesia and usually takes 15 minutes to an hour to complete depending on the extent of the veins.

Patients lie on their back with their legs slightly elevated. After the treatment area is cleansed with alcohol, the doctor uses a fine needle to slowly insert a solution or foam into the vein. Some patients experience minor stinging or cramps when the needle is inserted. The injection solution or foam irritates the lining of the vein, causing it to swell shut and block the flow of blood.

Once the needle is withdrawn, the doctor will apply compression and massage the area to keep blood out of the injected vessel and disperse the solution. For large veins, a compression pad may be taped onto the site to keep the area compressed while your doctor moves on to the next vein. The number of injections depends on the number and size of veins being treated.

What to expect after the procedure

  • You can stand up and walk around immediately after the procedure. It's important to move your legs to prevent the formation of blood clots and maximize treatment results.
  • Graduated compression stockings and/or bandages are worn over the treatment area for one to three weeks to maintain pressure on the treated veins.
  • Most people can return to normal activities immediately following the procedure.
  • You should avoid sun exposure in the treatment area for two weeks following the procedure.

What to expect before the procedure

Before the procedure, an ASDS dermatologist will usually review the patient’s medical history and conduct a physical exam. This is the time for the doctor and patient to discuss expectations, potential risks and outcomes of the procedure. The doctor will examine the veins to be treated and check for any underlying blood vessel disorders. Be sure to let your doctor know:

  • If you are pregnant. Most doctors recommend waiting until after your delivery to perform the procedure.
  • If you have any medical conditions, such as heart disease or a pre-existing cancer or coagulation disorder.
  • About any prescription or over-the-counter medicine you are taking as well as any supplements.
  • If you smoke or take oral contraceptives, which can increase your risk of blood clots.
  • If you have any allergies.