Spider Vein Injections (Sclerotherapy): Results, Side Effects and What to Ask

Spider veins, the small red, blue or purple lines on the legs, are common with age. Sclerotherapy is the main in-office treatment. Here is what the procedure involves, based on patient information from the American College of Radiology and the Radiological Society of North America.

What it is and who it’s for

A fine needle is used to inject a solution into small veins. The solution irritates the vein lining so it sticks together, turns to scar tissue and fades.¹ It’s used to improve the look of spider veins, to ease symptoms such as aching, burning, swelling and night cramps, and as the main treatment for small varicose veins.¹

Before the appointment

• Tell your clinician about all medicines and supplements. You may be asked to stop aspirin, anti-inflammatory pain relievers, blood thinners or iron beforehand.¹ Don’t stop a blood thinner without your prescriber’s advice.
• Skip lotion on your legs before and after.¹
• Bring shorts, and plan a ride home.¹

During and after

• You’ll feel small needle sticks and maybe mild burning. A session usually takes 30 to 45 minutes.¹
• Afterward you’ll wear support stockings or wraps.¹
• Bruising can last days to weeks. Raised red spots usually fade within days.¹
• Larger treated veins can feel lumpy or hard for several months.¹

Results

• Each session clears about 50% to 80% of the injected veins.¹
• Spider veins respond in about 3 to 6 weeks; larger veins take 3 to 4 months.¹
• Treated veins that respond don’t come back, but new veins can appear, so some people return for more sessions.¹
• Fewer than 10% don’t respond at all.¹

Side effects and risks

• Brown lines or spots at injection sites usually fade in 3 to 6 months but are permanent about 5% of the time.¹
• Infection needing antibiotics appears to occur in fewer than 1 in 1,000.¹
• Other risks include blood clots, severe inflammation, allergic reactions and small permanent scars.¹
• It isn’t done during pregnancy, breastfeeding or if you’re bedridden.¹

Questions to ask

1. Do my veins need an ultrasound first to check for deeper vein problems?
2. How many sessions do you expect, and what does each cost?
3. Will insurance cover any of it, or is it considered cosmetic? RadiologyInfo doesn’t list costs.¹
4. What compression should I wear, and for how long?
5. What should I do if I notice leg swelling or pain?

Our article on easy bruising and our guide to skin changes with leg vein problems cover related concerns.

Try: “I have spider veins and my legs ache by evening. Do I need a vein ultrasound first, and how many sclerotherapy sessions should I expect?”

Skin, Head to Toe includes a short-shelf planner and a 12-week SkinLog. Use them to photograph treated areas and track bruising, marks and results between sessions. See the book.