Overview

Sclerotherapy effectively treats varicose and spider veins. It's often considered the treatment of choice for small varicose veins.

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

After sclerotherapy, treated veins tend to fade within a few weeks, although occasionally it may take a month or more to see the full results. In some instances, several sclerotherapy treatments may be needed.

Why it's done

Sclerotherapy is often done for:

  • Cosmetic purposes — to improve the appearance of varicose and spider veins

The procedure can also improve related symptoms such as:

  • Aching
  • Swelling
  • Burning
  • Night cramps

If you're pregnant or breast-feeding, doctors recommend waiting to have sclerotherapy done.

Risks

Sclerotherapy results in few serious complications.

How you prepare

Before the procedure, your doctor performs a physical exam and gathers your medical history.

What you can expect

Sclerotherapy is typically done in your doctor's office and doesn't require anesthesia. It generally takes less than an hour to complete.

During the procedure

For the procedure, you'll lie on your back with your legs slightly elevated. After cleansing the area to be treated with alcohol, your doctor will use a fine needle to slowly insert a solution into the appropriate vein.

The solution, usually in liquid form, works by irritating the lining of the vein, causing it to swell shut and block the flow of blood. Some solutions contain a local anesthetic called lidocaine.

Eventually, the vein will become scar tissue and disappear. Sometimes a foam version of the solution may be used, particularly when a larger vein is involved. Foam tends to cover more surface area than liquid.

Some people experience minor stinging or cramps when the needle is inserted into the vein. If you have a lot of pain, tell your doctor. Pain may occur if the solution leaks from the vein into surrounding tissue.

Once the needle is withdrawn, your doctor applies compression and massages the area to keep blood out of the injected vessel and disperse the solution. A compression pad may be taped onto the injection 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.

After the procedure

You'll be able to get up and walk around soon after the procedure. Walking and moving your legs is important to prevent the formation of blood clots.

You'll be asked to wear compression stockings or bandages — usually for about two weeks — to maintain compression on the treated veins.

Most people return to their normal activities on the same day, but it may be wise to have someone drive you home after the procedure. Your doctor will probably advise you to avoid strenuous exercise for two weeks after the procedure.

You'll also want to avoid sun exposure to the treated areas during that time. The inflammation caused by the injections combined with sun exposure can lead to dark spots on your skin, especially if you already have a dark skin tone.

Results

If you were treated for small varicose veins or spider veins, you can usually expect to see definitive results in three to six weeks. Larger veins may require three to four months. However, multiple treatments may be needed to achieve the results you want.

Veins that respond to treatment generally don't come back, but new veins may appear.

Your doctor will likely schedule a follow-up visit about a month after the procedure to determine how well the procedure worked and if you need more sessions. Generally, you need to wait about six weeks before undergoing another sclerotherapy session.

Sclerotherapy care at Mayo Clinic

Feb. 06, 2021
  1. Scovell S. Liquid, foam, and glue sclerotherapy techniques for the treatment of lower extremity veins. https://www.uptodate.com/contents/search. Accessed Feb. 2, 2021.
  2. AskMayoExpert. Varicose veins (adult). Mayo Clinic; 2018.
  3. Varicose veins and spider veins. National Women's Health Information Center. https://www.womenshealth.gov/a-z-topics/varicose-veins-and-spider-veins. Accessed Feb. 2, 2021.
  4. Sclerotherapy of varicose veins and spider veins. Radiological Society of North America. https://www.radiologyinfo.org/en/info.cfm?pg=sclerotherapy. Accessed Feb. 2, 2021.
  5. Kang S, et al., eds. Treatment of varicose veins and telangiectatic lower-extremity vessels. In: Fitzpatrick's Dermatology. 9th ed. McGraw Hill; 2019. https://accessmedicine.mhmedical.com. Accessed Feb. 2, 2021.