Is it normal after sclerotherapy for spider veins to lighten initially and then begin to darken again?

It’s important to distinguish between varicose veins and spider veins when choosing between laser therapy, sclerotherapy, and vein surgery. With two board certified vein specialists, our center uses a combination of visual examination, functional flow measurements, ultrasound, transillumination, and infrared light to map out vein networks prior to therapy. Lasers can be used to treat deep varicose vein insufficiency, vein perforators, and varicose veins. Sclerotherapy is ideal for spider veins and reticular veins. Whereas surgery is reserved for severely incompetent varicose vein segments.


Best,
Dr. Karamanoukian
Realself100 Surgeon

Post sclerotherapy there are pigmentary changes and it is essential for patients to follow instructions and use topicals IMMEDIATELY, not 3 months later or six months later or a year later. This reduces the likelihood of skin discoloration. Use of compression stockings is essential and also avoidance of sun exposure and use of high SPF when out in the sun. Patients that don't follow such post sclerotherapy instructions are likely to get residual hyperpigmentation. 

After sclerotherapy you may experience itching, redness and inflammation for 24-48 hours. Because sclerotherpy is a solution that will cause the vein walls to become irritated and stick together the spider veins may actually feel and appear worse for 2-3 weeks. It can take up to 6 weeks to see improvement. Treated veins may become darker in color, or hyperpigmented, which will fade slowly over several months.
-VIP MD Team

yes, this is very normal as veins sclerose or scar , darkening of the tract can occur. Expect it to start to lighten over the next several weeks. Sometimes, trapped blood can cause staining which can last several months. This is always a risk with Sclerotherapy. 

Yes, it is common to go through different appearances or colors once spider veins are treated with sclerotherapy. Spider veins initially are seen to spasm and 'blanch' immediately followed by filling up again once treatment is complete. Spider veins will then heal and ultimately get absorbed by your body. Darker bluish or purple hue is normal, followed by greenish and finally a light brown to yellowish appearance of the spider veins as the iron pigment within the blood gradually gets absorbed. A small percentage, hyperpigmentation or the brownish-yellowish discoloration may persist. 

What you are describing is the normal course of events with sclerotherapy.  The veins initially lighten as the blood is pushed out of the vein then the vein will clot over time so it darkens. Following this the veins will again lighten and some will go away and some will not. Additional treatments may be necessary.

Initially when treated with sclerotherapy, spider veins will appear lighter and then darken over the next few weeks. This is because the sclerosant causes the vessel to collapse. The scarred vessel then gets re absorbed by your body over a period of several weeks to a few months. So yes, they will appear darker and then gradually fade. You should be wearing your compression stockings daily for about two weeks after each treatment. This helps with the results and has been shown in the medical literature. Also sunscreen is important!