How Soon Should I See Results After Sclerotherapy?

Laser and dermatologic surgeons have been trying to develop lasers to treat leg veins for over 25 years. Lasers sound scientific and sexy but they have never and will never replace or improve upon the results of properly performed sclerotherapy.

Yes, sclerotherapy uses a needle and injects a medicine into the vein. But the newer FDA-approved solutions like Sotradecol™ and Asclera™ are virtually painless and the needles used at the size of a hair. Lasers are VERY expensive and hurt MUCH MORE than injections. Some doctors still use hypertomic saline for the injection and that is VERY painful. I would advise seeing a doctor who ONLY uses FDA-approved sclerotherapy solutions (Saline is only approved to induce abortions!)

While I treat over 500 leg vein patients each year and have over 30 diferent lasers in my office, I only use a laser maybe 5 times a year for leg veins. When I choose to use a laser, it is to clean up any tiny veins that have not responded to sclerotherapy.

After having spider veins treated, an inflammatory process will take place, the veins will first swell a little bit and be slightly raised on the skin. You will also notice some redness around those veins that were injected. This usually will ease up after the first day or so. After that, you’ll notice that the veins are still very distinct and then they will start to fade after the first 2 to 3 weeks. Depending on the size of the veins, full resolution may take anywhere between two months and six months. Rare cases may even take longer. After treating a particular area of spider vein‘s, hopefully around  80% of those veins will go away. Most patients require a second treatment for each area to touch up any residual veins. 

Majority of patients seeking vein treatment need atleast three treatments, typically 3-6 weeks apart. Every patient is different but it is generally safe to say that most patients continue to see improvement for two or three months after their last treatment. It is important you see a board-certified dermatologist or an expert in sclerotherapy to ensure you avoid any complications and can start seeing results as soon as possible!

It may take 2-3 sclerotherapy treatments or possibly more depending on the individual to see best results.  Often times the most improvement is seen after the first treatment. 

Despite the advent of lasers, sclerotherapy, or the injection of a sclerosing solution to close off unwanted and superfluous spider veins on the legs, is still considered the method of choice. The appearance of one new laser after another, each one supposedly superceding the previous type, is implicit testimony to the fact that laser technology in this (as in many other skin treatment) has hardly been perfected yet

On the other hand, sclerotherapy has stood the test of time, with decades of proven efficacy, and yields fairly consisent and gratifying cosmetic results. Various sclerosing materials are currently available, and the particular one chosen will depend upon the specific areas needing treatment and the experience of the injector. Typically, for best results, two to four treatment sessions are needed per treatment site spaced at monthly intervals. Fees for each treatment may vary from $350-$750/session, depending upon the material used and the size of the area treated.

Usually it takes about 3-4 weeks after the treatment to see the results. It is recommended to wear compression stockings immediately after the sclerotherapy and continue for at least 3 weeks. During the follow up visit the physician will suggest if additional injections are necessary. Some patient choose to have the sclerotherapy done during the fall and winter months only because of the necessity to wear the compression stockings.

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.

I have found sclerotherapy to be a better treatment for treatment of veins. It usually takes about 4-6 weeks for the treated area to completely heal. During this time it is important to wear compression stockings for two weeks post treatment and avoid the sun to minimize the occurrence of hyperpigmentation.

We use both selectively in our large practice and use FDA approved sclerotherapy solutions only - Sotradecol™ and Asclera™
It is important to use compression stockings after sclerotherapy to improve healing and reduce hyperpigmentation. Adjunctive care is also recommended to reduce hyperpigmentation. Scleroquin plus and Sclerovase can be alternated as topical creams in the areas which have undergone sclerotherapy to reduce hyperpigmentation. Scler-X is also recommended. It is a post inflammatory hyperpigmentation relief complex. See the link below. 

In general, sclerotherapy works best on leg veins and laser for leg veins is used for the smaller veins into which a needle could not be inserted. On the face, laser may work better than sclerotherapy depending on the size of the vein treated. Following both procedures there will be some immediate improvement but most improvement will take up to 6 weeks and some veins will not resolve and need to be retreated.