Sclerotherapy: What It Is and What to Expect
Medically reviewed by Raghuveer Boddireddy, MD, Interventional Radiology. Last reviewed: October 23, 2026.
What kind of doctor provides Sclerotherapy?
A dermatologist, a skin doctor, often performs sclerotherapy. An interventional radiologist, a doctor who uses imaging to guide treatment, may also perform it. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What it is
Sclerotherapy is a minimally invasive treatment used to treat varicose and spider veins. A solution is injected directly into the affected veins, causing them to shrink and eventually disappear. The solution irritates the lining of the vein, which causes it to swell and stick together. Over time, the vessel turns into scar tissue that fades from view.
Varicose veins are enlarged veins that often twist and can bulge above the surface of the skin. Spider veins often look like webs. Sclerotherapy is the most common treatment for leg veins. Dermatologists use it to treat spider and small varicose veins.
In foam sclerotherapy, a chemical mixed with air, called foam, is injected into the vein. The chemical blocks the vein, so that blood stops flowing through it.
Why a doctor might recommend it
Sclerotherapy is used to improve the look of spider veins. It is also used to relieve some symptoms of spider veins, including aching, burning, swelling and night cramps.
How to prepare
Before the procedure, you can do the following.
- Tell your doctor about all the medicines you take, including herbal supplements.
- Tell your doctor if there is a possibility you are pregnant.
- Do not put lotion on your legs before or after sclerotherapy.
- Plan to have someone drive you home after your procedure.
Your doctor may tell you to stop taking aspirin, anti-inflammatory medicines called NSAIDs, or blood thinners before the procedure.
What happens during it
The doctor injects the solution into the veins with a very fine needle. You will feel small needle sticks and possibly a mild burning feeling. The procedure is usually done within 30 to 45 minutes. A compression stocking is then placed on each leg.
Recovery
To help prevent possible side effects, you will need to take daily walks and wear the compression stockings as directed. Most patients wear the compression stockings for 2 to 3 weeks. You can return to work and most activities the next day. In general, spider veins respond to sclerotherapy in three to six weeks, and larger veins respond in three to four months. During your follow-up visit, tell your doctor if you have noticed any side effects or changes.
Call 911 or go to the emergency room if you have chest pain or discomfort lasting two minutes or more, trouble breathing, fainting, coughing up or vomiting blood, or bleeding that will not stop.
Risks and side effects
Side effects can include the following.
- Brown lines or spots may be seen on the skin at the injection sites.
- In most cases, brown marks disappear within three to six months, but they can be permanent about five percent of the time.
- Bruising may occur around the injection site and can last several days or weeks.
Any procedure that penetrates the skin carries a risk of infection.
Other risks include the following.
- Blood clots in the veins
- Severe inflammation
- Allergic reactions to the solution
- Skin injury that could leave a small but permanent scar
Large varicose veins do not respond as well as small ones. A few people (less than 10 percent) do not respond to the injections at all.
Who performs it
A dermatologist can perform sclerotherapy during an office visit. An interventional radiologist may also inject the solution. The results you see depend largely on the person who performs the treatment.
Common questions
Does sclerotherapy hurt?
Yes, you may feel small needle sticks and possibly a mild burning feeling during the injections. You may also feel cramping for one to two minutes when larger varicose veins are injected.
How many sclerotherapy sessions will I need?
To get the best results, you may need 2 or 3 treatments. Each session typically clears 50 to 80 percent of the injected veins.
Can I have sclerotherapy if I am pregnant?
No, you will not be able to have sclerotherapy if you are pregnant, breastfeeding, or bedridden. You must wait at least three months after giving birth before you can be considered for this procedure.
Will the treated veins come back?
If the veins respond to the treatment, they will not reappear. However, new veins may appear over time.
How does a direct primary care or concierge doctor fit in?
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance.
Sources
- RadiologyInfo.org - Sclerotherapy of Varicose Veins and Spider Veins
- American Academy of Dermatology - Leg veins: Why they appear and how dermatologists treat them
- NHS - Varicose veins
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
