What it is
Sclerotherapy is the targeted injection of a sclerosing agent into an unwanted superficial vein. The agent irritates the inner lining of the vessel; the vessel walls swell, adhere, and collapse. Over the following weeks the body resorbs the closed vessel and the visible mark fades. Blood that previously flowed through the vessel is rerouted through deeper, healthy veins.
The technique is well established for spider veins and small reticular veins of the legs. Larger varicose veins and underlying venous insufficiency are a different problem — they typically require duplex ultrasound and procedures other than office sclerotherapy.
How we approach it
Sclerotherapy starts with looking at the legs, not the menu. The clinician evaluates whether what you see at the surface is the actual problem or the symptom of a deeper issue. If your pattern of veins, your symptoms, or your history suggest underlying venous insufficiency, you are referred for duplex ultrasound and vascular evaluation before any office injection. Treating the surface while the underlying feeder vein continues to fail is a recipe for recurrence.
When sclerotherapy is the correct treatment, the agent itself is selected per the lesion — concentration and formulation chosen to fit the size and depth of the vessels being treated. Most patients require more than one session per area.
The post-treatment plan — compression, walking, sun protection, what to expect at one week, three weeks, and three months — is reviewed in writing before you leave.
What to expect
Consultation: A focused exam of the legs in good light. If indicated, referral for duplex ultrasound.
Treatment: The skin is cleansed. The targeted vessel is injected with a very fine needle. Each injection is brief; most patients describe a mild sting or burning that subsides in seconds. A typical session covers a defined zone — a single thigh, a posterior calf, an ankle pattern — over thirty to forty-five minutes.
Immediately after: Treated vessels often appear darker and bruise-like. This is expected.
Compression: Compression stockings are worn per a specific schedule — typically continuously for the first day or two and during waking hours for one to two weeks.
Activity: Walking is encouraged. High-impact exercise, hot baths, saunas, and prolonged sun exposure on the treated area are restricted for a defined window.
Timeline: Visible fading at three to six weeks. Final result for a given session is judged at two to three months. Additional sessions are scheduled as needed.
Candidacy
Good candidates have spider veins or small reticular veins of the legs, have been evaluated for underlying venous disease when appropriate, and can comply with compression and activity instructions.
Not a candidate if you are pregnant or nursing, have significant underlying venous insufficiency or large varicose veins that have not been evaluated, have an active or recent deep vein thrombosis or untreated thrombophilia, have an active infection or open wound in the treatment area, have a known allergy to the planned sclerosing agent, or cannot reasonably wear compression or stay ambulatory afterward.