J. Michael Leary, MD

We encourage exercise after simple visual sclerotherapy for spider and reticular veins.  Patients can return to most all their normal activity's immediately after treatment.  Light lifting, hiking, yoga and flexibility training are all fine.  We recommend light compression (15-20) for three days post treatment.  So wear compression while exercising.  Compression can be removed for showering and sleeping. I would avoid hot tubs and Jacuzzi for about a week post treatment, and maybe hot yoga. If your workouts are super strenuous, dial it back for a few days. Don't get a sunburn, but a little sun exposure should cause no staining problems. Do avoid the antibiotic Minocycline while having sclerotherapy treatments. This can cause irreversible staining.

Clearing of veins after sclerotherapy varies from patient to patient, but in general someone who is younger will respond much faster then the older patient.  Ninety percent of my patients need at least three treatments, usually 3 to six weeks apart. I tell my patients that it will usually look worse after the first treatment, and most of the time you will notice the beginning of significant clearing after the second treatment. Some patients may need many more treatments, depending on the size and number of veins. Most patients continue to improve for two to three months after their last treatment. Sclerotherapy when performed by an experienced phlebologist should give you excellent cosmetic results. Laser is usually not successful for leg veins, and if used, should only be used after initial sclerotherapy to treat the underlying feeding veins.

In our practice the EVLA has a very high success rate, over 99%.  In follow up, if saphenous vein is found to have an area which has not been ablated,(still open) the open area can be successfully closed with an ultrasound guided injection of a foamed sclerosant agent.  This is a rare occurrence, but If untreated this open area in the vein can slowly create a new canal and eventually reopen the entire vein.

We commonly close the saphenous vein with laser or RF, and foam the larger tributaries which come off the saphenous vein with ultrasound guided foam during the same procedure.