Lisa Perez, MD

You should be fine.  Although most physicians recommend stockings after sclerotherapy, there are plenty who don’t have the patients wear them at all, especially for spider veins. Give the veins at least 4-6 weeks to resolve and if they aren’t completely gone, have them rechecked by your physician. 

These spider veins are extremely common and usually genetic. There is no reason to be alarmed or concerned. If you do not like the cosmetic appearance of them, they are easily treated with injections (sclerotherapy).

It looks like bruising rather than hyperpigmentation in your photos. Arnica tablets may help as well as wearing compression stockings for a week or so. Avoid sun exposure and the bruising should resolve in a few weeks. If you have any concerns about the way it is healing, do not hesitate to have the area rechecked by your provider.

Yes it is likely that this discoloration is due to venous insufficiency, especially with your history of varicose veins. An evaluation by a vein specialist is highly recommended.

Sclerotherapy has a much higher success rate at treating both spider and reticular veins of the legs, than topical laser.  It is important to know what medication and what strength was used on you that you did not respond well too.  There are different medications as well as different concentrations of sclerotherapy medications.  Also the experience of the person doing the injections makes a big difference.  As mentioned above, many clusters of spider veins have a feeding vein underneath that can sometimes only be seen with a vein light.  If these feeder veins are not injected, then the spider veins will not go away.  Make sure you are being treated at a vein center, and that your injector has a lot of experience.