Sclerotherapy is a minimally invasive treatment for varicose veins and spider veins. Your healthcare provider injects a chemical solution into your vein to close it off. This in-office treatment works well for many people, especially on smaller varicose veins. Recovery is quick, but it can take weeks or months to see results.
Sclerotherapy is a medical procedure that treats varicose veins and spider veins, usually on your legs. Your healthcare provider uses a needle to inject a special solution into your varicose vein or spider vein. This chemical solution irritates your blood vessel lining, making it expand, stick together and form a scar. This closes off your vein, making it look and feel better.
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Sclerotherapy may be appropriate for people with varicose veins or spider veins, but it’s not for everyone.
Before the procedure, you’ll meet with a vascular specialist who’ll decide if you qualify for sclerotherapy.
You’re not eligible for sclerotherapy if you:
You can still get sclerotherapy if you take birth control pills.
If you’ve had a blood clot in the past, you may be able to have sclerotherapy, depending on what caused the clot and how serious it was.
In most cases, your provider won’t do sclerotherapy on a vein you might need for future surgical bypass procedures, such as the saphenous vein for coronary artery bypass graft surgery (unless that vein is already unusable).
It’s a good idea to talk with your provider about how successful they think sclerotherapy treatment will be for you. Some people with high expectations are disappointed with their results. Knowing what to expect can help you avoid feeling disappointed. You should also know that results aren’t immediate. You won’t walk out of your provider’s office looking like a leg model.
Before your sclerotherapy treatment, you should avoid certain medications. Follow these guidelines:
Other guidelines before your procedure:
If you have compression hosiery (support stockings) from previous treatments, bring them with you so your provider can make sure they’ll give you enough support after your procedure.
Your healthcare provider will perform sclerotherapy in their office. They may use an ultrasound to help them find the right vein to treat.
Sclerotherapy treatment takes about 30 to 45 minutes. You’ll lie on your back or your stomach, depending on the location of the vein they’re treating.
Your provider can choose from several chemicals available for use in sclerotherapy. They’ll select the appropriate chemical and concentration of it based on the size of the vein they’re treating.
Before starting, your provider may try a test injection and wait a bit to make sure you don’t have a reaction to it.
They’ll follow these steps:
You’ll feel the needle pinch your skin, and possibly a mild burning feeling. You may feel mild discomfort when the injection goes into your veins. In larger veins, you may feel cramping for a minute or two during the injection.
The number of veins your provider treats in one session depends on the size and location of your veins, as well as your overall medical condition.
After your treatment, your provider may ask you to keep lying down for 15 minutes or so to make sure you don’t have a bad reaction to the injected material.
You’ll be able to drive yourself home. You may go back to your regular activities, especially walking.
You should wear support hosiery or compression wraps for three to seven days to compress the treated vessels. Support stockings purchased from a department store may not work if your healthcare provider prescribes a heavy compression stocking.
For 48 hours after your procedure, follow these guidelines:
Call your provider if you have any concerns or questions after your procedure.
Advantages of sclerotherapy include:
Sclerotherapy takes longer than surgery for varicose veins or spider veins. It can also have side effects.
Side effects of sclerotherapy may include the following:
Other side effects rarely develop after sclerotherapy.If you have any of these rare side effects, contact your healthcare provider immediately:
It doesn’t take long to recover from sclerotherapy. After treatment, you can drive home and get back to your normal activities. Walking is good for your recovery, so don’t be surprised if your healthcare provider recommends it.
You’ll most likely see your healthcare provider for a follow-up visit a month or two after sclerotherapy treatment. You may have a physical exam, blood tests or imaging. If you’re having multiple treatments, you may have your next session two or three months after your first one.
Insurance companies don’t provide coverage for sclerotherapy when it’s performed for cosmetic reasons. Some insurance companies cover sclerotherapy for specific medical conditions. Your insurance company may request a letter from your healthcare provider about the nature of your treatment. It’s a good idea to contact your insurance provider to confirm that they’ll cover sclerotherapy before you consider it.
Laser treatment, or endovenous thermal ablation, is another good alternative to ligation and stripping of varicose veins. It’s generally safe but can have some side effects like you do with sclerotherapy. However, it’s difficult to do ablation on a varicose vein that has a lot of twists and turns. Your healthcare provider will need to consider what your veins look like when deciding on the best treatment for you.
A note from Cleveland Clinic
Varicose veins can be hard to live with, but sclerotherapy works for many people. Having a conversation with your healthcare provider will help you understand your treatment options so you can decide if sclerotherapy is right for you. It’s good to know what to expect from the procedure. For the best results, be sure to follow all of your provider’s instructions before and after sclerotherapy.
Last reviewed by a Cleveland Clinic medical professional on 06/12/2022.
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