Sclerotherapy is a minimally invasive treatment designed to address unwanted veins, typically spider veins or smaller varicose veins. The procedure involves injecting a chemical solution, known as a sclerosant, directly into the affected vein. This solution irritates the blood vessel lining, causing it to swell, seal shut, and collapse. The treated vein scars, and the body naturally reabsorbs it over time, diverting blood flow to healthy veins nearby.
Immediate Care and Activity Guidelines
Following specific instructions for the first 48 to 72 hours is important for treatment effectiveness. Patients are typically required to wear compression stockings or bandages continuously, often for two days, to apply sustained pressure to the treated vessels. This external compression helps keep the collapsed vein walls sealed together and encourages scar tissue formation.
While rest is important, prolonged inactivity should be avoided, and patients are encouraged to walk for 20 to 30 minutes at least twice daily. Light activity promotes healthy blood circulation in the legs, which helps prevent the development of blood clots in deeper veins. High-impact activities like running, weightlifting, or vigorous aerobics should be avoided for at least a few days to two weeks, as strenuous exercise puts excessive pressure on the treated vessels.
Patients must also avoid exposure to intense heat sources for one to two weeks, including hot baths, saunas, and hot tubs. Heat causes blood vessels to dilate, which can potentially reopen the treated veins and hinder the sealing process. Direct sun exposure or tanning beds should also be avoided, as ultraviolet light can increase the risk of developing skin discoloration.
Common Physical Changes and Sensations
Mild aching, throbbing, or slight discomfort in the treated limb is common during the first 24 to 48 hours. This can often be managed with over-the-counter pain relievers that do not thin the blood. Some patients also report temporary itching or a mild burning sensation directly at the injection sites.
Visual changes are expected and generally resolve as the body heals the treated area. Bruising around the injection sites is nearly universal and can last for several days to a few weeks, depending on the number and size of the veins treated. Temporary redness may also appear at the needle entry points but usually fades within a few days.
One of the most common post-treatment findings is the development of firm, palpable lumps or cord-like structures along the path of the treated vein. These hardened areas represent the collapsed vein that has been successfully sealed and filled with coagulated blood. These lumps are temporary and will gradually soften and be reabsorbed by the body over several weeks to months. Less commonly, a brownish discoloration, known as hyperpigmentation, may appear due to the temporary leakage of iron from the treated blood into the skin.
While most side effects are minor, patients should be vigilant for signs that may indicate a complication. Sudden, severe pain, excessive swelling, or the appearance of an open sore or ulcer at the injection site warrants immediate contact with a healthcare provider. Symptoms such as sudden shortness of breath, chest pain, or significant swelling in the entire leg are rare but require urgent medical attention.
Managing Recovery and Long-Term Expectations
Setting realistic expectations for the timeline of resolution is important, as the results of sclerotherapy are gradual, not immediate. Smaller spider veins typically begin to fade within three to six weeks following the procedure. Larger varicose veins, or reticular veins, require a longer time frame and can take three to four months to fully disappear.
Most patients require more than one treatment session to achieve their desired outcome, especially when addressing extensive networks of veins. Subsequent treatments are typically spaced about six weeks apart to allow the body sufficient time to heal from the previous session before new injections are performed. A single treatment session usually collapses only 50 to 80% of the injected veins.
Regular follow-up appointments are scheduled to monitor progress and determine if further treatment is needed. While the successfully treated veins will not reappear, sclerotherapy does not prevent the formation of new veins in the future. Maintaining an active lifestyle and wearing compression garments as advised contributes to long-term vein health and may reduce the likelihood of new veins developing.