Sclerotherapy is a minimally invasive procedure used primarily on the legs to treat spider veins and smaller varicose veins. The treatment involves injecting a sclerosant solution directly into the affected vein. This solution irritates the vessel lining, causing it to collapse, scar shut, and reroute blood flow to healthier veins. Full recovery involves both immediate physical healing and the longer-term cosmetic resolution of the treated vessels.
Immediate Recovery and Temporary Side Effects
The first 48 to 72 hours following a sclerotherapy session represent the acute post-procedure period. Patients typically experience mild, localized side effects at the injection sites, which is a sign the sclerosant is working. These immediate reactions often include slight redness, minor swelling, and a light stinging sensation or mild discomfort.
It is highly recommended that patients engage in light activity, such as walking, immediately after the treatment. This action is important because it promotes healthy blood flow and helps prevent potential complications like blood clots. Patients are generally advised to avoid strenuous exercise, heavy lifting, hot baths, saunas, and hot tubs for at least a few days to two weeks. Excessive heat can cause veins to dilate, which interferes with the desired collapse and scarring of the treated vessel.
The Critical Short-Term Healing Timeline
The primary healing phase generally spans the first three to six weeks. During this period, initial side effects begin to resolve as the body starts absorbing the collapsed vein. Bruising and tenderness around the injection site, common in the first week, will gradually diminish.
A strict regimen of compression therapy is required during this short-term timeline to ensure the procedure’s success. Compression stockings or bandages are typically worn continuously for the first 24 to 48 hours, followed by daytime use for one to two weeks, though specific duration varies by physician. The pressure from the garment helps to keep the treated vein walls pressed together, forcing them to scar and close permanently.
Patients may also notice the formation of small, firm lumps or knots along the path of the treated vein, a condition known as induration. This is trapped, coagulated blood within the collapsed vessel and is a normal, expected part of the healing process. While this trapped blood can cause localized tenderness, it is a temporary condition that signifies the treatment has been effective. For small spider veins, noticeable cosmetic improvement often begins to appear toward the end of this three- to six-week window.
Long-Term Resolution and Factors Affecting Results
There is a distinction between feeling healed (when discomfort resolves) and the final resolution (the complete disappearance of the treated vein). While patients feel recovered within weeks, the full absorption of the scarred vein segment takes significantly longer. For smaller spider veins, the final result is often visible within three to six weeks, but larger veins may require three to four months for complete resolution.
A common occurrence during this long-term phase is hyperpigmentation, which appears as a brown or darkened discoloration over the treated area. This staining is caused by deposits of hemosiderin, an iron-storage complex released when red blood cells break down inside the closed vein. Hyperpigmentation usually fades within three to six months, though it can persist for a year or longer in a small percentage of patients.
The ultimate timeline for seeing the final cosmetic outcome is influenced by several patient-specific factors. The overall size and number of veins treated, the concentration of the sclerosant solution used, and the patient’s underlying circulatory health all play a role. Adherence to all post-procedure instructions, especially the consistent use of compression garments, is the most direct way a patient can positively influence the speed and quality of the long-term result.
Recognizing Normal vs. Concerning Symptoms
Patients must monitor their legs and differentiate between expected healing symptoms and those requiring immediate medical attention. Normal signs include small, firm lumps (induration) and temporary skin darkening (hyperpigmentation). Mild pain and aching manageable with over-the-counter pain relievers are also typical.
Certain symptoms are concerning and require immediate contact with a healthcare professional. These include signs of infection, such as increasing warmth, spreading redness, pus, or fever. A rare but serious complication is deep vein thrombosis (DVT), a blood clot in a deep vein. Symptoms of DVT or a pulmonary embolism (PE) require emergency care, including sudden, severe calf pain, major swelling, shortness of breath, chest pain, or coughing up blood.