Can Matting That Occurs After Sclerotherapy Be Eliminated? It Seems to Just Get Worse Each Time.

A physician specializing in treatment of veins performed sclerotherapy on my leg, after which I developed a circle of tiny veins above my knee. I went back and he injected them but it didn't help. Then he injected a feeder vein and more and now I have several areas of these tiny veins around my knee. After reading posts here it appears this is called matting. What should I do or where should I go to get rid of this? Or will it just keep getting worse and spreading more with more injections?

Doctor Answers 8

Matting After Sclerotherapy

Though matting after sclerotherapy is somewhat normal, there are steps that can be taken to eliminate and prevent it from occurring more often than it should. First and foremost, visiting a sclerotherapy specialist will be able to bring you the best injection results possible, as they have the highest level of knowledge to do so. As a board certified dermatologist, Diplomat of the American Board of Cosmetic Surgery, and pioneer of sclerotherapy, I always make sure to treat the root source of the spider veins rather than each tiny vein itself. To help get rid of matting that is already present, make sure that you are following your post treatment guidelines and properly wearing your compression stockings. It may also be a viable option to consider laser vein removal for smaller veins that are not dissolving as you would like from sclerotherapy injections.

San Diego Dermatologic Surgeon
4.9 out of 5 stars 25 reviews

Treatrment of matting following sclerotherapy

Matting can occur following sclerotherapy and the treatment that you describe does seem appropriate.  Re injecting the matted area and looking for a feeder are all appropriate.  If this fails, then you have three choices- 1.allow time for it to resolve and it could take up to one year, 2. a topical laser such as 532 may help or IPL, and 3. have a venous reflux exam to see if you have underlying malfunctioning valves in the saphenous system which may be feeding the matting.

John Landi, MD
Naples General Surgeon
5.0 out of 5 stars 5 reviews

Sclerotherapy works well but can sometimes have matting

Matting can be a potential side effect of Sclerotherapy.  Often the matting goes away in several months.  However, if these small veins do not go away, I use a combination of lasers to get rid of these small unsightly veins.  I used to see a lot more matting from injections of saline.  Now with Asclera, I do not see this side effect in patients as much as before.  Please find someone experienced in your area to treat your spider veins.

Michele S. Green, MD
New York Dermatologist
5.0 out of 5 stars 76 reviews

Skin Side Effects after Sclerotherapy

It can be frustrating to get skin side effects after sclerotherapy, as the treatment is usually done to rid your skin of an unsightly vein and it is very disappointing when a new unsightly skin lesion forms in its place.  Luckily, skin reactions are relatively rare and they usually fade away over time.  Yes, the reaction that you have (as documented in your photograph) is known as matting.  It looks like a bruise or cluster of very tiny capillaries. Luckily, matting usually resolves on  its own with time (give it at least 6 months).  I would avoid any further treatments or trauma to the area until it resolves.  Repeat treatments or attempt to inject it again usually just aggravates things. If it fails to resolve on its own, surface laser can often resolve it.

Joel Gotvald, MD, FACS
Austin Vascular Surgeon
5.0 out of 5 stars 2 reviews

Most Matting after Sclero Resolves with Time



Matting can be a common side effect following sclerotherapy.  It would be also great to know what sclerosant was used during treatment.  Hypertonic saline (which I do not use) has a much higher rate of side effects such as matting.  Give it time, most matting resolves on its own in 6-12 months as your body heals.  If not, several lasers including an Nd:YAG laser, IPL, or even pulsed dye laser can be used to improve the matting.

Melanie D. Palm, MD
San Diego Dermatologic Surgeon
4.9 out of 5 stars 23 reviews

Matting After Sclerotherapy

Matting can occur after sclerotherapy and sometimes the best treatment is a tincture of time.  They can sometimes take some months to resolve on their let own, otherwise I sometimes use a combination of an Nd:YAG laser with a pulsed dye laser to treat them.

Sabrina Fabi, MD
San Diego Dermatologic Surgeon
5.0 out of 5 stars 83 reviews

Telangiectatic Matting is a Stubborn Problem to Treat

Telangiectatic matting an occur with sclerotherapy or any kind of vein treatment. I have seen it occur in microphlebectomy incisions. I have seen telangiectatic matting in the pucture wound site used to perform VNUS Closure and EVLT procedures. The phlebology data and books state that telangiectatic matting goes away without treatment as much as a year after the procedure. If it is still there, it can be diminished with topical laser treaments. An article by Dr Neil Sadick showed that telangiectatic matting spontaneous resolves "in 70% at 6 months with 99% resolution occurring within 1 year". So, don't waste your money on vitamin K cremes and other products that offer a lot but don't work !

Hratch Karamanoukian, MD, FACS
Buffalo Phlebologist
4.8 out of 5 stars 41 reviews


telangiectasia/matting can be extremely difficult to treat. sclero in my hands doesnt help. i have heard some doctors can rid them with lasers.  make sure whomever you visit knows lasers inside and out.  if they cant give you a straight answer, then it probably means you are going to get anywhere. if they say there is a 50% chance its probably lesss.


good luck, if u do find something that works, please let me know so i can get it.

Timothy Mountcastle, MD
Ashburn Plastic Surgeon
4.3 out of 5 stars 29 reviews

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.