How are varicose veins treated?

Depending on their size and location, varicose and spider veins can be treated with surgery, injections (sclerotherapy), or laser surgery.


Sclerotherapy is a non-surgical treatment option that involves injecting a chemical solution into the veins to make them collapse. As the veins can no longer carry blood, they will eventually disappear. Circulation improves because the work of carrying the blood is shifted to nearby healthy blood vessels.

Sclerotherapy requires multiple sessions. One to 3 injections are usually required to effectively treat any vein. Ten to 40 veins may be treated in one session. The same area should not be re-injected for 4 - 6 weeks to allow for complete healing, although other areas may be treated during this time.

Sclerotherapy does not require anesthesia.

Will I feel pain during treatment?

No, you will feel no pain during the treatment sessions. However, you will feel discomfort due to the sensation of the small needle pricks.

What are the complications of sclerotherapy?

Temporary reactions to the sclerotherapy might include:

  • Slight swelling of the leg or foot
  • Minor bruising, itching, redness, or mild soreness

Rare complications include the development of telangiectasias (small clusters of red blood vessels, skin ulcerations, and brown pigmentation around the treated vessels).

What happens after sclerotherapy?

Once treated, the veins disappear over a period of 6 months and do not recur. But sclerotherapy treatment cannot stop new varicose or spider veins from developing.

For 2- 4 weeks after treatment, you will wear medical-grade support stockings. Walking and moderate exercise can also help speed recovery.

What are some other treatment options for dilated veins?

  • Photoderm therapy: Intense, pulsed light can be used to treat small spider veins, certain sizes of varicose veins, and vascular birthmarks. This treatment might be recommended when sclerotherapy or laser therapy does not effectively treat the dilated vein. One to six treatments might be required to properly treat the area.
  • Laser therapy: Most effective for small facial and leg blood vessels, laser therapy heats the blood vessel and makes the vein fade away.
  • Surgical ligation/stripping: Severe varicose veins might require a surgical procedure in which the dilated vein is either removed or tied off through a small incision in the skin. The surgery is done in the hospital by a vascular surgeon.
  • Endovenous ablation therapy: Endovenous ablation therapy uses lasers or radio waves to create heat to close off a varicose vein. Your doctor makes a tiny cut in your skin near the varicose vein. He or she then inserts a small tube called a catheter into the vein. A device at the tip of the tube heats up the inside of the vein and closes it off. You will be awake during this procedure, but your doctor will numb the area around the vein. You usually can go home the same day as the procedure.
  • Endoscopic vein surgery: For endoscopic vein surgery, your doctor will make a small cut in your skin near a varicose vein. He or she then uses a tiny camera at the end of a thin tube to move through the vein. A surgical device at the end of the camera is used to close the vein. Usually, endoscopic vein surgery is used only in severe cases when varicose veins are causing skin ulcers. After the procedure, you usually can return to your normal activities within a few weeks.

Last reviewed by a Cleveland Clinic medical professional on 07/15/2019.


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