Frequently Asked Questions
Before Your Treatment
Where do spider veins come from?
Spider veins are extremely common, affecting approximately 1 in 3 adults. Genetics play a significant role, so if spider veins run in your family, you may be more likely to develop them. Other contributing factors can include pregnancy, hormonal changes, aging, prolonged periods of sitting or standing, and increased pressure on the veins of the legs.
What is venous insufficiency?
Venous insufficiency occurs when the valves within the veins of the legs do not function properly, allowing blood to flow backward and pool in the lower extremities rather than efficiently returning toward the heart.
This increased pressure within the veins can contribute to varicose veins as well as symptoms such as aching, heaviness, swelling, and other changes associated with chronic venous disease.
Am I a candidate for sclerotherapy?
Most patients with spider and small reticular veins are candidates for sclerotherapy. However, if you have larger varicose veins or signs or symptoms that may suggest underlying venous insufficiency, an ultrasound evaluation may be recommended before beginning cosmetic treatment.
When significant venous insufficiency is present, treating the underlying source of the problem first may improve the effectiveness and longevity of your cosmetic results.
Your medical history, medications, vein pattern, and treatment goals will be reviewed during your consultation to determine whether sclerotherapy is appropriate for you.
How many treatments will I need?
Every patient’s veins are different, so there is no single number of treatments that applies to everyone. Most patients require multiple sessions to achieve their desired results and then maintenance treatments to maintain development of new veins.
Successful treatment often involves addressing not only the visible spider veins but also the slightly larger blue or green “feeder” veins beneath them, known as reticular veins.
During your consultation, your veins will be carefully evaluated and an individualized treatment plan will be created based on your specific vein pattern and goals.
Your Treatment
What is sclerotherapy?
Sclerotherapy is a minimally invasive treatment used to eliminate unwanted spider and reticular veins. A sclerosing medication is injected directly into the targeted vein, where it affects the inner lining of the vessel and causes the vein to close.
Over time, the treated vein is naturally absorbed by the body and gradually fades from view.
What medication is used for sclerotherapy?
At Brady Vein Therapy, we use Asclera® (polidocanol), an FDA-approved sclerosing medication for the treatment of uncomplicated spider and reticular veins of the lower extremities.
Once injected into the targeted vein, polidocanol causes the vessel to close. Blood is naturally redirected through healthy veins, and the treated vessel is gradually absorbed by the body.
What can I expect during treatment?
Using a very fine needle, small amounts of medication are carefully injected into the targeted veins. Multiple injection sites are typically used during each session to treat the desired area.
Most appointments last approximately 20–60 minutes depending on the number and extent of the veins being treated.
You will be able to walk immediately following your procedure, and walking is encouraged after treatment.
Does sclerotherapy hurt?
Most patients tolerate sclerotherapy very well. Because a very fine needle is used, you may feel a small pinch with each injection as well as temporary stinging or burning when the medication enters the vein.
Discomfort is generally brief and resolves quickly. No anesthesia is required.
After Your Treatment
What should I expect after sclerotherapy?
It is completely normal for treated areas to look worse before they look better.
Immediately after treatment, you may notice redness, swelling, bruising, or raised areas along the treated veins. Some veins may temporarily appear darker or more noticeable as they begin to close and heal.
Trapped blood can occasionally develop within a treated vein and may appear as a small, firm, dark area beneath the skin. When appropriate, trapped blood can be drained during a follow-up visit, which may help relieve discomfort and reduce prolonged discoloration. Temporary brown discoloration, or hyperpigmentation, can also occur along the course of a treated vein.
These changes generally improve as your body heals and gradually absorbs the treated veins. Your individual response and healing process will be reviewed with you throughout your treatment.
When will I see results?
Sclerotherapy results are gradual. Smaller spider veins may begin fading within several weeks, while larger reticular veins can take several months to fully resolve.
It is important to remember that sclerotherapy is a process rather than an immediate cosmetic fix. Your legs may temporarily look worse during the healing process before you begin to see your final result.
Multiple treatment sessions are often necessary, and continued improvement can occur for weeks to months following each treatment.
Are there risks or side effects?
Sclerotherapy is generally very well tolerated, but like any medical procedure, it carries potential risks and side effects.
Common temporary effects can include bruising, redness, swelling, tenderness, trapped blood within a treated vein, and temporary skin discoloration. Less commonly, patients may develop small new blood vessels near the treated area, known as matting.
Rare but more serious complications can occur, including allergic reactions, skin injury or ulceration, blood clots, and other vascular complications.
Before treatment, your medical history and individual risk factors will be reviewed with you, and you will have the opportunity to discuss any questions or concerns.
Are compression stockings required after treatment?
Yes. Compression is an important part of your post-treatment care.
At Brady Vein Therapy, patients are generally instructed to wear 20–30 mmHg compression stockings continuously for the first 48 hours, followed by daytime use for an additional three days, for a total of five days.
Thigh-high compression stockings are typically recommended depending on the area being treated. Please bring your compression stockings with you to every treatment appointment. Compression stockings are also available for purchase at the practice.
What are the activity restrictions after sclerotherapy?
For the best possible treatment outcome, you will be asked to avoid strenuous exercise, hot tubs, hot baths, saunas, and massage for five days following treatment.
Walking is not only permitted—it is encouraged.
You will receive detailed post-treatment instructions so you know exactly what you can and cannot do following your procedure.
Can I travel after sclerotherapy?
Long periods of immobility should be avoided immediately following sclerotherapy. We recommend avoiding air travel and car rides longer than four hours for 72 hours after treatment.
If you have upcoming travel plans, please let us know when scheduling your appointment so your treatment can be planned appropriately.
Will my spider veins come back?
Veins that have been successfully treated with sclerotherapy are permanently closed and gradually absorbed by the body. However, sclerotherapy does not prevent new spider or reticular veins from developing in the future.
Genetics, hormonal changes, pregnancy, aging, underlying venous disease, and other factors can contribute to the development of new veins over time. Some patients therefore choose occasional maintenance treatments to address new veins as they appear.