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What is sclerotherapy?

Sclerotherapy is a medical procedure used to treat varicose veins and ” spider veins ”. Sclerotherapy involves injecting a solution directly into the varicose vein. The solution irritates the lining of the vein causing it to swell and stick the walls together. This fibrous tissue then disappears from view. Sclerotherapy is a proven procedure that has been used since the 1930 to treat varicose veins.

How is sclerotherapy performed?
Sclerotherapy is performed in the office or in the operating room for some selected cases. In most cases, a sterile solution of the alcohol derivative is injected into the vein using a fine needle. The number of injected varicose veins in a session varies depending on the size and location of the veins and the overall medical condition of the patient. The patient may feel mild discomfort and a cramping sensation for 1 to 2 minutes when during the injection. An average sclerotherapy session takes about 20-30 minutes.

How successful is sclerotherapy to treat varicose and spider veins?
Sclerotherapy works very well for most patients. It is estimated that about 50% to 80% of injected veins may be eliminated with each session. A few, less than 10% of the individuals who undergo sclerotherapy, do not respond to the injections successfully. In these cases, changes in the concentrations or alternating types of medication can be tried. “Spider veins ” typically respond to sclerotherapy in 3 to 6 weeks and larger veins respond in 3 to 4 months. If the veins respond to treatment, they will not reappear. However, new veins may appear over time and if necessary or desired, these emerging veins can also be treated.

What do you need to do before the procedure?
Do not take aspirin, ibuprofen or other anti-inflammatory medications for 48 hours before or after sclerotherapy. These medications can interfere with the action of the sclerosing agent . Acetaminophen is allowed. Ask your doctor for specific guidelines before discontinuing any medication before a sclerotherapy procedure.

Prednisone also decreases effectiveness. Ask the doctor who prescribed your prednisone if it can be safely suspended for 48 hours prior to sclerotherapy.

No cream should be applied to the legs before or after it is sclerotherapy.

If you have compression socks or previous treatments, please bring them with you to make sure to provide adequate compression after sclerotherapy procedure.

What are the side effects of sclerotherapy?
Certain side effects may be experienced after sclerotherapy. The large veins may feel lumpy and hardened for several months before disappearing. Redness in the area of the injection should disappear within a few days. The appearance of bruising may occur around the injection site and can last several days or weeks. Brown lines or spots on the skin can be observed at the site of injection, possibly caused by a form of iron that escapes from injected veins. In most cases, these spots disappear within 3 to 6 months, but 5% of the time may be permanent. There are treatments available that can help clear the stain and make it less visible.

Other side effects rarely occur after sclerotherapy. If you have any of these side effects, please contact your doctor immediately:

  • Sudden onset of a swollen leg
  • Small ulcers at the site of injection
  • Red coloration in the groin area
  • Allergic reactions to the sclerosing agent may occur when injecting and are rarely serious.


What happens after treatment?
After the treatment you may resume your regular activities. It is important to walk and essential to use compression stockings or bandages to “compress” the treated vessels.

Do not take very hot baths, use a sauna or whirlpool tubs. Do not apply hot compresses or any form of heat to the injected areas for 48 hours after treatment. Also, avoid direct exposure to sunlight, running, swimming and high impact aerobics for 7-10 days after the procedure.

The water for the bath should be cooler than usual. The injection sites may be washed with a mild soap and warm water.

How will I know if I am a candidate for sclerotherapy?

Before the procedure, you will have an initial the doctor will tell you if you are eligible for sclerotherapy.

You are not a candidate for sclerotherapy if you are pregnant, nursing or are bedridden. You should wait at least three months after birth before being considered for this procedure.

You can have sclerotherapy if you take birth control medication . If you have had a blood clot (DVT) in the past, it will be reviewed individually , and will depend on the conditions of the limb and the cause of venous thrombosis.

Veins that are potentially usable for future surgical bypass procedures (such as the saphenous vein for heart surgery) are not generally considered for injection.

Will my insurance cover sclerotherapy?

Insurance does not cover sclerotherapy when performed for cosmetic reasons. Some insurance companies cover sclerotherapy for specific medical conditions.

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