Sclerotherapy performed on spider veins 2 weeks ago. Looks worse than before. What should I do? (photo)

Question

Board certified vascular surgeon did the sclero using Asclera. He also did Venefit on same leg. My spider vein looks worse at my 1 week check up. He told me to see him in 3 weeks. Should i see someone else? It looks worse than before the sclero!

Joseph J. Castellano, MD · Answer

Thank you for your question and photos. It’s a normal part of the healing process for spider veins to look worse before they fade. This is because the injections cause the veins to clot, making them darker and larger, before they break down. Compression stockings can help this process along. Good luck.

J. Jason Wendel, MD, FACS · Answer

Thank you for your question in regards to sclerotehrapy. After sclerotherapy the veins will look worse than before treatment, this is part of the healing process. Compression  stockings should be wore and following post-care instructions are essential. To be sure what is best for you, see two or more board-certified providers in your area for a complete evaluation to make sure you are a good candidate and that it is safe for you to have treatment. I hope this helps!

Jason Emer, MD · Answer

This can be typical post sclerotherapy and you should be wearing compression for a few weeks to help limit any brown discoloration that can form. Typically it takes 2-3 treatments of sclerotherapy for improvement otherwise you can try lasers for the smaller vessels. See an expert. Best, Dr. Emer

Hratch Karamanoukian, MD, FACS · Answer

You need to use some adjunctive measures after sclerotherapy to reduce post inflammatory hyperpigmentation. it is those that don't follow such instructions immediately following sclerotherapy, starting on day1 (next day) that seem to get retained hyperpigmentation. I recommend 2 creams: Scleroquin plus and Sclerovase and also Scler-X supplement to reduce post inflammatory hyperpigmentation (see link below) as well as compression stockings for at least 2 weeks.
H Karamanoukian MD FCS
certified vein specialist from ABVLM and double board certified surgeon

Albert Malvehy, MD · Answer

When I counsel patients about sclerotherapy, I draw them a little graphic that shows the veins are going to get worse during the first two weeks - bruising, bulging, more noticeable - and that means it worked. Your body will then absorb the veins and turn them into scar tissue, a process that takes 4-12 weeks depending on how fast you heal, the size of the vein, and the location within your leg. Good luck!

Michael Nguyen, MD · Answer

ForSclerotherapy treatment performed on spider veins, it can look worse ordarker before it looks better. Consider waiting 6 weeks to follow up again withthe vein specialist to re-assess or to treat again if needed.

Gary Nackman, MD, FACS · Answer

I always try to impress upon my patients that one's legs after sclerotherapy will always look worse before they look better. Bruising almost always happens. The body needs to resorb the closed veins. It may take 1 to 3 months for most patients.

Haroon Mojaddidi, MD · Answer

Sclerotherapy works by initially irritating the spider veins and causing inflammation before it scars and goes away. In addition, depending on severity, it may take more than a single treatment for the desired effect. Your pictures one week after treatment are consistent with what one should expect after treatment, and compression stocking will add even more benefit. Looks like your right on track, good luck.

John Landi, MD · Answer

Your pictures are normal one week post sclerotherapy.  Veins look worse before they look better.  It seems to me that you have a very good treatment.

Sclerotherapy performed on spider veins 2 weeks ago. Looks worse than before. What should I do? (photo)

Answers (9)

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