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For patients bothered by the appearance of spider veins and varicose veins, dermatologists offer several treatment options. The most widely used are sclerotherapy and laser treatment. Before selecting the treatment option best for each patient, a dermatologist considers many factors including the vein type, location of the vein, and the patient’s medical history.

It is important for your dermatologist to know if you have a history of blood clots in the lungs or legs or a clotting disorder. This does not necessarily mean that treatment must be avoided, but it may affect treatment options. For best results, more than one treatment option may be used.


What is Sclerotherapy Treatment?

Sclerotherapy is the most popular treatment option for veins on the legs. It is used to treat spider and varicose veins on the legs and spider veins on the face.

Sclerotherapy involves injecting small doses of solution directly into the unwanted vein with a very fine needle. The solution irritates the vein, causing it to swell, stick together and the blood to clot. This essentially seals off the treated vein from other veins. Over a period of weeks, the treated vein turns into scar tissue that is absorbed by the body. Eventually, the scar tissue becomes barely noticeable or invisible. This procedure can be performed in a dermatologist’s office and does not require anesthesia.

A treatment session generally lasts 15 to 20 minutes. A number of veins can be treated during one treatment session and a single vein may be injected several times. Some veins require more than one treatment session. Sessions may be spaced weeks or months apart, depending on the vein.

To treat larger varicose veins, a dermatologist may use ultrasound-guided sclerotherapy. The ultrasound gives the doctor a live view of the veins, which allows the solution to be injected exactly where it will be most effective.

After treatment, most patients can expect to see an 80 to 90 percent improvement. This may require several treatments. Fading is gradual and occurs over a period of time.

While sclerotherapy can be safely used on all skin types, there are potential side effects. Most side effects are mild and temporary. Potential side effects include:

  • Stinging or pain at the injection site and muscle cramps. Sometimes an injection is painful. Occasionally swelling of the ankles or feet and muscle cramps occur.
  • Red, raised areas at the injection sites. Hive-like reactions and itching can occur and usually fade within 10 to 15 minutes of the injection. Sometimes, it can take a day or so for the red, raised areas to disappear.
  • Brown lines or spots on the skin at the treated sites. Darkened areas may appear and tend to be more common in patients who undergo treatment for a large or delicate vein and patients who tan easily. In most, the discoloration disappears within a year, but it can last longer.
  • Clusters of fine, red blood vessels develop near the injection sites (matting). When larger veins are treated, about one-third of patients develop these clusters. Especially common on the thigh, many clusters disappear with time. Some respond to additional sclerotherapy or laser therapy. A few may last.
  • Small, painful ulcers at treatment sites. Appearing immediately or within a few days of treatment, these develop when some of the solution escapes into the surrounding skin or enters a small artery. This can be successfully treated, but it is necessary to inform the dermatologist immediately, especially if increasing pain or scabbing is noticed.
  • Temporary bruises. Patients who tend to bruise easily may have temporary bruising. This usually disappears in a few weeks.
  • Allergic reaction. Some patients have an allergic reaction to the injected solution. Wheezing, difficulty swallowing, and severe swelling are the usually signs of a severe allergic reaction. Most commonly this happens during treatment or shortly afterwards. Inform the dermatologist immediately if these symptoms occur so that appropriate medical treatment can be given.
  • Inflammation of treated blood vessels (phlebitis). More common in patients who have a family history of clotting disorders, phlebitis can be effectively treated with aspirin, compression, antibiotics, or heat.
  • Lumps (thrombi) in injected vessels. Most common following treatment of larger varicose veins or very large spider veins, this can be successfully treated by draining the coagulated blood from the areas.

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