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Sclerotherapy

By

Megan Freedman

What is sclerotherapy?

Sclerotherapy is a treatment for spider veins and small varicose veins in your legs. It involves injecting small doses of a chemical into your veins. The chemical irritates the lining of your veins, which causes them to shrink and eventually disappear. Your body redirects blood flow to other veins in your legs.

Sclerotherapy has some risks and potential complications. is only one method used to treat varicose veins. Discuss all of your treatment options with your doctor to understand which options are right for you. 

Why is sclerotherapy performed? 

Your doctor may recommend sclerotherapy to eliminate or minimize spider veins and small varicose veins. Some people seek sclerotherapy for cosmetic reasons when their veins are protruding or unsightly. Others are seeking relief from discomfort or painful sensations, such as burning, aching, swelling, soreness and cramping.

Veins are blood vessels that carry blood from your body back to your heart. There are valves inside veins that help direct blood back to your heart. When the valves are damaged or weakened, blood can pool in your veins causing them to swell and weaken. This results in varicose and spider veins. 

Varicose veins can look blue, twisted and bulging, and feel uncomfortable. Spider veins are smaller, closer to your skin surface, and look like small, jagged lines or starbursts. They tend to cause less discomfort and bulging. 

Your doctor may only consider sclerotherapy for you if other treatment options with less risk of complications are ineffective. You may be able to prevent spider veins and varicose veins by exercising, losing weight, and wearing compression stockings. Ask your doctor about all of your preventive and treatment options and consider getting a second opinion before deciding on sclerotherapy. 

Who performs sclerotherapy?

The following specialists perform sclerotherapy:

  • Dermatologists specialize in the medical and surgical care of the skin, hair and nails.

  • Plastic surgeons specialize in correcting physical defects that affect a person's appearance or ability to function.

  • Vascular surgeons specialize in surgical treatment of diseases and conditions of the lymphatic system and blood vessels outside the heart and brain.

  • Phlebologists specialize in diagnosing and treating vein conditions including varicose veins, spider veins, chronic venous insufficiency, and vein birth defects.

  • Interventional radiologists and vascular radiologists specialize in diagnosing and treating diseases using radiation and other imaging technologies.

How is sclerotherapy performed?

Sclerotherapy is performed in a doctor’s office or outpatient surgery setting. It takes less than an hour and generally includes these steps:

  1. You can wear your own clothing, typically shorts so your legs are exposed.

  2. Your doctor examines your spider veins and varicose veins using a bright light and possibly a magnifying instrument.

  3. Your doctor gives you one to three injections in each spider vein or varicose vein that requires treatment. The injections contain either a saline (salt) solution or a chemical. These substances irritate your veins, which eventually scar and shrink. The injections may sting or cause minor cramping for a minute or two.

  4. Your care team will provide you with compression stockings to wear for up to two weeks after your procedure. The compression stockings stabilize your veins and minimize swelling.

Will I feel pain?

Your comfort and relaxation is important to both you and your care team. Sclerotherapy generally causes minimal and temporary pain, but it can be uncomfortable. Take a few long, deep breaths to help yourself relax. Tell your care team if any discomfort does not pass quickly. Increased pain may be a sign that the solution has leaked outside your veins.

What are the risks and potential complications of sclerotherapy?  

Any procedure involves risks and potential complications. Complications may become serious and life threatening in some cases. Complications can develop during the procedure or throughout your recovery. Risks and potential complications of sclerotherapy include:

  • Allergic reaction to the solution

  • Blood clots

  • Bruising

  • Infection

  • Inflammation at the treatment sites

  • Lines, spots or patches of skin discoloration near the treatment sites or along the veins

Reducing your risk of complications

You can reduce the risk of certain complications by following your treatment plan and:

  • Following activity, dietary and lifestyle restrictions and recommendations before the procedure and during recovery

  • Informing your doctor if you are nursing or if there is any possibility of pregnancy

  • Not smoking. Smoking increases your risk of poor wound healing and blood clots.

  • Notifying your doctor immediately of any concerns such as bleeding, fever, increase in pain, or wound redness, swelling or drainage

  • Taking or stopping your medications and wearing your compression stockings exactly as directed

  • Telling all members of your care team if you have any allergies and of all your medications

How do I prepare for my sclerotherapy? 

You are a very important member of your own healthcare team. The steps you take before sclerotherapy can improve your comfort and outcome.

You can prepare for sclerotherapy by:

  • Answering all questions about your medical history and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications, and allergies at all times.

  • Following any lifestyle recommendations to prepare for your procedure such as wearing shorts to your appointment and not applying lotion to your legs the day of your sclerotherapy

  • Taking or stopping medications exactly as directed. This may include not taking aspirin, ibuprofen (Advil, Motrin), blood thinners, and certain antibiotics such as tetracycline or minocycline.

Questions to ask your doctor

Having sclerotherapy can be stressful. It is common for patients to forget some of their questions during a doctor’s office visit. You may also think of other questions after your appointment. Contact your doctor with concerns and questions before your procedure and between appointments.

It is also a good idea to bring a list of questions to your appointments. Questions can include:

  • Why do I need sclerotherapy? Are there any other options for treating my condition?

  • Where will my sclerotherapy take place?

  • What should I wear to the procedure?

  • How long will the procedure take? When can I go home?

  • What restrictions will I have after the procedure? When can I return to work and other activities?

  • How should I take my medications?

  • How will you treat my pain?

  • When should I follow up with you?

  • How should I contact you? Ask for numbers to call during and after regular hours.

What can I expect after sclerotherapy?

Knowing what to expect after sclerotherapy can help you get back to your everyday life as soon as possible.

How will I feel after sclerotherapy?

You should be able to return to light to moderate activities immediately after sclerotherapy. You will need to avoid strenuous exercise or activities for two weeks. Your legs may feel sore for a few days to a few weeks afterward. You will wear compression stockings and possibly bandages to help ease swelling and stabilize your veins during this time.

When can I go home?

You will probably go home right after sclerotherapy. Multiple sclerotherapy treatments are sometimes needed to make veins disappear, so you may need to return for more sclerotherapy treatments in four to six weeks. 

When should I call my doctor?

You should keep your follow-up appointments after sclerotherapy. Contact your doctor if you have any concerns between appointments. Call your doctor right away if you have:

  • Breathing problems such as shortness of breath, difficulty breathing, labored breathing, or wheezing

  • Change in alertness such as passing out, dizziness, unresponsiveness, or confusion

  • Fever. A low-grade fever (lower than 101 degrees Fahrenheit) is common for a couple of days after your procedure and not necessarily a sign of a surgical infection. However, you should follow your doctor's specific instructions about when to call for a fever.

  • Leg pain, redness or swelling, especially in the calf, which may indicate a blood clot

  • Unexpected drainage or pus coming out of the skin in your leg

How might sclerotherapy affect my everyday life?

Sclerotherapy may erase your existing varicose veins or spider veins or significantly reduce your symptoms. It will not prevent varicose veins and spider veins from coming back, so you may need more sclerotherapy or other vein procedures in the future. 

You can make changes in everyday life that may help prevent or delay recurrence of varicose veins and spider veins including:

  • Exercising

  • Losing weight

  • Wearing compression stockings

Medical Reviewers: William C. Lloyd III, MD, FACS Last Review Date: Sep 3, 2016

© 2017 Healthgrades Operating Company, Inc. All rights reserved. May not be reproduced or reprinted without permission from Healthgrades Operating Company, Inc. Use of this information is governed by the Healthgrades User Agreement.

View Sources

Medical References

  1. Sclerotherapy of Varicose Veins and Spider Veins. RadiologyInfo.org. http://www.radiologyinfo.org/en/info.cfm?pg=sclerotherapy.
  2. Spider and varicose vein treatment information. American Society for Dermatologic Surgery. http://www.asds.net/SpiderAndVaricoseVeinTreatmentInformation.aspx.
  3. Spider Vein Treatment (Sclerotherapy). The American Society for Aesthetic Plastic Surgery. http://www.surgery.org/consumers/procedures/skin/spider-vein-treatment.
  4. Spider Vein Treatment. American Society of Plastic Surgeons. http://www.plasticsurgery.org/Cosmetic-Procedures/Spider-Veins.html.
  5. Treatment Options. The American College of Phlebology. http://www.phlebology.org/patientinfo/treatment.html.
  6. Varicose Vein Treatment [Transcript]. Johns Hopkins Medicine. http://www.hopkinsmedicine.org/heart_vascular_institute/media/video/transcriptions/varicose_vein_tre....
  7. Varicose veins and spider veins fact sheet. Womenshealth.gov. http://www.womenshealth.gov/publications/our-publications/fact-sheet/varicose-spider-veins.cfm.
  8. What Are Varicose Veins? National Heart Lung and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/vv/.

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