Sclerotherapy is a minimally invasive medical procedure used to treat the appearance and discomfort of varicose veins and spider veins. It involves injecting a specialized chemical solution, known as a sclerosant, directly into the problematic vein. This irritant causes the vein lining to swell, stick together, and ultimately close off, rerouting blood flow to healthier vessels in the area. Understanding the longevity of this treatment involves distinguishing between the permanence of the treated vein and the overall timeline for cosmetic improvement.
Permanence of the Treated Vein
The outcome of a successful sclerotherapy treatment on an individual vein is permanent; the specific vessel that was treated cannot return. The sclerosant, which can be a detergent like polidocanol or sodium tetradecyl sulfate, chemically damages the endothelial cells lining the vein wall. This irritation causes an acute inflammatory reaction, forcing the vessel walls to collapse and stick together, a process called endofibrosis.
Once the vein is sealed, blood flow stops, and the body begins a healing response. Over time, the treated vein segment transforms into scar tissue—a fibrous cord that is no longer functional. This scarred tissue is gradually broken down and absorbed by the body’s macrophage cells, leading to the vein’s eventual disappearance. This process ensures the closed-off vessel is eliminated and cannot reopen or refill with blood.
While the targeted vein is permanently disabled, this does not prevent the development of new veins nearby. The underlying condition that caused the initial issue, known as venous insufficiency, may continue to progress in other vessels. The treatment’s success is defined by the irreversible closure of the injected vessel, not by a guarantee of a lifetime without new vein formation.
Timeline for Cosmetic Improvement
The physical closure of the vein happens quickly, but the time required for visible cosmetic improvement varies significantly based on the vein’s size. Smaller vessels, such as spider veins (telangiectasias), begin to fade relatively fast, with noticeable improvement appearing within three to six weeks. Larger vessels, including varicose veins, take longer for the body to absorb the sclerosed tissue, and the final result may require three to four months, or longer.
Patients often experience transient side effects that temporarily obscure the final result. Bruising at the injection sites is common, caused by blood leaking into the surrounding tissue, and resolves within a week or two. A more persistent side effect is hyperpigmentation, which appears as brownish discoloration along the treated vein.
This temporary staining is caused by hemosiderin, an iron-storage complex released when red blood cells are trapped inside the closed vessel and break down. Hyperpigmentation occurs in a notable percentage of patients (ranging from ten to thirty percent), but it fades within six months. In a few cases, the discoloration can last up to a year, but permanent staining is infrequent.
Factors Influencing Long-Term Durability
The long-term durability of the outcome is determined by the patient’s susceptibility to developing new veins. Sclerotherapy does not alter the underlying physiological tendency toward venous disease, which is influenced by genetic predisposition. An individual’s inherited vein structure and the integrity of their venous valves play a substantial role in whether new vessels become incompetent and visible over time.
Lifestyle factors also impact the rate at which new veins may form, necessitating future maintenance treatments. Conditions that increase pressure in the leg veins, such as obesity and pregnancy, can accelerate the development of new varicose or spider veins. Occupations or habits that involve prolonged periods of sitting or standing impede proper blood circulation and increase the likelihood of venous disease progression.
To maximize the time a person remains vein-free after treatment, specific maintenance steps are recommended. Consistent use of compression stockings helps support the venous system, reduces pressure, and prevents the formation of new varicosities. Maintaining a healthy body weight and regularly engaging in physical activities that promote leg muscle contraction, such as walking, support long-term vein health and extend the cosmetic benefits of sclerotherapy.