Sclerotherapy uses an injection of a special
chemical (sclerosant) into a
varicose vein to damage and scar the inside lining of
the vein. This causes the vein to close.
During this procedure,
the affected leg is elevated to drain blood, and the sclerosant is injected
into the varicose vein. The procedure is done in a doctor's office or clinic
and takes 5 to 30 minutes, depending on how many varicose veins are treated and
how big they are.
After the injection of sclerosant is given,
pressure is applied over the veins to prevent blood return when you stand up.
You may need to wear
compression stockings for several
days or weeks to maintain the pressure.
injection may be painful, and the chemical (sclerosant) that is injected can
cause a feeling of burning or cramping for a few minutes in the area where the
shot was given. You may need repeated sessions and many injections each
session, depending on the extent of the varicose veins and type of sclerosant
A newer, minimally invasive technique allows your doctor to inject sclerosant
with a catheter. The catheter and sclerosant are guided to the affected vein
with the help of
duplex ultrasound. This process allows sclerotherapy
treatment to be used on larger varicose veins that previously could only be
treated surgically with ligation and stripping, in which larger varicose veins
are tied off and removed.
What To Expect After Treatment
Sclerotherapy generally does not
require any recovery period. You will likely be able to walk immediately after
the treatment, but you should take it easy for a day or two. Bed rest is not
recommended, but you may need to avoid strenuous exercise for a few days after
sclerotherapy. Avoid exposing your legs to the sun for the first 2 weeks after the procedure.
You will probably have to wear compression
stockings for a short time after having sclerotherapy.
Why It Is Done
Sclerotherapy is used to
- Spider veins and small veins that are
not causing more serious problems.
- Smaller varicose veins that come
back after vein-stripping surgery.
- Larger varicose veins, when
minimally invasive techniques are used.
Sclerotherapy may be done alone or as a follow-up to
Sclerotherapy should not be done if you:
How Well It Works
Sclerotherapy costs less than
surgery, requires no hospital stay, and allows a quicker return to work and
Sclerotherapy can reduce symptoms and improve the look
of the skin. It works in about 80 out of 100 people. It doesn't work for about 20 out of 100 people who have the procedure.1
The risks of sclerotherapy include:
- Skin color changes along the treated vein. This
is the most common side effect of sclerotherapy. The discoloration may take 6
to 12 months to disappear. In some people, it may be
- Failure of treatment to prevent varicose veins from
- Itching, bruising, pain, and blistering where the veins
- Scarring resulting from ulcers or death of the tissue
around the treated vein (skin or fat necrosis) if sclerosant is injected
outside a vein or sclerosant escapes through the wall of a weakened
- A mild or severe (anaphylactic)
reaction to the sclerosant. (Severe reaction is very rare but can be
- Blood clots or damage in the deep vein
What To Think About
If it is done for cosmetic reasons, sclerotherapy is
usually not covered by insurance.
If you are considering sclerotherapy, you
might want to consider some
questions about treatment. These questions might
include: How much experience does the doctor have with the particular
treatment? How much do the exam and treatment cost? How many treatments does
the doctor think you will need?
For help deciding whether to have a procedure for varicose veins, see:
- Varicose Veins: Should I Have a Surgical Procedure?
In some cases, laser therapy or
freezing (cryotherapy) may be used instead of sclerotherapy to treat small
veins and spider veins.
Complete the special treatment information form (PDF)(What is a PDF document?) to help you understand this treatment.
Van den Bos R, et al. (2009). Endovenous therapies of lower extremity varicosities: A meta-analysis. Journal of Vascular Surgery, 49(1): 230–239.
|Primary Medical Reviewer||E. Gregory Thompson, MD - Internal Medicine|
|Specialist Medical Reviewer||David A. Szalay, MD - Vascular Surgery|
|Last Revised||February 1, 2012|