Two rounds of sclerotherapy and the veins are still there. What should I do? (Photo)

I had the second round of ultrasound guided sclerotherapy three weeks ago, and the largest vein which starts mid-thigh and continues down the front of my leg and around my knee is still there. Not sure if the doc didn't get to the feeder vein or what, but it hasn't gone away after three weeks of the strong hose. Is this a sign of a poor job by the doctor? Or a deeper issue such as CVI? I'm also wondering what the next step in getting rid of this would be. Another round of sclero?

Doctor Answers 5

Vein surgeon in Los Angeles

I would suggest a vein ultrasound followed by another round of sclerotherapy to treat the proximal and distal problematic veins. 


Dr. Karamanoukian

Los Angeles

Los Angeles Plastic Surgeon
4.8 out of 5 stars 94 reviews


Thank you for your question in regards to sclerotherapy. A venous doppler should be performed to identify if you have any underlying reflux. If present, only treating what is visible on the surface will reoccur and results will not be achieved. 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.

J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
5.0 out of 5 stars 183 reviews

Veins on Legs -- Sclerotherapy and Laser

Often multiple treatments are needed including lasers and sclerotherapy.  I suggest seeing an expert for treatment.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 196 reviews

Visible veins.

The picture looks like the vein is bulging just lateral and above the knee.  If the area is firm or hard, it may be residual scar tissue that is going to take a while to be re-absorbed by the body.  If still soft, they vein is probably patent.
After 2 rounds I would definitely suggest getting a venous doppler to look for underlying reflux.  If this is not fixed first, the resultant pressure will often cause a poor result from any sclerotherapy.

Outside of that, there are different medications for sclerotherapy.  I find some work better for certain individuals than others.  

Also, as a larger vein this may require a microphlebectomy.  This involves using small needle holes and tiny hooks to remove the vein.  Done well, it should not really leave any scars.

Scott Powell, MD
Denton General Surgeon

Venous ultrasound.

The posted picture looks like varicose veins around the knee area.  Varicose veins are due to underlying refluxing valves and a venous ultrasound should identify this.  If you have malfunctioning valves these may need to be treated as they are the source of the veins.  Treating just the veins is not treating the cause of the problems so the veins may not respond to sclerotherapy.  See a vein specialist.

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