Spider Vein Treatment (Sclerotherapy)

One of the advantages of living in such a warm environment is we are able to wear swimsuits and shorts almost all year long.  The disadvantage of this is sometimes we develop unsightly small vessels on our legs, called telangiectasias or “spider veins’.  These are easy to treat so you can wear the clothes you want, with confidence. 

What causes spider veins?

There is not one cause of spider veins instead there are a number of different factors that can contribute, such as genetics, pregnancy, and standing for long periods of time (6 hours a day).  It is also possible that oral contraceptive usage, obesity, wearing tight clothing, prolonged sitting in chairs, sitting with one leg crossed over the other, trauma to the area, excessive sun exposure, and chronic increased intra-abdominal pressure could also contribute to “spider veins” forming.

What is sclerotherapy?

Scherotherapy is a popular method of eliminating superficial telangiectasias or “spider veins” is by injecting a solution, called a sclerosing agent, into the affected veins.  The solution we prefer to use at RevivaMed is called Asclera. This causes sclerosis or an inflammatory reaction, which causes clotting. This process causes a gradual fading of the treated vessel over a period of several weeks to several months.

Does Sclerotherapy work for everyone?

Most people treated will have good results, however, there is no guarantee that sclerotherapy will be effective in every case.  Approximately 10% of patients who undergo sclerotherapy have poor to fair results, with “poor results” means that the veins have not totally disappeared after 6 treatments.  In very rare instances, the patient’s condition may become worse after sclerotherapy. It is important to understand the sclerosing solution being used and its present FDA status.  At RevivaMed, we use Asclera, which is FDA-approved for the treatment of “spider veins”.

How many treatments will I need?

The number of treatments differ from patient to patient and depends on the number of spider veins and their pattern.  One to six treatments may be needed and the average is three to six. Individual veins usually require one to three treatments.

How often should I be treated?

Usually you can space treatments to every 2 months to allow time for the treated veins to be eliminated.

Will the veins come back after they are treated?

The veins that are treated will not return, however if you are susceptible to developing spider veins, new ones will develop over time.  Many patients schedule 1 or 2 “maintenance” appointments per year.

What are the most common side effects?

Bruising- Lasts from one to several weeks.  Use of support stockings may be recommended and avoidance of alcohol and anticoagulant for 72 hours prior to each treatment session may minimize the risk for bruising.

Transient Hyperpigmentation- Approximately 30% of patients who undergo sclerotherapy notice a discoloration of light brown streaks after treatment.  In almost every patient the veins become darker immediately after the procedure and begin to fade.

Pain- There is minor pain at the site of the injection and the veins may be tender to the touch.  This is usually temporary and lasts about 1-7 days at the most.

Blood accumulation in treated vessel- This may present as a tender bump at the treatment site and compression stockings can help prevent these from forming.

What are the other side effects?

Other side effects include a burning sensation during injection of some solutions and the development, usually temporary, of new tiny blood vessels; transient swelling of the wein might cause the ankles to swell, temporary superficial blebs or wheals (similar to hives); and very rarely, ulcers, wound infection, poor healing and scarring.

Patients who are contraindicated for Sclerotherapy

There are a few medical conditions that would prevent a patient from being treated with sclerotherapy

-Pregnancy, or Nursing

-Advanced Collagen Vascular Disease/Autoimmune Disorders

-Rheumatoid Arthristis/ Crippling Osteoarthritis

-Current Fever

-Taking Anticoagulation Medication

– Severe Bronchial Asthma


-Taking Corticosteroid Medication

-Hyper-Keloid Formation

-Severe Circulatory problems

What are the Pre-Treatment Instruction?
  • Do not take Aspirin or other blood thinning drugs (Vitamin E, Fish Oil, GIngko, Motrin, Eleve) for 2 days before and 2 days after your treatment because these medications can cause bruising.
  • If you take birth control pills or estrogen, inform RevivaMed.
  • We recommend not to drink alcoholic beverages and not to smoke for 2 days before and 2 days after your treatment because drinking alcohol and smoking may impair healing.
  • Do not apply any cream, lotion, oil, or self-tanners to your legs the night before or the day of your treatment.
  • Eat a light meal or snack 1 ½ hours before your appointment.
  • Bring loose fitting shorts or a leotard to wear during the treatment and a long skirt or long loose fitting pants to wear after treatment.
  • It is advised when having treatment of larger veins to postpone flying for 48 hours afterwards.
  • If you develop a fever or flu or other illness before your appointment you must reschedule.
What are the Post-Treatment Instruction?
  • Immediately after the procedure you may be required to wear support hose and walk for 10-30 minutes.  Please make sure to bring loose-fitting pants or skirt and comfortable walking shoes with you.
  • Taped compression pads/cotton balls can be removed 24 to 48 hours after sclerotherapy procedures.  If you notice that you are developing an allergy (rednes/rash) to the tape, remove the tape and put on support stockings.
  • If you remove the tape prior to the 24 hours, please put on support hose or TED hose.
  • You can continue your usual daily activities.  We encourage you to walk as much as possible and to avoid standing in one location for long periods of time.
  • Avoid strenuous physical activities, such as high impact aerobics, running, or weight lifting for the first 48-72 hours following your treatment.
  • Avoid hot baths for 2 weeks.  Cool your legs with cold water after each shower.
  • Avoid sunbathing and ultraviolet exposure for at least 1 week.
  • Avoid blood-thinning medications, such as Aspirin and other non-steroidal anti-inflammatory drugs (e.g. Ibuprofen, Motrin, Advil, etc.) for 48-48 hours following treatment.
  • Avoid flying for 48 hours after treatment of larger veins.
  • If you notice redness or a  small lump, use a warm compress several times a day to resolve.  If you experience any open area(s) you can apply Bacitracin Ointment to the affected areas along with the warm compress.