Does Sclerotherapy Really Work?

Veins. We all have them. Some are more prominent than others. As people age, those blue and purple squiggles often become more prominent. For adults with leg vein disease (a common condition that affects up to 50 percent of all adults) regular blood flow is interrupted, causing blood to pool in the veins. The result? Varicose and spider veins. One of the most common treatments to minimize or eliminate the appearance of such veins is sclerotherapy. But, is it worth it? We asked a plastic surgeon and a patient for an honest assessment.

Sclerotherapy 101

One of the more treatment options to to improve the appearance of spider veins and small varicose veins, sclerotherapy is a minimally invasive procedure that uses an injectable sclerosant to dissolve the veins.

“Sclerotherapy can be effective for both spider veins and varicose veins, but it depends on the size of each,” says Melissa Doft, MD, a double board board certified plastic and reconstructive surgeon in New York City. “During the procedure, a small needle is inserted into the vein and sclerosing medicine is injected into the vein which irritates the sides of the veins and causes them to collapse, cutting off the blood flow.” The collapsed vein will dissolve into the local tissue within a few weeks for small veins or a few months for larger veins. Occasionally, some patients will need multiple sclerotherapy sessions to treat the varicose or spider veins.

Sclerotherapy treatment has become a popular choice among patients looking to improve the appearance of the varicose and spider veins because it is relatively quick and painless. The entire treatment takes under an hour. Some solutions contain a local anesthetic, though patients may have a bit of discomfort when the fine needle is inserted into the vein. While many patients will experience side effects like bruising, redness, and discoloration around the injection site, most people can resume normal activities immediately after the treatment — though they will have to wear compression garments and avoid excess exposure.

Ideal Candidate for Sclerotherapy

Sclerotherapy is not always the best or only solution to minimize the appearance of veins. “A spider vein has to be large enough to thread with a needle and the varicose vein needs to be small enough to collapse down,” Dr. Doft says. As she explains it, some spider veins are too small for sclerotherapy, so lasers are a better treatment choice. For patients who have large varicose veins, she recommends consulting with a vascular surgeon. “[They] will not only evaluate their venous flow, but can perform a surgery to remove the feeding vessel to large varicose veins or remove the veins individually,” Dr. Doft shares.

Medical history is also an important factor in determining whether or not sclerotherapy will be effective. If you have a heart condition, are prone to blood clots, or taking certain medications or blood thinners, sclerotherapy may not be the right treatment for you.

Sclerotherapy Cost & Results

Each sclerotherapy treatment session costs around $350 and has a 50 to 80 percent success rate. For some patients, health insurance may cover the procedure. “Some varicose vein treatments may be medically necessary if you have symptoms from the veins,” Dr. Doft says. “Typical symptoms include pain, swollen legs at the end of the day, and the pain interfering with your daily activities.”

One thing to keep in mind is that while the treatment is permanent, new veins may appear and require additional treatment. Dr. Doft says many patients will come into her office every few years for maintenance.

Patient Perspective

For Autumn, sclerotherapy did not prove to be the most effective treatment option for her varicose veins. Here, she candidly shares her experience.

So, Is Sclerotherapy Worth It?

“I think it is worth it for the right patient,” Dr. Dofts says. “Like all cosmetic procedures, it really depends on how much the issue bothers you.” In her personal experience, lasers can serve as an effective alternative depending on the size of the vein. “I had tons [of] small spider veins on my thighs from pregnancy and surgical residency which bothered me every time I wore a skirt or a bathing suit,” she shares. “I recently used the laser in my office to treat all of them, and I could not be happier. It was so easy and not very painful.”

Because sclerotherapy procedures can amount to a large investment over time, it is important to consult with a board certified dermatologist or plastic surgeon to ensure you are receiving the best treatment for your condition. For those looking to thwart the development or worsening of varicose and spider veins, Dr. Doft suggests compressions stockings as the first line of defense.