Updated:
by
Saina Attaran, MD, DABVLM, MRCS, FRCS
Medically reviewed by Saina Attaran, MD, DABVLM, MRCS, FRCS
Do your legs ache or swell at the end of a long day? Maybe you've noticed a tangle of red or purple lines on your calves, or veins that seem to push right through the surface of your skin. These are among the most recognizable signs of spider or varicose veins, affecting millions of adults across the United States.
The good news is that a quick, well-established in-office procedure called sclerotherapy has helped patients find real relief for more than a century. If you've been told sclerotherapy might be right for you, or you're just starting to explore vein treatment options, Center for Vein Restoration (CVR) has what you need to know before your first vein appointment.
We consulted with Saina Attaran, MD, DABVLM, MRCS, FRCS, a board-certified vein specialist at Center for Vein Restoration's Gilbert, Arizona, and Mesa, Arizona, vein clinic locations. After a decade as a cardiac surgeon, Dr. Attaran was drawn to vein care because of the immediate positive results achieved after vein treatment. She has since helped hundreds of patients reclaim comfort and confidence in their legs.
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📞 Call Center for Vein Restoration at 240-249-8250
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Before discussing sclerotherapy, it is important to understand why spider veins develop in the first place, says Dr. Attaran. Understanding the "why" behind your spider veins is the first step toward finding a treatment that works.
Spider veins are tiny, dilated blood vessels that sit close to the surface of the skin. Think of them as the outermost branches of your circulatory system. They often develop when pressure builds up in the veins, which can happen when the veins are not moving blood as efficiently as they should. This condition is called venous insufficiency.
Because of this, spider veins are sometimes a sign of a deeper vein problem rather than just a cosmetic concern. That is why treatment is not one-size-fits-all. The right approach depends on where the spider veins are located and what is causing them.
Dr. Attaran adds: A useful way to think about it: spider veins are like the leaves on a tree. If you remove the leaves without treating the root of the problem, they are likely to grow back.
“Location matters quite a bit. Spider veins on the outer thigh, for example, are often caused by pressure from nearby perforator veins and are common after pregnancy. These tend to be more straightforward to treat. Spider veins on the inner knee, on the other hand, may be associated with a problem in the great saphenous vein, which runs along the inside of the leg. Spider veins near the ankle are often linked to prolonged standing or sitting, which can build pressure in the lower leg.”
—Dr. Saina Attaran
Lead physician, CVR, Gilbert & Mesa, AZ
Sclerotherapy is a minimally invasive procedure used to treat spider veins and smaller varicose veins. According to the National Institutes of Health, when properly performed, sclerotherapy can successfully resolve 90 percent or more of treated vessels.
Although sclerotherapy is the primary treatment for spider veins, some patients may require more comprehensive management if underlying reflux or feeder veins are present. In many cases, spider veins are supplied by multiple feeder veins, and achieving optimal results may require multiple treatment sessions.
A qualified vein doctor injects a solution called a sclerosant directly into the affected vein. The solution irritates the vein's inner lining, causing it to swell shut and seal closed. Over the following weeks, the treated vein is slowly absorbed by the surrounding tissue and fades from view. Blood is naturally rerouted through nearby healthy veins, according to the Mayo Clinic.
Dr Attaran adds:
“From a technical standpoint, the veins must be of sufficient size to allow safe and effective injection using very fine needles (typically up to 32-gauge). It is also essential to distinguish true spider veins from skin discoloration or telangiectatic matting, as these conditions may not respond to injection therapy.”
—Dr. Saina Attaran
The procedure typically takes 30 minutes or less and is performed in a vein center; no hospital stay or general anesthesia is required. Patients can drive themselves home the same day and return to normal activity immediately with few restrictions.
Sclerotherapy has roots that stretch back to the 1850s, when physicians in France first began injecting iron and iodine compounds directly into varicose veins to collapse them—a surprisingly modern concept for the era, confirmed the Indian Journal of Vascular and Endovascular Surgery. Early sclerosants caused serious complications, and the technique was largely abandoned by the end of the 19th century, but researchers continued refining it throughout the early 1900s, according to PubMed.
The development of sodium tetradecyl sulfate in 1946, a sclerosant still used in clinics today, marked a turning point that transformed sclerotherapy into the safe, well-tolerated outpatient procedure it is today.
Before treatment begins, your vein specialist will identify the veins to be treated and clean the skin over the area. Using a very fine needle, the provider injects the sclerosant into each targeted vein. You may feel a mild burning or cramping sensation at the injection site, but it usually passes within seconds.
After the sclerotherapy session, you'll be asked to wear compression garments over the treated area. These help the vein walls stay closed and support healthy circulation while you heal. Most patients are advised to:
Most people return to their normal routines the same day, with few restrictions.
"Sclerotherapy is one of the most well-tolerated procedures we offer. Most patients are surprised by how straightforward the recovery is. They walk in, we treat the veins, and they walk out. That's genuinely it for most people."
—Dr. Saina Attaran
Ready to explore your vein treatment options? Center for Vein Restoration has 120+ locations nationwide, each staffed by board-certified vein specialists who can evaluate your symptoms and recommend the right treatment for you.
Sclerotherapy has a strong track record. The Cleveland Clinic notes that it is considered the standard treatment for spider veins and small varicose veins, with the majority of patients seeing meaningful improvement.
Results aren't always immediate. It can take several weeks to a few months for treated veins to fully fade. Some veins may need two or more sessions, depending on their size and severity.
For patients with venous insufficiency, a condition in which faulty valves in the leg veins cause blood to pool, leading to symptoms such as leg pain and swelling, sclerotherapy may be part of a broader treatment plan. Your vein doctor will assess your situation before recommending a course of action. You can learn more about venous insufficiency and its symptoms at the Cleveland Clinic.
"Not every vein responds the same way, and that's completely normal. We set realistic expectations with each patient upfront, and we adjust the treatment plan based on how the veins respond. The goal is always the best possible outcome for that individual."
—Sanjiv Lakhanpal, MD, FACS
Founder, President, and CEO of Center for Vein Restoration
Sclerotherapy is generally well-tolerated. The most common side effects are mild and temporary, according to the Mayo Clinic:
More serious complications are rare but possible, including allergic reactions to the sclerosant or, in very uncommon cases, blood clots. Your vein specialist will review your health history before treatment to identify any risk factors. If pain, significant swelling, or skin changes persist beyond a few weeks, contact your vein center right away.
Sclerotherapy is effective for spider veins and smaller varicose veins, but it isn't the only option and isn't a good fit for every patient. Minimally invasive alternatives include radiofrequency ablation, endovenous laser therapy, and ambulatory phlebectomy, each suited to different types and severities of vein disease.
The right vein treatment depends on the size and location of the affected veins, whether underlying venous insufficiency is present, and your overall health. A board-certified CVR vein doctor can evaluate your legs, often using ultrasound imaging, and develop a treatment plan tailored to your needs.
“Overall, patients should undergo a thorough consultation and examination to ensure accurate diagnosis and appropriate treatment planning. Setting realistic expectations is key, as outcomes may vary depending on the underlying condition and the extent of disease."
—Dr. Saina Attaran
If leg pain, swelling, or visible vein problems have been affecting your quality of life, don't wait. Center for Vein Restoration's board-certified vein specialists are ready to help you find the right solution. Schedule your appointment today.
📞 Call Center for Vein Restoration at 240-249-8250
📅 Or book online HERE
Vein problems rarely improve on their own, and the longer they go untreated, the more discomfort they tend to cause. Whether you're dealing with spider veins, varicose veins, or the early signs of vein disease, the specialists at Center for Vein Restoration offer sclerotherapy and a full range of minimally invasive treatments, all in a comfortable, physician-led outpatient setting.
With 120+ locations across the country and a team of board-certified vein doctors, CVR is the most trusted name in vein care in the United States. Your legs deserve expert attention. We're here to provide it.
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