Sclerotherapy for Spider and Reticular Veins

What is Sclerotherapy?

Sclerotherapy treats spider veins and reticular veins with injections of a solution that closes the treated veins so they gradually fade. At your consultation, we look at which veins can be treated, whether another vein problem needs attention first, and what you can expect from treatment.

What Does Sclerotherapy Treat?

Sclerotherapy treats spider veins, the small vessels visible near the skin’s surface, and reticular veins, which sit deeper beneath the skin. We examine your veins to see which ones are suitable for injections.

Who is a Good Candidate

Sclerotherapy is commonly used for small veins, including veins about 1–3 mm in diameter. Vein size alone does not determine whether treatment is appropriate.

• Underlying vein problems: An examination may identify venous insufficiency that needs evaluation before treating visible spider veins.
• Pregnancy: We postpone sclerotherapy during pregnancy. Read more about pregnancy and vein treatment.
• Blood-clot history: Tell us about any previous blood clots so we can assess whether sclerotherapy is suitable.

Sclerotherapy Solutions and How it Works

Sclerotherapy solutions include sodium tetradecyl sulfate (Sotradecol), polidocanol (Asclera or Aethoxysclerol) and hypertonic saline. At SF Vein Center, we use Sotradecol. For more detail, see our comparison of sclerotherapy solutions.

What Is Foam Sclerotherapy?

Foam sclerotherapy uses a vein-closing solution, called a sclerosant, mixed with air or another gas to form tiny bubbles. Liquid sclerotherapy uses the solution without turning it into foam. Both forms are injected into a vein to close it; the choice depends on the veins being treated.

What Happens During Treatment?

We perform sclerotherapy in the office. You lie down, and we position your leg so we can reach the veins being treated. We use a fine needle to inject small amounts of solution into those veins. You may notice a needle prick, brief stinging or cramping during the injections. Tell the clinician if an injection is particularly uncomfortable.

How to Prepare for Sclerotherapy

At your consultation, discuss your medical history, previous vein treatments and any questions about the session. Review the compression stockings you will need afterward and the aftercare instructions before your appointment. See how to prepare for your sclerotherapy session for the full preparation instructions.

Recovery and Aftercare

Recovery includes compression and care of the treated skin while the veins fade.

• Compression stockings: Wear stockings continuously for the first 24 hours, then daily for about three weeks. Thigh-high stockings cover treatment on the thighs or behind the knees; knee-high stockings may be used when only the calves are treated. Our office can help with fitting and a prescription. Learn more about compression stockings.
• Sun exposure: Avoid direct sun on treated areas to reduce the chance of discoloration. Read about sun exposure after vein treatment.
• Exercise: Walking is encouraged after sclerotherapy. Avoid strenuous exercise for 14 days unless your treating clinician gives you different instructions.

Sclerotherapy Side Effects and Risks

Bruising, redness, itching and discoloration can occur after sclerotherapy. Treated areas may look worse before they improve. Bruising can last several weeks, and brown spots or lines can take longer to fade; some discoloration may persist.

Less common complications include inflammation, skin injury, allergic reactions and blood clots. Contact the office if you develop increasing pain, warmth, swelling or a sore at an injection site. Seek urgent medical care for chest pain or difficulty breathing.

For additional information, see Mayo Clinic’s overview of sclerotherapy

Results and How Many Treatments Are Needed

Sclerotherapy results develop over weeks or months rather than immediately. The number of sessions depends on how your veins respond. Sessions may be spaced several months apart, so allow time when planning treatment before a trip or event.

Treatment does not prevent every new spider vein from developing. Read more about spider vein recurrence after treatment.

Does Insurance Cover Sclerotherapy

Sclerotherapy is considered a cosmetic treatment for spider veins and is generally not covered by insurance. Some patients may have coverage after radiofrequency ablation (RFA) which is typically considered medically necessary, depending on their plan and its requirements. Read more about insurance coverage for vein treatment.

Sclerotherapy or Laser Treatment?

Sclerotherapy injections are commonly used for leg spider veins and reticular veins. Laser treatment for spider veins may be an option for some tiny vessels on the face or legs. The size and location of the veins help determine which approach is suitable.

Scheduling a Treatment

A sclerotherapy treatment at San Francisco Vein Center can include both legs. If you are unsure whether sclerotherapy is right for you, arrange a consultation first. Insurance covers the consultation, subject to your plan and provider network. Your usual copay or deductible may apply.

Use our appointment request form to arrange a consultation or treatment.