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What is Sclerotherapy and Why is it Possibly the Best Option to Treat Your Spider Veins

Are you bothered by unsightly spider veins in your skin? While not life-threatening, spider veins can be progressive and won’t disappear unless you do something about them. One of the most common procedures to treat problematic veins medically and effectively is sclerotherapy. 

Sclerotherapy is a minimally invasive medical procedure a certified healthcare provider administers to treat spider veins. It is done by injecting a chemical solution into the vein to seal it off and make it gradually disappear. This prevents the backflow of blood from the heart to the vein. 

You see, the veins’ work is to pump blood to the heart with the help of leg muscle movement. Typically, this flow happens in a one-way, gravity-defying manner through the valves in the veins. When these valves weaken, the flow becomes two-way, and some blood flows back to the veins. 

This back leak causes the veins to dilate and the blood to pool. This leads to the raised, bluish appearance of spider veins, usually on the legs, and the thread-like branches of spider veins. 

Spider veins are not a serious health issue; herbs and skin topics for relief are common. However, if left untreated, the veins could grow and cause discomfort or pain. The causes of spider veins vary — genetic disposition, prolonged sitting or standing, sun exposure, hormonal changes, or aging. 

Many patients afflicted by it also resort to sclerotherapy for cosmetic purposes,  especially when the veins become unsightly, bulging, and bruise-like.  

How Does Sclerotherapy Work?

Sclerotherapy involves injecting a chemical directly into the problematic vein with a thin needle. The injected fluid irritates the vein wall, causing it to swell, stick together, and close off. This sealing-off reroutes the blood flow to other healthier veins, and the sealed-off veins gradually collapse and fade away. 

Sclerotherapy is an outpatient procedure that, depending on the size of the area and the number of spider veins to be treated, can last approximately 30 minutes. 

It is important to have this procedure done by a certified health professional with extensive experience to get optimal results and enjoy its long-term benefits. New York Metropolitan Vein and Aesthetic Center is a trusted source of services for treating spider veins, with top cardiologist, venous disease, and aesthetic medicine expert Dr. Adam Goldman. Learn more about how sclerotherapy works here.

Sclerotherapy Injection Solution Options

The chemical solution, also called sclerosants, are usually sodium tetradecyl sulfate,  glycerin, polidocanol, sodium correlate, and ethanolamine oleate in varying concentrations. The doctor determines which solution is the most suitable for the patient. 

What Conditions Does Sclerotherapy Treat?

A woman getting a sclerotherapy injection on her calf with the words "What conditions does sclerotherapy treat?" written on top

Sclerotherapy is used to treat the following conditions:

Spider Veins

Also known as telangiectasias or spider angiomas, these are typically red, blue, or purple thread-like veins that appear on the legs, face, chest, and other body areas. They spread from a central point. Sclerotherapy can minimize or eliminate their appearance.

Symptomatic Vein Conditions

Sclerotherapy minimizes swelling, aches and pain, skin changes, and discomfort in your veins. These symptoms are usually tied to vein conditions like spider veins, but the specialist also evaluates any other possible serious vein problems requiring further medical attention.

Venous Insufficiency

Sometimes, the vein cannot adequately facilitate blood flow to the heart. This can also cause swelling and pain. Sclerotherapy helps reroute the blood flow. 

Peripheral Vascular Malformations

Peripheral Vascular Malformations are abnormal formations of blood vessels in the lymphatic system. Through sclerotherapy, these anomalies become scarred and eventually collapse. 


Swollen blood vessels associated with hemorrhoids, especially internal hemorrhoids, can be shrunk through sclerotherapy, minimizing or eliminating pain and discomfort in the area, especially during your bowel movements. 

Lymphatic Malformations 

Lymphatic Malformations, also known as Lymphangiomas, are abnormal, fluid-filled clusters of cysts that form during fetal development. They can also be treated with pediatric sclerotherapy. Sclerotherapy irritates the lining of the lymphatic vessels, causing them to close off and eventually collapse.  

When to Consider Sclerotherapy Treatment?

If you have symptoms like vein swelling, leg pain, discomfort, cramps, fatigue, itching, or skin changes, you should seek the evaluation of a vascular specialist, dermatologist, dermatologic surgeon, or phlebologist. Based on their assessment, the specialist will inform you if sclerotherapy is the best treatment for your case. 

Many patients seek treatment for their leg vein issues, particularly spider veins, especially when the pain and discomfort become intolerable. For some, severe cases of spider veins that appear on their legs or the spread of spider veins can affect self-confidence, and they can seek treatment to minimize their appearance and feel better. 

Whatever your reason, it is essential to undergo proper evaluation by certified specialists to know if sclerotherapy can help you.

How to Prepare for a Sclerotherapy Procedure?

Knowing what to expect before, during, and after the treatment is important so you can be mentally and physically prepared for it, minimize risks, and gain optimal results.

First, the doctor will discuss your goals, examine the veins you want treated, and assess if you have any serious underlying vein problems that need to be addressed. Photos may be taken for documentation and before-after comparison. You will also be asked to disclose your medical history, any medical procedures you may have undergone, or any medications and supplements you’re taking.

The attending specialist usually instructs that you temporarily stop taking antibiotics, anti-inflammatory medications like Aspirin or Ibuprofen, or Prednisone to avoid effects like skin stain, bleeding, or reduced efficacy. 

You will also be instructed not to apply any lotion or oil on your legs before (or after) the procedure and to wear or bring shorts if the procedure is being done on the legs.

You will be advised to make arrangements for transportation back to your home. Learn more about what to avoid after sclerotherapy here.

What to Expect During the Procedure

During the procedure, you will be asked to lie on your back and slightly elevate your legs. The doctor will cleanse the target area/areas, stretch the skin out, and inject the fluid directly into the blood vessel using a fine needle. The doctor may use ultrasound to help identify the right vein to inject. During the procedure, some veins may need to be injected multiple times, and multiple veins may also be injected. 

Expect the needle to sting a bit. You may also experience some cramps. Each injection will be followed by compression and massage to the area to disperse the solution and to keep blood from pooling. You may also be given a compression pad taped to the treated area. 

What to Expect After Treatment

The post-procedure experience varies per individual, but the common experiences include stinging in the injection sites, cramps, and some swelling of the ankles or feet. The latter usually only happens if the doctor uses a hypertonic saline solution- which is rare as it causes a burning sensation. 

Expect to feel some cramping a minute or two after getting injected into your larger veins. Depending on the veins to be treated, the location, and your overall health condition, the doctor will determine which chemical solution and concentration to use, how much of the veins will be treated, and how many sessions are needed to complete the procedure.  

After the procedure, some patients may experience temporary bruises, inflammation of the treated veins, lumps in the treated area, burning sensations, ulcers, discoloration, reddish bumps, streaking or inflammation near the groin, brown lines or spots, or some swelling. These subside after a few days, weeks, or months in the case of the brown lines and spots.

What to Avoid After Sclerotherapy?

Avoid heavy lifting, strenuous activities, and sun exposure after the procedure. You are also advised to avoid activities that interfere with blood circulation and closure of the treated veins, such as hot baths, saunas, tight clothing, high heels, too-tight compression stockings, smoking, alcohol, prolonged sitting or standing, and missing follow-up appointments with your doctor. 

Is Sclerotherapy Safe?

Sclerotherapy is an effective and low-risk treatment, but like any medical procedure, it also comes with some risks or complications. These may be extremely rare occurrences but should be discussed by your doctor to help you make an informed decision. Some of these risks include:

Allergic Reactions

Allergic reactions are not common, but there is still a chance that your body may have a reaction to the injected solution. This can be treated with medications. You should inform your doctor immediately if you experience any signs of allergies following your procedure. 

Permanent Brown Lines or Spots

This potential side effect normally fades within 3 to 6 months, but 5% of patients end up having them permanently on the injection site. 


Anaphylaxis is a severe whole-body allergy reaction. Those with chronic or previous post-sclerotherapy urticaria and mastocytosis are at risk for this. Hypersensitivity reactions are minimized by using foam sclerosants. 

Venous Thromboembolism

Sclerotherapy does not cause this blood clot directly, but certain risk factors may cause it. These include puncturing a deeper vein during injection, prolonged immobilization, and pre-existing conditions like overweight, smoking, and aging.

Nerve Injury

This has a 0.02% chance of occurring when the saphenous or sural nerves are accidentally injected with sclerosants. The use of modern ultrasound can effectively prevent this. 

Tissue Necrosis

Tissue necrosis is the death of body tissue due to a lack of blood supply. The rare case of sclerotherapy causing it can be due to an accidental leaking of a sclerosant solution into surrounding tissues. Other causes include improper injection technique, extremely concentrated sclerosant, and some pre-existing conditions in the patient- such as compromised circulation. 

The Cost of a Sclerotherapy Procedure

The cost of sclerotherapy depends on several factors, such as the number and extent of the veins to be treated, the location of the treatment, the doctor’s fee, and the number of sessions it takes to complete the procedure.

In the U.S., the average cost can range from $300 to $3,000 per session. The number of sessions will vary based on the severity of the veins. Some insurance plans cover sclerotherapy if it’s documented as a medical necessity.  New York Metropolitan Vein and Aesthetic Center has accredited insurance providers that help cover the cost of the procedure based on plans. 

The Benefits of Sclerotherapy

According to the University of California San Francisco Health or UCSF Health, sclerotherapy is the most common treatment for spider veins. Cleveland Clinic also lists the benefits of this procedure, and they include:  

Long-term Effects

Sclerotherapy has a permanent effect and will only need new sessions if new spider veins appear. 

Minimally Invasive

There are no surgery scars or suturing involved. The process is straightforward, and you don’t have to be admitted to a hospital.

Quick Process and Results

The process can be carried out in a clinic quickly, and patients can walk out and head home accompanied with only minimal discomfort. Spider veins often improve in about three to six weeks post-treatment, but larger, more severe spider veins may take three to four months to improve visibly.

No Downtime

There is practically no downtime, as most patients can resume their work or activities shortly after the treatment. 

Does Not Require Anesthesia

Unlike surgeries and other treatments, sclerotherapy does not need anesthesia, which means less time, cost, and no grogginess post-procedure. 

Relief from Discomfort 

The procedure has a high success rate. You can experience relief from pain, swelling, itch, or discomfort shortly following the procedure. 

Low-Risk Procedure

It is an effective procedure with manageable side effects and infrequent risks. 

Is Sclerotherapy Right for You?

A before and after of a person who got sclerotherapy with the words "Book Your Sclerotherapy Appointment TODAY!" with two phone numbers on the right hand side

At New York Metropolitan Vein and Aesthetic Center, you can be assured that we will guide you with the right procedure for your vein problem. We will discuss your goals, what to expect, the instructions, side effects, risks, cost, insurance coverage, if any, and proper post-treatment care. 

We will walk you through the entire process to help you determine if sclerotherapy is the right approach to address your spider vein problems. Contact us today for a free consultation or visit our Washington Heights, NY,  and Corona, Queens clinic locations. 

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