After sclerotherapy, you can walk out of the office and resume most normal activities the same day. The procedure itself takes 15 to 30 minutes, and recovery is straightforward, but the weeks that follow involve compression stockings, some bruising, and a gradual wait for treated veins to fade. Here’s what that timeline actually looks like.
The First 48 Hours
Walking is the single most important thing you can do right after treatment. It keeps blood flowing through your deep veins and helps your body begin absorbing the treated vessels. Walk as much as you comfortably can, starting immediately. There’s no need for bed rest.
You’ll leave the office wearing compression wraps or stockings, and they need to stay on continuously for the first two to three days, including at night. Most providers recommend 20 to 30 mmHg pressure, though yours may adjust that based on the size and location of veins treated. Don’t remove them to shower during this initial stretch unless your provider says otherwise.
Some soreness at the injection sites is normal. You may notice small, firm lumps along the treated veins or a tight, pulling sensation. For pain relief, stick with acetaminophen (Tylenol). Avoid ibuprofen, aspirin, and other anti-inflammatory medications for at least 48 hours. These can interfere with the sclerosing solution’s ability to irritate and close the vein walls, and they may increase bleeding or bruising.
Compression Stockings: How Long You’ll Wear Them
After the first two to three days, you can start removing your compression stockings at night and to shower. Put them back on as soon as you dry off. You’ll continue wearing them during all waking hours, whether you’re standing, walking, or sitting, for roughly two weeks total. Some providers extend this to three weeks for larger veins.
Compression isn’t optional. It keeps pressure on the collapsed vein walls so they seal together properly. Skipping it can lead to the vein reopening or increase the chance of discoloration along the treated area.
Activity Restrictions
Normal walking, light household tasks, and desk work are fine from day one. What you need to avoid for about seven days is aerobic exercise like running, cycling, or swimming, along with heavy lifting and squatting. These activities increase blood pressure in your legs, which can push the sclerosing solution out of the treated veins or force blood back through before the walls have sealed.
Hot baths, hot tubs, and saunas should also be avoided for several days. Heat dilates veins, which works against the treatment. Warm (not hot) showers are fine once your compression wraps come off after the first few days. Sun exposure on treated areas can worsen discoloration, so keep those spots covered or use sunscreen for several weeks.
Bruising, Discoloration, and Other Normal Side Effects
Bruising around injection sites is nearly universal and typically fades within two to four weeks. The more common concern is hyperpigmentation: brownish staining along the path of the treated vein caused by iron deposits from trapped blood. This happens in roughly 10 to 35 percent of patients depending on the solution used and the size of veins treated. It usually fades on its own, but it takes time. Expect six to 12 months for pigmentation to resolve, and in about 1 to 2 percent of patients, some degree of staining persists beyond a year.
Another side effect worth knowing about is telangiectatic matting, which is the appearance of tiny new reddish blood vessels near the treatment site. These fine webs of capillaries develop in a small percentage of patients and can take months to fade or may need additional treatment.
You may also feel hardened, cord-like areas along treated veins. This is trapped blood inside the sealed vessel and is a normal part of the process. Your provider can drain these with a small needle prick at a follow-up visit, which often speeds up healing and reduces discoloration.
When Treated Veins Actually Disappear
Don’t expect instant results. The veins look worse before they look better. In the first week or two, treated spider veins often appear darker and more noticeable as the body begins breaking them down.
Smaller spider veins typically fade within three to six weeks. Larger varicose veins take longer, usually three to four months to fully resolve. Some veins need more than one treatment session, and your provider will usually schedule a follow-up four to six weeks after the procedure to assess results and decide whether retreatment is needed.
Rare but Serious Complications
The vast majority of sclerotherapy patients experience nothing beyond bruising and temporary discoloration. The most serious risk is a blood clot forming in a deep vein, known as DVT. In a study of 1,000 legs treated with foam sclerotherapy, DVT occurred in 1.5 percent of cases, and only 0.2 percent were symptomatic, meaning most were caught on routine follow-up ultrasound rather than causing noticeable problems.
Signs that warrant a call to your provider include sudden swelling in the treated leg, significant pain that worsens rather than improves over the first few days, shortness of breath, chest pain, or skin ulceration at an injection site. These are uncommon, but recognizing them early makes a difference.
What Recovery Looks Like Week by Week
- Days 1 to 3: Compression stockings on continuously. Walking encouraged. Soreness, tenderness, and mild swelling at injection sites. Avoid anti-inflammatory pain relievers.
- Days 3 to 14: Compression stockings during the day only. Bruising peaks and begins to fade. Treated veins may look darker. Showers are fine, but skip hot baths.
- Week 2 to 3: Resume exercise gradually. Most bruising resolves. You can stop wearing compression stockings per your provider’s guidance.
- Weeks 3 to 6: Spider veins begin visibly fading. Follow-up appointment to evaluate results.
- Months 2 to 4: Larger veins continue to shrink and disappear. Any hyperpigmentation is still present but slowly lightening.
- Months 6 to 12: Residual brown staining, if present, continues to fade.
Most people return to work and daily routines within a day of treatment. The recovery itself is more about patience than discomfort. The hardest part for most patients is simply waiting for the cosmetic results to catch up with the treatment.