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Sclerotherapy is considered the gold standard for superficial vein treatment. 

The key to successful results is in the thorough primary assessment of the entire venous system before initiating treatment. The "see and inject" approach will fail if there are deeper diseased varicose veins underlying the small spider veins on the surface of the skin. The sclerosing medication type and strength is selected based on the location, type, and size of the superficial and varicose veins and your individual medical history. For the smallest spider veins, visual sclerotherapy with liquid sclerosant may be used and for bigger spider veins, reticular veins and varicose veins, sclerotherapy with the fiberoptic veinlite with foamed Tromboject in varying concentrations may be used. 

Using the smallest needles available, the medication is injected into the diseased veins causing irritation and an inflammatory reaction to the lining of the vein resulting endothelial damage (sclerosis) and fibrosis of the vein. It has a local effect and a short duration of action. Several treatments may be needed depending on the size and severity of the varicose vein disease. Treatments are typically performed in 3 month intervals for each treatment area.  

Each session of sclerotherapy lasts 30-45 minutes. During the session there is mild discomfort associated with the needles and there may be some mild cramping in the legs intermittently following treatment. It is normal to experience bruising, tenderness and redness at the injection sites.  There are risks of potential skin staining, itching, burning, and bruising with injections. 

Following each session, graduated compression stockings are worn continuously for 24 hours, and then during the daytime for 2 weeks. Graduated compression stockings are a vital part of effective treatment as they assist in keeping the vessels collapsed post treatment and decrease post treatment complications such as staining and pigmentation.

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