Best sclerosant for reticular veins?

I have lot of reticular veins running all over my legs. This is hereditary, no dysfunction in deep veins. I had sclerotherapy (3 treatments) 5 years ago and it worked quite well. Now I have had 2 treatments, but only spider veins have reacted. Polidocanol 0,5% was used first and then Polidocanol 1%, but reticular veins didn't react. Is it possible to use even a stronger sclerosant for reticular veins? I don't know which sclerosant was used five years ago.

Doctor Answers 5

Sclerotherapy for Spider or Thread Veins

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Reticular veins, small blue veins between 1-3 mm in diameter, should not require more than 1% Polidocanol. I am a fan of foam sclerotherapy, and almost alway perform it rather than using liquid.


Clifton Vascular Surgeon
5.0 out of 5 stars 3 reviews

Reticular veins.

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I use both polidocanol and sotradecyl and I use them as foam.  Sotradecyl is stronger than polidocanol but I never go above 1% for reticular veins.

John Landi, MD
Naples General Surgeon

STS foam scerotherapy for reticular complexes

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Thank yu for your question.

I recommend 1% to 3% foam sclerotherapy with sodium tetradecyl sulfate using ultrasound guidance to treat underlying feeder veins at the same time to improve the efficacy of treatment. 

H Karamanoukian MD FACS

certified by ABVLM and doube board certified surgeon

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Foam sclerotherapy works well for reticular veins

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Reticular veins are important to treat as part of any cosmetic vein treatment. Our practice uses foam, usually 0.3% polidocanol, which is quite effective in the vast majority of these. Foam sclerotherapy, in larger veins (like reticular veins), has a number of advantages over liquid including increased dwell time, increased viscosity, and increased potency by concentration. Make sure you go to someone who is comfortable with this technique.

Albert Malvehy, MD
Miami Beach Physician
5.0 out of 5 stars 8 reviews

Dilated veins not responding to sclerotherapy

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Healthy leg veins contain valves that open and close to help the blood return back to the heart. Venous reflux disease develops when the valves that keep blood flowing out of the legs and back to the heart no longer function, causing to pool in the legs and leading to signs and symptoms like dilated veins that you can see close to the skin in your legs among other symptoms you may or may not present. If sclerotherapy is not giving you the results you are looking for, consider a visit to a vein specialist who you can trust. Using ultrasound to scan your legs, your physician will determine if venous reflux is present. Factors that contribute to this include age, gender, family history, heavy lifting, pregnancies, obesity, and prolonged standing. Your physician can help you make informed health care decision on the best treatment for you according to the ultrasound results and according to your specific goals. If reflux is present, it might be the reason why sclerotherapy is not working now and there are other options you can discuss with your physician about type of treatments.  

All the best, 

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.