Sclerotherapy
A solution injected with a fine needle into spider veins on the legs, which irritates the vein lining so the vein closes and is absorbed. It takes several sessions, and a brown line often marks the treated vein for months afterward.
Key facts
Treats
Spider and small varicose leg veins
Recovery
Compression stockings; bruising possible
Treatment plan
Often 2–4 sessions
Typical cost
Per-session quote
What is it?
It closes veins.
A sclerosant injected into a vein damages its lining.
The vein fades over time.
It is gradually replaced by fibrous tissue.
Assessment guides treatment.
Small visible veins and underlying reflux are treated differently.
History matters.
Previous clots, circulation problems and pregnancy should be discussed.
What it treats
Spider Veins
Clears leg veins.
Varicose Veins
Treats small varicose veins.
Rosacea
Not used on the face.
Port-Wine Stains
Lasers are used instead.
Treatment areas
Sclerotherapy
Leg veins.
Sclerotherapy
Leg veins.
Skin tones
Lighter skin
Some risk
Brown lines along veins for months.
Medium skin
Some risk
Brown staining more visible.
Deeper skin
Some risk
Staining can last longer; usually fades.
How it works
Diagram explanation
Solution enters a selected vein: A clinician injects a sclerosant into the target vessel. The vein lining is injured: The treated vessel closes through a controlled local response. The vein gradually fades: Scar tissue replaces the treated vein as blood uses other pathways.
Schematic illustration. Technique and response vary. This explains a mechanism and does not specify treatment settings.
Types
The solution can be injected as a liquid or mixed with air into a foam. Foam spreads further and is used for larger veins.
Before your treatment
2–4 weeks before
2 weeks before: Sun: Avoid sun and sunbeds on your legs for a couple of weeks before and after.
The week before
1 to 2 days before: Shaving: Shave your legs a day or two before, if you shave.
Day of treatment
Before you arrive
Clean, dry skin: Tape and dressings need clean, dry skin.
What to bring: Stockings and clothes: Buy the compression stockings your provider recommends beforehand.
Arrival & prep
Your legs are examined standing up, when veins fill, and photographs are usually taken.
Treatment
You lie down, the skin is cleaned, and the provider works along the leg injecting small amounts into each vein, often using magnifying glasses or a vein light.
A session runs about 15 to 45 minutes. Each injection stings for a second or two, sometimes with brief cramping along the vein.
Before you leave
Stockings or wraps go on before you stand, and you walk for fifteen or twenty minutes.
After your treatment
First 24 hours
Days 1 to 14: Small red welts, itching and mild aching along the treated veins.
Weeks 2–4
Weeks 3 to 8: The veins fade and most bruising resolves.
Beyond 1 month
Months 2 to 12: Brown staining fades slowly, and most clears within six to twelve months.
Time to results
1–3 months
How long results last
Treated veins are gone; new ones can appear
Risks
Most of what happens is expected
stinging during injection, bruising, itching, small raised welts, firm threads under the skin, and brown discoloration along the treated veins. Serious complications are uncommon. Staining and matting bother people most, and both are worth understanding before the first session.
Brown staining along the vein
Very common — iron left in the skin when trapped blood breaks down. Most fades over six to twelve months; it is more visible and slower on deeper skin tones, and sun makes it worse. A little can persist beyond a year.
Matting
A patch of fine new red vessels at a treated area, usually within a few months. It happens to a minority, often fades on its own, and sometimes needs treating in its own right.
A firm, tender lump along a vein
Trapped clotted blood in a closed vein. Not dangerous, and easily released with a needle in the office, which speeds fading and reduces staining — worth an appointment rather than waiting.
A vein that has not responded
After two treatments, this sometimes means a larger vein underneath is refilling it. An ultrasound is next.
Itching or a rash over the treated area
Usually a reaction to the tape, the compression or the solution. Mention it before the next session.
Cost
Typical cost
Per session
Pricing
In the US a session usually runs about $300 to $600, priced per leg or per block of time rather than per vein.
Insurance
Ask what a session includes, whether the price covers both legs, and whether a follow-up visit to release trapped blood costs extra.
Alternatives
Laser for leg veins
Useful for very fine vessels too small to inject, for matting, and for people who cannot tolerate needles. Generally more painful per pulse, usually more sessions for the same veins, more expensive, and carries its own pigment risk, which matters more on deeper skin tones.
Foam sclerotherapy, ultrasound-guided
For larger veins rather than spider veins. Done by a vein specialist after a scan. It is the same idea in a form that can treat a vein you cannot see.
Endovenous ablation with heat or glue
The standard treatment when a larger vein underneath is not working. Often covered by insurance when there are symptoms. If this is the actual problem, treating it first is what makes spider vein treatment last.
Vein stripping surgery
Largely replaced by the less invasive options above for most people. Still used in particular situations, decided by a vein specialist.
Compression stockings
For symptoms — aching, heaviness and swelling — and none for appearance. They do not remove veins. Worth wearing regardless of what else you do.
Doing nothing
Spider veins on their own are a cosmetic issue and carry no health risk. Leaving them alone is a legitimate choice, and the honest comparison for anyone weighing several hundred dollars a session.
Walking, leg elevation and calf exercises
The calf muscle pumps blood back up the leg, so movement genuinely helps symptoms and helps prevent worsening. It does not clear existing veins.
Horse chestnut seed extract
For symptoms. Some evidence for reducing leg aching and swelling in vein disease. No effect on appearance. Worth checking with a doctor before taking it alongside other medicines.
Sun protection on the legs
The one home step that genuinely changes the outcome of treatment, by keeping brown staining from darkening and lasting longer.
Questions
How many sessions will I need?
Usually two to four per leg, four to six weeks apart, and stubborn veins sometimes need injecting more than once. Extensive veins need more. Expect a course, plus touch-ups every year or two as new veins appear.
Why is there a brown line where my vein was?
Blood trapped in the closed vein breaks down and leaves iron in the skin. Most fades over six to twelve months, and sun makes it darker and slower to clear. It is more visible and slower to fade on deeper skin tones. If a firm tender lump forms, having it released in the office speeds the fading.
What is matting?
A patch of very fine new red vessels where a vein was treated, usually within a few months. It happens to a minority, often fades on its own over months, and occasionally needs further injections or laser.
Will it work on my bulging varicose veins?
No. Ropey bulging veins need a vein specialist, an ultrasound to find the source, and usually a procedure that closes the larger vein with heat, glue or ultrasound-guided foam. Treating the spider veins on top is why some people see them return quickly.
Does it hurt?
Each injection stings for a second or two, sometimes with brief cramping along the vein. Dozens in a session make it repetitive rather than severe. Afterward, aching and itching for a few days.
Will my legs look worse before they look better?
Usually yes, for the first week or two. Bruising, raised red lines and brownish streaks are the normal middle stage. Judge the result months after the course finishes.
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Nd:YAG Laser vs Sclerotherapy
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