Sclerotherapy

Sclerotherapy is a procedure used to treat spider veins and small varicose veins. A solution called a sclerosant is injected directly into the affected vein, causing it to swell, seal shut, and gradually fade. The treated vein is absorbed by the body over several weeks and blood naturally reroutes through healthier vessels nearby.

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What can it treat?

  • Spider veins (telangiectasias): small red, blue, or purple vessels visible just under the skin

  • Reticular veins: larger feeder veins that often supply spider veins

  • Small varicose veins: bulging, rope-like veins close to the surface

Before your appointment

  • Avoid shaving or applying moisturiser to your legs on the day of treatment

  • Wear or bring loose, comfortable clothing; you will need to expose your legs

  • Avoid anti-inflammatory medications (such as ibuprofen or aspirin) for 48 hours beforehand if possible, as these can increase bruising. Check with your doctor first

  • Arrange to walk for 15-30 minutes after the procedure, so plan your transport accordingly

  • Do not book the procedure close to a holiday or event where you need your legs looking their best; results take weeks to appear

What to expect

  • You will lie on a treatment table with your legs elevated

  • The skin is cleaned with an antiseptic solution

  • A very fine needle is used to inject the sclerosant solution into each targeted vein. Multiple injections are usually given in a single session

  • Light pressure is applied after each injection

  • Compression bandaging or stockings are applied at the end of the session

Each session typically takes 20-45 minutes depending on the number of veins being treated. Local anaesthetic is not usually required, though you may feel a mild stinging or cramping sensation with each injection.

Frequently asked questions

  • Most patients require between 2 and 4 sessions to achieve a satisfactory result, spaced 4-6 weeks apart. The number depends on the extent and size of the veins being treated. Smaller spider veins tend to respond faster than larger reticular veins.

    Results are gradual: veins do not disappear immediately. Most treated veins fade significantly over 3 to 6 weeks, though larger vessels can take up to 3 to 4 months to fully resolve.

  • In the first 24-48 hours:

    • Wear your compression stockings continuously as directed, usually 24 hours a day for the first 2 days, then during the day for a further 1-2 weeks

    • Walk for at least 15-30 minutes immediately after the procedure and each day during recovery. Walking is important and helps prevent complications

    • Avoid prolonged sitting or standing still

    • Avoid strenuous exercise, heavy lifting, and high-impact activity for at least 1 week

    In the following weeks:

    • Avoid hot baths, saunas, spas, and direct sun exposure to the treated area for at least 2 weeks. Heat causes vessels to dilate and can reduce the effectiveness of treatment

    • Avoid swimming for 1-2 weeks

    • Apply SPF 50+ sunscreen to treated areas when outdoors to prevent post-treatment pigmentation

    • Bruising: common around injection sites; fades over 1–2 weeks

    • Redness or raised areas: small hives or wheals at injection sites, usually settling within a few hours

    • Darkening of the skin (hyperpigmentation): a brownish discolouration along the treated vein; occurs in up to 30% of patients and usually fades over 3–12 months, though in rare cases may be permanent

    • Matting: a fine blush of tiny new vessels around the treated area; usually temporary but may require additional treatment

    • Trapped blood (haematoma): a small, firm lump along the treated vein; not dangerous and can be drained at a follow-up appointment if needed

  • Serious complications are uncommon but include:

    • Allergic reaction: rare; symptoms include hives, swelling, or difficulty breathing. Seek emergency care immediately if this occurs

    • Ulceration: if the sclerosant leaks outside the vein, a small skin ulcer may form; this generally heals but can leave a scar

    • Deep vein thrombosis (DVT): a blood clot in a deep vein; rare with sclerotherapy of superficial veins; risk is reduced by walking after treatment and wearing compression

    • Visual disturbances: temporary visual changes have been reported, particularly with foam sclerotherapy; these are generally brief and resolve without treatment

    Contact the clinic promptly or seek emergency care on 000 if you develop: significant leg swelling, redness tracking up the leg, chest pain, shortness of breath, or visual changes.

  • Sclerotherapy improves the appearance and symptoms of treated veins but does not prevent new veins from forming. Spider and varicose veins are influenced by genetics, hormones, pregnancy, and prolonged standing, so new vessels can appear over time. Maintenance sessions may be needed in future years.

    Results vary between individuals. Some veins respond well in a single session; others are more stubborn. Your doctor will reassess at each visit and adjust the treatment plan accordingly.