Sclerotherapy is a treatment for spider veins, the blood vessels that are obvious through the surface of the skin. These may appear due to hormonal changes, prolonged standing, aging, heredity, or other factors. Sclerotherapy involves injecting a solution into the vein that irritates it, causing it to collapse and disappear from view.
If you’re choosing sclerotherapy, make sure you’re choosing it because you really want it, not to please someone else or to fit an imagined ideal. No one else can make the choice for you; it’s your body, and you’re in charge of it. After you do your research and understand the procedure, if you believe that sclerotherapy is right for you, then proceed. To help you in your decision-making process, we have some information about the risks and benefits of having sclerotherapy at Sclerotherapy: Risks and Benefits.
Please note that this page is for informational purposes only, and is not a substitute for qualified, individualized medical advice. You should discuss your potential elective procedure with your own doctor(s), including your primary care physician and the doctor who will perform your procedure if you decide to proceed.
How it’s done
Usually, no anesthesia is used for sclerotherapy treatment. If you wish to have the area numbed for your injections, then you can get an over-the-counter numbing cream. You need to apply it about an hour before your treatment, covering it with plastic and leaving it on until right before your treatment.
First, the area(s) that you wish to have treated will be cleaned, and any numbing cream wiped off. A small needle will be used to inject the sclerosing solution into the veins. Your provider may use a magnifier to ensure that the small vein being injected is correctly targeted. After all of the injections are completed, your provider will put a compressive stocking or elastic bandage around the treated area to provide compression; this reduces swelling and bruising.
Preparing for the procedure
Choosing your doctor
While cosmetic dermatology procedures may be offered at spas and beauty salons, they’re actually technical procedures that should be performed by qualified medical professionals. Your provider should have the degree MD (Medical Doctor), or should be an RN (Registered Nurse) or PA (Physician’s Assistant) who is under the direct supervision of an MD. Ideally, this doctor should be trained and board-certified in either plastic surgery or dermatology.
When you go to a doctor’s clinic for your procedure, be aware that the doctor whose name is on the clinic may not be directly involved in your treatment; you may never even meet him or her. Sometimes, the doctor doesn’t even stay at the clinic during the day! For safety reasons, it’s best to have an MD on-site who has examined you personally. This is because while the risks from these procedures are small, adverse reactions can and do happen, so you want someone present who can deal with problems if they do arise. When you call to schedule an appointment, ask who will be performing the procedure and whether a qualified physician will be present in the clinic during the procedure.
For more help in your search for a cosmetic dermatologist, visit our How to Find the Best Cosmetic Dermatologist page. At Doctor Review, you can also search providers for patient reviews to help you find the very best.
Getting ready for the procedure
In order to reduce the amount of bruising from your sclerotherapy procedure, you’ll need to stop taking any medications that thin the blood for about a week prior to the procedure. This includes aspirin, Advil, Motrin, and similar medications. You’ll also need to stop smoking, because this can interfere with blood clotting. Talk to your doctor about which medications you can and cannot take before your sclerotherapy, and never stop any regular medication without talking to your doctor first.
After the procedure, there may be some bruising around the sites where injections took place. This will slowly resolve. There may also be some cramping in the leg near the injection sites; you can take over-the-counter medications such as Advil or Motrin if necessary, but rarely is the cramping severe enough to require prescription painkillers or muscle relaxers. You may be asked to wear compressive stockings or to wrap the treated area in elastic bandages for several days, as the compression will reduce the swelling and bruising from the treatment. The spider veins will take a few weeks to disappear, gradually fading over this time. As they heal, you should walk every day, and avoid sitting or standing in one place for more than an hour or two (as this increases pressure in the veins of the legs, and may prevent the spider veins from collapsing as intended). For the first few days, you will need to avoid vigorous activities of the legs, such as squatting, lunging, and running. There may be some hyperpigmentation (slightly increased brown color, as though the area were tanned) in the treated areas, which will usually fade over the course of a few months.
The spider veins will have completed their healing after two months. If they have not completely disappeared at that time, you should discuss with your doctor whether further treatment might be desirable. Sometimes, more than one sclerotherapy treatment is needed for optimal results.