Why are there more blue veins on my legs after sclerotherapy?

I recently had a reflux procedure and sclerotherapy a month later. Four weeks after sclerotherapy, I'm noticing many new large blue veins all over my legs and no difference in the veins injected with saline. Why is this happening?

Answers from doctors (10)


Hratch Karamanoukian, MD, FACS, RVT, RPVI , RPhS

Published on May 18, 2018

If the veins are darker following sclerotherapy then they need a period of three months to heal. It is important to wear compression stockings in the healing phase (3 months) and to use adjunctive measures such as topical creams to reduce the likelihood of hyperpigmentation (bronzing, discoloration). You can read about products called Scler-X and Sclerovase and decide if they are things you want to invest in to improve the cosmetic outcome after scerotherapy.

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Answered by Hratch Karamanoukian, MD, FACS, RVT, RPVI , RPhS

If the veins are darker following sclerotherapy then they need a period of three months to heal. It is important to wear compression stockings in the healing phase (3 months) and to use adjunctive measures such as topical creams to reduce the likelihood of hyperpigmentation (bronzing, discoloration). You can read about products called Scler-X and Sclerovase and decide if they are things you want to invest in to improve the cosmetic outcome after scerotherapy.

Published on Jul 11, 2012


The Sheen Vein Institute

Published on Jun 26, 2014

If all you had done was a reflux procedure?? and a sclerotherapy session, then you really did not get adequate treatment if you are like an average patient. Comprehensive treatment of a person's veins means addressing all parts of a person's vein issues starting with the larger vessels deep in the leg all the way out to the skin surface where you see the blue reticular veins and spider veins. If you are seeing new large blue veins, it is probably due to one of two things. 1. the veins were already there but got larger due to the normal venous flow adjustments that occur with treatments. 2. these new veins developed or became bad after your treatment when you again see a venous flow adjustment due to venous pathways being closed down. These venous adjustments occur because your vein structure is like a 3-D network. They are all interconnected. Therefore, when you start closing branches down with treatments, you are forcing the blood that is normally just sitting in these abnormal veins to redirect into your healthier veins. If these healthier veins by chance have an inherent defect to them, this increase in flow volume can cause them to fail. Thus your new veins. This is why proper vein treatments requires good follow up and comprehensive treatment where the doc is constantly re-evaluating a person's vein issues because they change with each treatment.

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Answered by The Sheen Vein Institute

If all you had done was a reflux procedure?? and a sclerotherapy session, then you really did not get adequate treatment if you are like an average patient. Comprehensive treatment of a person's veins means addressing all parts of a person's vein issues starting with the larger vessels deep in the leg all the way out to the skin surface where you see the blue reticular veins and spider veins. If you are seeing new large blue veins, it is probably due to one of two things. 1. the veins were already there but got larger due to the normal venous flow adjustments that occur with treatments. 2. these new veins developed or became bad after your treatment when you again see a venous flow adjustment due to venous pathways being closed down. These venous adjustments occur because your vein structure is like a 3-D network. They are all interconnected. Therefore, when you start closing branches down with treatments, you are forcing the blood that is normally just sitting in these abnormal veins to redirect into your healthier veins. If these healthier veins by chance have an inherent defect to them, this increase in flow volume can cause them to fail. Thus your new veins. This is why proper vein treatments requires good follow up and comprehensive treatment where the doc is constantly re-evaluating a person's vein issues because they change with each treatment.

Published on Jul 11, 2012


Intermountain Vein Center

Published on Jun 24, 2014

Hypertonic saline has been proven ineffective. Find a clinic with a physician who is accredited by the American College of Phlebology and a clinic who uses polidocanol. We use polidocanol and it is extremely effective and safe at a 0.5% to a 1% dilution. Now if you have big blue veins, if they are not bulging, then those are called reticular veins and normally those aren't to be treated. Some people just have translucent skin and the veins are more visible, but you run the risk of having those veins stained brown after treatment, which can be permanent sometimes. Spider veins are the veins that need to be treated. Now if those veins are bulging, you definitely do not want those injected, but taken out using a procedure called ambulatory phlebectomy. Go to phlebology.org to find a physician who can better assist you.

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Answered by Intermountain Vein Center

Hypertonic saline has been proven ineffective. Find a clinic with a physician who is accredited by the American College of Phlebology and a clinic who uses polidocanol. We use polidocanol and it is extremely effective and safe at a 0.5% to a 1% dilution. Now if you have big blue veins, if they are not bulging, then those are called reticular veins and normally those aren't to be treated. Some people just have translucent skin and the veins are more visible, but you run the risk of having those veins stained brown after treatment, which can be permanent sometimes. Spider veins are the veins that need to be treated. Now if those veins are bulging, you definitely do not want those injected, but taken out using a procedure called ambulatory phlebectomy. Go to phlebology.org to find a physician who can better assist you.

Published on Jul 11, 2012


Daniels Vein and Cosmetic Center

Published on Jun 11, 2014

Hi,
Not sure whether you have more blue veins (reticular veins), or perhaps simply notice more now. Would have to see to make any real comment. Follow up with your doc!

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Answered by Daniels Vein and Cosmetic Center

Hi,
Not sure whether you have more blue veins (reticular veins), or perhaps simply notice more now. Would have to see to make any real comment. Follow up with your doc!

Published on Jul 11, 2012


Vanish Vein and Laser Center

Published on Jun 10, 2014

The reflux procedure is done to close the leaking valves that lead to the blue branch veins and, frequently, the spider veins. Following sclerotherapy, sometimes, new veins will form (neovascularization). I would first make sure that the valves are closed and there is no other source for the new vein formation. This can be done with a follow up ultrasound. If this is normal, then I would treat the veins with a stronger sclerotherapy solution and preferably foam.

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Answered by Vanish Vein and Laser Center

The reflux procedure is done to close the leaking valves that lead to the blue branch veins and, frequently, the spider veins. Following sclerotherapy, sometimes, new veins will form (neovascularization). I would first make sure that the valves are closed and there is no other source for the new vein formation. This can be done with a follow up ultrasound. If this is normal, then I would treat the veins with a stronger sclerotherapy solution and preferably foam.

Published on Jul 11, 2012


Cosmetic Vein Centers of Texas

Published on Jun 10, 2014

You probably need more sclerotherapy.

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Answered by Cosmetic Vein Centers of Texas

You probably need more sclerotherapy.

Published on Jul 11, 2012


Vein Center of Orange County

Published on Jun 10, 2014

Hypertonic saline works well for spider veins but loses it effectiveness for larger veins. The four possible remedies for your situation are:
1. A more potent sclerosant agent should be used for larger reticular
veins (the blue-green flat veins you describe) which often feed the smaller
spider veins.
2. Better technique by an expert vein specialist.
3. Some patients develop new veins as a response to sclerotherapy - an
unfortunate unpredictable event.
4. Ultrasound or VeinLite transillumination may uncover important feeder
veins.

//imgs-origin.edoctors.com/imageresizer/image/user_uploads/58x58_85-1/doctors/1015_1408044084.jpg
Answered by Vein Center of Orange County

Hypertonic saline works well for spider veins but loses it effectiveness for larger veins. The four possible remedies for your situation are:
1. A more potent sclerosant agent should be used for larger reticular
veins (the blue-green flat veins you describe) which often feed the smaller
spider veins.
2. Better technique by an expert vein specialist.
3. Some patients develop new veins as a response to sclerotherapy - an
unfortunate unpredictable event.
4. Ultrasound or VeinLite transillumination may uncover important feeder
veins.

Published on Jul 11, 2012


Lone Star Vein Center

Published on Jun 10, 2014

Tough question to answer with limited info. I would have this discussion with your provider and make sure you understand the difference between the superficial venous system veins, reticular veins, spider veins, and the
veins that are still discolored/healing following sclerotherapy.

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Answered by Lone Star Vein Center

Tough question to answer with limited info. I would have this discussion with your provider and make sure you understand the difference between the superficial venous system veins, reticular veins, spider veins, and the
veins that are still discolored/healing following sclerotherapy.

Published on Jul 11, 2012


More About Doctor Laser Vein Center

Published on Jun 10, 2014

You may have had a complication of the sclerotherapy called matting where new veins appear. However matting is usually small veins. Another possibility is that you have an underlying vein disorder that is not
treated that needs to be treated. I would follow up with your vein specialist to discuss.

Answered by Laser Vein Center (View Profile)

You may have had a complication of the sclerotherapy called matting where new veins appear. However matting is usually small veins. Another possibility is that you have an underlying vein disorder that is not
treated that needs to be treated. I would follow up with your vein specialist to discuss.

Published on Jul 11, 2012


Heart and Vein Center

Published on Jun 09, 2014

Saline is a sclerotherapy solution that was used in the middle ages. Your doctor seems to be using outdated practices. I suggest you have your legs evaluated and treated by a Board Certified Vein Specialist.

//imgs-origin.edoctors.com/imageresizer/image/user_uploads/58x58_85-1/doctors/923_1408044082.jpg
Answered by Heart and Vein Center

Saline is a sclerotherapy solution that was used in the middle ages. Your doctor seems to be using outdated practices. I suggest you have your legs evaluated and treated by a Board Certified Vein Specialist.

Published on Jul 11, 2012


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