Sclerotherapy is an appropriate treatment of small- to medium-sized reticular veins that feed spider veins, or small varicose veins that remain after the endovenous laser treatment of reflux in the large saphenous veins. Occasional patients will also have perforator veins (connection between the deep and superficial veins) that are causing a skin ulcer. These are also well-treated with injection sclerotherapy.
Either visually or with ultrasound guidance, a tiny needle is used to inject foamed sclerosant into the vein. The lining of the vein then swells and eventually seals shut. The vein will usually fade in a few weeks. As with laser treatment, this procedure may take three to five treatment sessions. Staining, or brown discoloration on the skin, is a possible side effect to sclerotherapy and may take six months or longer to fade.
A laser fiber is inserted through the skin and directly into the vein that is causing the bulgy, unattractive, and often painful varicose veins. The laser heats the lining within the vein, damaging it and causing it to collapse, shrink, and eventually disappear. This technique typically is used to treat the large varicose veins in the legs and takes less than 30 minutes to perform.