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

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

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.

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

Failed sclerotherapy can be addressed in such sizable veins with micophlebectomy.H Karamanoukian MD FACS
certified vein specialist from ABVLM

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.

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.