• Not all patients are candidates for sclerotherapy.  Sclerotherapy works best on little veins of about 1-3 mm in diameter.   Some patients may want sclerotherapy who have veins that are too small for injections.  Other people may want sclerotherapy when in fact, their veins are quite serious, and should not be injected without investigating the underlying reason for the vein problem.  Because not all patients have veins suitable for injection, I do a 10 minute consultation prior to an initial treatment.  The purpose of this is to allow me to evaluate whether the veins are suitable for sclerotherapy, or whether a more thorough investigation is needed prior to treatment.
• In my office, sclerotherapy is only perfomed on the legs.  Sclerotherapy can occasionally performed on other areas, such as the face, chest, and back, but in my office, I generally only perform injections on the legs.
• Compression stockings are very important!  On the day of sclerotherapy, good compression stockings must be brought to the appointment.  A prescription for compression stockings is always given at the initial consultation.  Compression is absolutely essential to achieving a good cosmetic result after sclerotherapy.  If your spider veins are also in the thighs or on the backs of the knees,  please purchase thigh high stockings for best results.  If they are only on the calves, then knee high stockings will be sufficient.  Usually, the stockings should be worn for 24 hours straight after the procedure, then every day (all day) for about 3 weeks
• Sclerotherapy often causes bruising for several weeks.  Only after the bruising disappears, and the veins heal and disappear, can we really assess how successful the treatment was.  For this reason, I recommend that sessions be scheduled several weeks apart.  Also, it is best to have sclerotherapy done well in advance of important events (such as sunny vacations, weddings, etc) because often legs look worse before they look better.  This is absolutely normal, and should be expected after treatment.
• The agent used for sclerotherapy is called sotradecol, or sodium tetradecyl.  It is an FDA approved agent which has been used extensively for this purpose.  It generally hurts much less than saline injections, and has very good results.
• Sclerotherapy is generally considered a cosmetic procedure, and is therefore not covered under most insurance plans.  One exception is sclerotherapy which is done after radiofrequency ablation.  In this case, the medical condition of venous insufficiency was present, and so occasionally, insurance companies will pay for a few sessions of sclerotherapy once the radiofrequency ablation has been performed.

If you have any additional questions regarding sclerotherapy, my office staff can likely address them.  Our number is 650-991-1122.