Sclerotherapy

Our Process: What to Expect During Treatment

Here’s what to expect during your sclerotherapy appointment:

1. Pre-Treatment Preparation: You may be asked to change into a gown and lie down on an examination table. The treatment area will be cleaned and sterilized to prevent infection.
2. Vein Mapping: Your doctor may use ultrasound imaging to precisely locate the veins that need treatment. This step ensures accuracy and helps plan the injection sites.
3. The Injection Process: Using a very fine needle, your doctor will inject a sclerosing solution directly into the targeted veins. Most patients describe the sensation as small pinches or mild stinging. Most patients need multiple injection sites in a single session, since one injection typically treats about an inch of vein.
4. Massage and Compression: Apply massage and compression to the treated area immediately after injection. You'll be asked to wear compression stockings and walk around for a short period. This helps promote blood flow and prevents blood clots.
5. Leaving the Clinic: Sclerotherapy is an outpatient procedure, so you'll be able to leave the clinic immediately after treatment. Most patients can drive themselves home and return to normal activities the same day.

Sclerotherapy’s minimally invasive nature, combined with its proven efficacy, makes it a popular choice for those seeking to address unsightly or uncomfortable varicose and spider veins.

Book Your Free Vein Evaluation

Subject to insurance eligibility

Who Is a Good Candidate for Sclerotherapy?

Sclerotherapy treatment can be effective for many individuals with varicose and spider veins, but it's not suitable for everyone.

Here are the characteristics of ideal candidates for sclerotherapy:

• Vein Size and Type: Sclerotherapy works best for smaller spider veins and small-to-medium varicose veins. For larger, more bulging veins, ultrasound-guided sclerotherapy may be recommended.
• Overall Health: Those with a history of blood clots or certain clotting disorders may not be suitable for this treatment. Significant peripheral artery disease can also rule out treatment.
• Pregnancy or Breastfeeding Status: Women who are pregnant, trying to become pregnant, or have given birth or breastfed within the last 90 days are not considered good candidates. Sclerotherapy is generally avoided during pregnancy.
• Mobility: Patients should be mobile and able to walk regularly after treatment
• No Conflicting Medical Conditions: Patients should not have any medical conditions that could interfere with the treatment or healing process. For example, those who might need the affected veins for future bypass procedures may not be suitable candidates.

A vein specialist will confirm candidacy during your evaluation. A quick ultrasound can determine whether sclerotherapy or another treatment fits your specific veins best. Since sclerotherapy is typically a multi-session process, most patients need more than one treatment before results fully show. Follow-through matters too. Wearing compression stockings as directed and staying active afterward are essential in ensuring your best possible results.

Different Types of Sclerotherapy Treatments

Not all sclerotherapy is the same. Your vein specialist selects the approach based on vein size, depth, and location. Here are the different types of Sclerotherapy offered at our vein clinics:

• Traditional liquid sclerotherapy — a liquid solution for smaller, visible veins
• Foam sclerotherapy — solution mixed into foam for better contact with larger vein walls
• Ultrasound-guided sclerotherapy — ultrasound imaging guides injections into veins beneath the skin's surface
• Microsclerotherapy — a fine-needle technique for the smallest spider veins
• Polidocanol endovenous microfoam (PEM) — an FDA-approved microfoam formulation for larger varicose veins
• Catheter-directed sclerotherapy — solution delivered via catheter for larger or harder-to-reach veins

Sclerotherapy Recovery: What to Expect

You can typically return to work and regular activities the same day. To support healing:

Do:

• Wear compression stockings as directed by your provider
• Walk and stay lightly active — movement supports circulation and healing
• Avoid prolonged sun exposure on treated areas

Don't:

• Skip your compression stockings, even if the area feels fine
• Resume strenuous exercise or heavy lifting until your provider clears you

As you heal, you can generally expect fading of visible veins, reduced pain, improved leg appearance, and better circulation.

The number of sessions and the spacing between them depends on the size and extent of the veins being treated; most patients need 1–5 sessions (2–4 on average), spaced several weeks apart. Your vein specialist may recommend a follow-up visit to check your progress.

Side effects: Sclerotherapy is extremely safe with few side effects. Some patients experience: temporary bruising, skin soreness, redness, stinging, or cramping during or shortly after injection. Darkened skin at the injection site can also occur. This typically resolves within days to weeks, though in some patients it can persist longer.

Sclerotherapy vs. Other Vein Treatments

Sclerotherapy treats the surface veins you can see, but unlike endovenous laser ablation (EVLA) or microphlebectomy, it does not treat the underlying venous insufficiency that can occur in larger veins beneath the surface. If an ultrasound evaluation shows an underlying cause, your vein specialist may recommend pairing sclerotherapy with another treatment.