Sclerotherapy is a very safe and effective treatment for spider veins, however all medical procedures carry potential risk and side effects.

Potential Risks and Side Effects

Transient hyperpigmentation:

After sclerotherapy you may notice some discoloration (dark streaks) after treatment. This occurs when the blood gets trapped inside the vein after it closes down. We can usually “flush” the trapped blood out on your next visit. If the flushing does not alleviate the discoloration it will fade on it’s own in 4 to 12 months.  In rare instances this darkening of the skin may persist for years.

Skin Ulceration:

In rare cases, a blister may form, open, and become ulcerated. Healing occurs slowly over a few months. After healing, this will usually leave a scar.

Allergic Reaction:

Very rarely, a patient may have an allergic reaction to the sclerosing agent.  The risk of this is greater in patients who have a history of allergies.

Deep Vein Thrombosis

Deep Vein Thrombosis is a very rare complication. The dangers of deep vein thrombosis include the possibility of pulmonary embolus (a blood clot carried to the lungs) and post phlebitic syndrome, resulting in a permanent swelling of the leg.

Most Common Side Effects

The veins may be tender to the touch after treatment, and an uncomfortable sensation may run along the vein route. This discomfort is usually temporary. Bruising is very common and to be expected. Some patients complain of an itchy sensation after treatment, which is also very normal. Trapped blood may cause a discoloration, which can be flushed out, although this may leave hyperpigmintation up to one year.

Alternative Treatments

Spider veins are not life-threatening conditions, treatment is not mandatory.  Some patients get adequate relief of symptoms from wearing graduated support stockings. The other option is to receive no treatment at all.

What can I expect during treatment?

Before beginning the treatment your legs will be cleaned off front and back with alcohol. This is a cold sensation but not uncomfortable. Infection is highly unlikely with sclerotherapy, but this type of preparation is standard before any type of injection.

A very small gauge needle is used to perform the injections. Most patients relate the discomfort to that of an ant bite. If the discomfort is too much and you need a break, speak up.

Often you will see the spider veins on the surface of your legs but may be unaware of a network of veins not so visible which may be feeding the spider veins.

We will first look at your legs with an illuminating light which helps us to identify any feeder veins. In some cases the feeder veins may be extensive and in other cases minimal. This will be part of what your physician bases the estimated number of treatments you may need.

If you have extensive feeders your first treatments will concentrate on these veins. Since you could not see them you may not notice a dramatic change in the appearance of your legs initial. In most cases you will see the most impressive changes after the second and third treatment.

Your treatment session will take approximately 30 minutes. We are limited to the amount of medication we can inject because of maximum dosage limits specific to the medication we use. We try to treat as many veins as possible during your session. If there are specific veins that bother you more than others, please make us aware of those veins so we can start with those first. After your treatment the veins we be red and irritated as shown above. There may be welts at the site of injection which are a normal histamine reaction. The areas treated may be itchy for an hour or two after the treatment. What can you expect after the treatment?

Your legs may be sore for several days. We encourage walking for twenty minutes twice a day to promote healing. If you are involved in an exercise program you may continue as tolerated. You may notice a significant amount of bruising, this is normal and to be expected. The bruising will fade in approximately ten days to two weeks.

Please avoid any hot tub baths for ten days as this will decrease the effectiveness of the treatment.







Mild Hyperpigmentation &Significant Hyperpigmentation

After your treatment you may notice that you have dark lines where your veins were. This is where the veins have closed down and there is no longer any flow through the vessel. Blood has gotten trapped inside the vein and it appears dark. This is actually a good sign that the treatment was effective. The degree of pigment changes varies greatly based on the extent and type of spider veins you have.

The picture on the left demonstrates mild hyperpigmentation which can occur with any type spider veins. This degree of hyperpigmentation requires no treatment and will fade gradually.

Ninety percent of all hyperpigmentation left untreated will fade with time, sometimes taking up to one year. It is rare that pigmentation changes are permanent.

Below is an example of a patient with significant hyperpigmentation and the results after flushing out the trapped blood. The pigmentation changes will continue to fade more with time.

Before Treatment

Change After First Treatment  

One Month After Flushing

Realistic Expectation of Results

It is important to remember that it has often taken years for these veins to develop, and they will not disappear overnight. Your Doctor has will give you an estimate of how many treatments you will need. It is important to keep a regular schedule of treatments every four to six weeks for the prescribed number of treatments.

It is reasonable to expect a 70%-80% clearing of your spider veins, however some people will just not respond well to the treatments and we have no way of knowing how you will respond. If you do not think your treatments are progressing well please inform our staff and we will review your treatment plan and progress. It is not realistic to expect 100% clearing.

Remember, once your have achieved the expected results, new veins will develop over time. We recommend a touch up session every six to twelve months as needed.

Below are photos of typical sclerotherapy results.

We look forward to helping you improve the appearance of your legs.


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Before Treatment 



After Four Treatments

Before Treatment

After Treatment