Medically reviewed by: Luke Maj, MD
When bathing suit season rolls around, every little imperfection on your legs suddenly becomes noticeable, including those squiggly red or purple veins known as spider veins. If you’ve researched how to get rid of spider veins, you probably have questions about sclerotherapy, the most used spider vein treatment.
Read on to learn what sclerotherapy is, how it feels and what you can expect your legs to look like in that bathing suit after treatment.
What is sclerotherapy?
Sclerotherapy is an in-office treatment that uses an injected solution or foam to destroy spider veins or small varicose veins in the legs. The solution irritates the lining of the treated veins, which makes them collapse. Once they’re closed, the body reroutes the blood through healthier veins.
What happens during sclerotherapy for spider veins?
You’ll lie on your back or stomach, depending on which part of your leg is being treated. Your leg will be cleaned with an antiseptic. The phlebologist (vein doctor) might use a vein light to locate the right vein. Then they’ll use a very thin needle to inject a liquid or foam into the vein. This process is repeated for each cluster of veins you’re having treated. Depending on how many veins you have done, the whole procedure should take about 30 to 45 minutes.
Most people need more than one treatment. Treatments are typically spaced about six weeks apart.
Does sclerotherapy hurt?
Sclerotherapy isn’t painful, but it can be slightly uncomfortable. You’ll feel a pinch when the needle goes in and a slight burning sensation as the liquid enters your vein.
Is sclerotherapy safe?
Sclerotherapy is a safe procedure in the hands of an experienced phlebologist. Most of the side effects that can happen are mild and disappear within a few weeks.
What are possible sclerotherapy side effects?
Your legs will look a bit worse before they look better. Bruising, vein swelling and small sores or raised red areas are common. Other possible side effects are staining and matting.
Sclerotherapy staining, or hyperpigmentation, is the development of brown spots near the collapsed veins. Brown spots after sclerotherapy are the result of red blood cells dying and releasing an iron-containing pigment called hemosiderin.
About one to three out of every 10 people who undergo sclerotherapy will develop color changes in their skin within a month after their treatment. It’s more likely in people with darker skin tones and when veins larger than 1 millimeter in diameter are treated. The hyperpigmentation usually disappears within six months. Only 1% to 2% of people have permanent color changes.
Matting after sclerotherapy
Matting is when new, very thin red blood vessels pop up around the injection site. As many as one in five people have matting after sclerotherapy. Experts don’t know what causes it, but you’re more likely to have this problem if you’re female, you’re very overweight or you have a family history of spider veins.
This side effect usually clears up on its own within a few months. Rarely, it can be permanent. If the matting doesn’t go away, your phlebologist can treat it with more injections or a laser.
Rare sclerotherapy side effects
More serious side effects such as blood clots, an allergic reaction and small air bubbles in the blood are rare. Let your doctor know right away if you have any of these symptoms after your procedure:
- Vision problems
- Trouble breathing
- Chest pain
- Dizziness or fainting
- Difficulty moving your arms or legs
How do I get ready for sclerotherapy?
Your doctor will tell you how to get ready for sclerotherapy, including whether you should stop taking certain medicines or supplements a few days beforehand. They will probably instruct you to buy compression stockings of a certain compression strength before your procedure. Wearing these stockings for a week or two after sclerotherapy will speed healing and help prevent bruising. They may feel a little snug, but they’re important.
You might be instructed to wear shorts on the day of your procedure. (At the Water’s Edge Dermatology Vein Center, shorts are provided.) Don’t apply any lotion that day.
What to avoid after sclerotherapy
You should be able to go back to work and your other activities on the day of treatment. Just avoid intense exercise for a few days. Walking is fine. In fact, moving will help you recover faster and prevent blood clots from forming in your leg.
For about two weeks, keep the treated areas of your skin covered when you go outside. Sun exposure can increase the risk of dark spots.
Can you fly after sclerotherapy?
Hold off on travel right after your procedure. A drive to the supermarket is fine, but long-distance travel isn’t recommended for two days after sclerotherapy. When you sit for long periods on a plane or in a car, blood can pool in your legs and form clots.
How long after sclerotherapy do veins disappear?
The veins should fade in about three to six weeks. In some cases, they disappear completely. In other cases, the veins look much lighter but are still visible.
It’s likely that over time, you’ll develop new spider veins, at which point, you can undergo sclerotherapy again.How much does sclerotherapy cost?
The cost of sclerotherapy varies depending on where you live and how many veins you have treated. Your health insurance probably won’t cover sclerotherapy because it’s considered a cosmetic procedure.
Looking to get rid of unsightly spider veins? Schedule an appointment with the Water’s Edge Dermatology Vein Center today.
Written by: Stephanie Watson, a freelance writer based in Providence, Rhode Island. She has written for WebMD, Healthline, HealthCentral, Harvard Health Publications, SELF, and many other consumer health publications.