Should my spider veins disappear after four sclerotherapy treatments?

I have had four treatments of sclerotherapy and one treatment of laser on my legs. One area on the inside of my knee still has dark red veins visible. Will this improve post-treatment? It has been 6 weeks since my treatments, and my nurse said if this doesn't work they may need to change the serum.

Answers from doctors (12)


Interventional Radiology Consultants

Published on Jul 11, 2012

This depends on several factors. Were you diagnosed with venous reflux (via ultrasound)? Also, the number of sessions for sclerotherapy to be successful vary from patient-to-patient. I would encourage you to speak with your physician about your results or lack thereof. You may wish to seek a second opinion if you are still not satisfied after speaking with your physician.

//imgs-origin.edoctors.com/imageresizer/image/user_uploads/58x58_85-1/doctors/1268_1408044091.jpg
Answered by Interventional Radiology Consultants

This depends on several factors. Were you diagnosed with venous reflux (via ultrasound)? Also, the number of sessions for sclerotherapy to be successful vary from patient-to-patient. I would encourage you to speak with your physician about your results or lack thereof. You may wish to seek a second opinion if you are still not satisfied after speaking with your physician.

Published on Jul 11, 2012


More About Doctor Austin Vein Specialists

Published on Jul 03, 2012

It will likely go on to fade and disappear after that many treatments. I would be patient, as it just may take longer if it was a larger vein. If it doesn't disappear, it may have survived through the treatment and require a higher concentration of the sclerosant solution.

Answered by Austin Vein Specialists (View Profile)

It will likely go on to fade and disappear after that many treatments. I would be patient, as it just may take longer if it was a larger vein. If it doesn't disappear, it may have survived through the treatment and require a higher concentration of the sclerosant solution.

Published on Jul 11, 2012


Cosmetic Vein Centers of Texas

Published on Jul 03, 2012

Some patients require 6-8 treatments before spider veins disappear.

//imgs-origin.edoctors.com/imageresizer/image/user_uploads/58x58_85-1/doctors/554_1447800116.jpg
Answered by Cosmetic Vein Centers of Texas

Some patients require 6-8 treatments before spider veins disappear.

Published on Jul 11, 2012


Bella MD Laser Vein and Aesthetic Center

Published on Jul 03, 2012

You should be using polydocanol 1%. This usually works best.

//imgs-origin.edoctors.com/imageresizer/image/user_uploads/58x58_85-1/doctors/772_1408044077.jpg
Answered by Bella MD Laser Vein and Aesthetic Center

You should be using polydocanol 1%. This usually works best.

Published on Jul 11, 2012


Advanced Vein Center

Published on Jul 03, 2012

Yes, four treatments should have made improvement. There may be reflux in larger veins underneath that will only be appreciated with ultrasound. Changing the sclerosant may help.

//imgs-origin.edoctors.com/imageresizer/image/user_uploads/58x58_85-1/doctors/464_1408044069.jpg
Answered by Advanced Vein Center

Yes, four treatments should have made improvement. There may be reflux in larger veins underneath that will only be appreciated with ultrasound. Changing the sclerosant may help.

Published on Jul 11, 2012


Vein Specialties of St. Louis

Published on Jul 03, 2012

First, did the nurse check for "feeding' reticular veins below the spider vein complexes? This is done with a vein light (transillumination) in a darkened room. These must be treated or the surface vein treatments won't be as effective. Treatments vary, but one way is to laser the surface veins and then immediately inject the reticular feeders. There are only two FDA approved sclerosants on the market: Asclera and Sotradecol. Both are effective in the right dilutions. If you only have one residual area in the inside of the knee, these can be resistive to treatments. At times, ultrasound examination can show a small perforator vein which should also be injected, and the worst case scenario would show saphenous reflux. A thorough evaluation by a surgeon specializing in vein treatment may be in order.

//imgs-origin.edoctors.com/imageresizer/image/user_uploads/58x58_85-1/doctors/623_1499902138.jpg
Answered by Vein Specialties of St. Louis

First, did the nurse check for "feeding' reticular veins below the spider vein complexes? This is done with a vein light (transillumination) in a darkened room. These must be treated or the surface vein treatments won't be as effective. Treatments vary, but one way is to laser the surface veins and then immediately inject the reticular feeders. There are only two FDA approved sclerosants on the market: Asclera and Sotradecol. Both are effective in the right dilutions. If you only have one residual area in the inside of the knee, these can be resistive to treatments. At times, ultrasound examination can show a small perforator vein which should also be injected, and the worst case scenario would show saphenous reflux. A thorough evaluation by a surgeon specializing in vein treatment may be in order.

Published on Jul 11, 2012


They could still disappear but it's not unusual to have to try a different concentration or sclerosant if the original one isn't working.

Answered by North Country Thoracic & Vascular (View Profile)

They could still disappear but it's not unusual to have to try a different concentration or sclerosant if the original one isn't working.

Published on Jul 11, 2012


South Palm Cardiovascular Associates

Published on Jul 03, 2012

There are many variables in sclerotherapy - the type of sclerosant used, the strength of the sclerosant (it should be diluted to different concentrations based on the size of the vein being treated) and, lastly, every person responds differently - based on the quality of the treatment, and the skin tone, compliance with limited sun exposure after treatment. What does your treating physician say?

//imgs-origin.edoctors.com/imageresizer/image/user_uploads/58x58_85-1/doctors/1131_1499985707.jpg
Answered by South Palm Cardiovascular Associates

There are many variables in sclerotherapy - the type of sclerosant used, the strength of the sclerosant (it should be diluted to different concentrations based on the size of the vein being treated) and, lastly, every person responds differently - based on the quality of the treatment, and the skin tone, compliance with limited sun exposure after treatment. What does your treating physician say?

Published on Jul 11, 2012


Intermountain Vein Center

Published on Jun 25, 2012

It is possible that the particular serum did not work for you specifically and it may be necessary to change it. With some people, their bodies accept treatment with certain serums and not others. Sometimes it takes a little trial and error to find the serum that works for each individual patient. It might take a few more months before the veins completely disappear.

//imgs-origin.edoctors.com/imageresizer/image/user_uploads/58x58_85-1/doctors/1153_1408044089.jpg
Answered by Intermountain Vein Center

It is possible that the particular serum did not work for you specifically and it may be necessary to change it. With some people, their bodies accept treatment with certain serums and not others. Sometimes it takes a little trial and error to find the serum that works for each individual patient. It might take a few more months before the veins completely disappear.

Published on Jul 11, 2012


The Sheen Vein Institute

Published on Jun 22, 2012

How quickly you notice veins going away post sclerotherapy depends on how much you started with. So the more you have to start, the longer it takes for the practitioner to actually hit all of those veins. Assuming they have hit all of the abnormal veins, I would have expected to see a marked improvement in the way your legs looked after 6 weeks. That being said, there are two possibilities that might explain why they are not gone. First, the practitioner did not treat everything. Two, you have abnormal veins deep in your leg that are feeding into those resistant veins that were never addressed. Did they ultrasound your legs first before any treatment? If not, then find someone who actually does this. Any practitioner who injections you first without ever looking inside your leg first to see what is wrong inside, probably does not really know what they are doing.

//imgs-origin.edoctors.com/imageresizer/image/user_uploads/58x58_85-1/doctors/1116_1499984661.jpg
Answered by The Sheen Vein Institute

How quickly you notice veins going away post sclerotherapy depends on how much you started with. So the more you have to start, the longer it takes for the practitioner to actually hit all of those veins. Assuming they have hit all of the abnormal veins, I would have expected to see a marked improvement in the way your legs looked after 6 weeks. That being said, there are two possibilities that might explain why they are not gone. First, the practitioner did not treat everything. Two, you have abnormal veins deep in your leg that are feeding into those resistant veins that were never addressed. Did they ultrasound your legs first before any treatment? If not, then find someone who actually does this. Any practitioner who injections you first without ever looking inside your leg first to see what is wrong inside, probably does not really know what they are doing.

Published on Jul 11, 2012


Vein Center of Orange County

Published on Jun 20, 2012

If spider veins have been properly injected four times without improvement, it's certainly time for a new approach. A Vein-Lite transillumination device may show an underlying vein below the surface as the culprit. Alternatively, a stronger sclerosant may be indicated, or an ultrasound to look for a deeper "saphenous" vein. Finally, very fine spider veins may respond only to VeinGogh radiofrequency. In any event, surface lasers are rarely used by expert phlebologists for leg veins due to their poor efficacy.

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

If spider veins have been properly injected four times without improvement, it's certainly time for a new approach. A Vein-Lite transillumination device may show an underlying vein below the surface as the culprit. Alternatively, a stronger sclerosant may be indicated, or an ultrasound to look for a deeper "saphenous" vein. Finally, very fine spider veins may respond only to VeinGogh radiofrequency. In any event, surface lasers are rarely used by expert phlebologists for leg veins due to their poor efficacy.

Published on Jul 11, 2012


Vanish Vein and Laser Center

Published on Jun 20, 2012

Usually the treatment of spider veins is a process and takes time to see the results. I would recommend that you be certain that you have no underlying reflux which could be contributing to the spider veins not resolving. A venous ultrasound would show this. By laser, I am not sure if this means closure or topical laser treatment. If topical laser, it is not very effective on leg spiders. If you have no underlying reflux, then I agree that the solution may need to be changed or the concentration increased. Also all reticular veins should be treated.

//imgs-origin.edoctors.com/imageresizer/image/user_uploads/58x58_85-1/doctors/1053_1499982262.jpg
Answered by Vanish Vein and Laser Center

Usually the treatment of spider veins is a process and takes time to see the results. I would recommend that you be certain that you have no underlying reflux which could be contributing to the spider veins not resolving. A venous ultrasound would show this. By laser, I am not sure if this means closure or topical laser treatment. If topical laser, it is not very effective on leg spiders. If you have no underlying reflux, then I agree that the solution may need to be changed or the concentration increased. Also all reticular veins should be treated.

Published on Jul 11, 2012


Related Questions for Sclerotherapy

Sclerotherapy -11 answers
How long does it take to see spider veins vanish after Sclerotherapy? Is there any hope the veins will disappear after more time has gone by?
See More
Sclerotherapy -12 answers
I have a lot of green veins on my legs, calves, even my arms and other parts of my body. Are those on my legs reticular veins, or could they be normal veins? They are very obvious. I never had them until my pregnancy last year. I have delivered 1 year ago.
See More
Sclerotherapy -10 answers
Why is it necessary to wear Compression Stockings after Sclerotherapy?
See More
Sclerotherapy -10 answers
I had 6 treatments of sclerotherappy one week apart. Much of the treatments were injecting "feeders". It's been over 2 months since my first treatment and my veins look worse. I have new quite dark veins that have popped up. What happened?
See More
Sclerotherapy -9 answers
Will the length of time be longer then two weeks?
See More
Sclerotherapy -10 answers
It has been 8 weeks since I had spider and 1 surface blue vein injected by vein surgeon. I still have black blue spots and the surface vein looks worse, will this correct itself or do i need more treatments/ new doc??
See More
Sclerotherapy -11 answers
I had a sclerotherapy treatment, but instead of being prescribed compression stockings, my doctor advised me to use an elastic bandage. Is the bandage just as effective as compression stockings?
See More
Sclerotherapy -12 answers
What chemicals are in the saline solution and does it have mercury in it and if not what is in it? what are the side effects if any.
See More
Sclerotherapy -4 answers
I recently just noticed that all of my veins are visible all over my body, including a few in the chest area....is this normal? I'm currently on Accutane too.
See More
Sclerotherapy -9 answers
How long after Sclerotherapy can you get in the sun?
See More
Get answers from our experienced doctors.
How it works
Sclerotherapy -11 answers
I just had the sclerotherapy procedure today. I would love to cut off the feet of my compression stockings. I feel like it would be much more comfortable. Would that defeat the purpose?
See More
Sclerotherapy -6 answers
How soon after sclerotherapy can I play tennis? run? dance?
See More
Sclerotherapy -9 answers
After sclerotherapy, there is a small section that is lumpy and discolored. My treating pysician does not drain these, is there any way to speed up the healing/fading of pigmentation?
See More
Sclerotherapy -9 answers
I hade sclerotherapy yesterday, but I can still see a few of the veins that were treated. How long until all the veins disappear?
See More
Sclerotherapy -13 answers
I've heard that occasionally, small lumps of clotted blood can be felt after sclerotherapy. Aren't blood clots quite dangerous?
See More
Sclerotherapy -10 answers
Will running short distances, say 2-4 miles three times per week, be of detriment to sclerotherapy procedures? What about medium distance hikes of 5-10 miles that include hills?
See More
Sclerotherapy -11 answers
Can you go in a hot tub after sclerotherapy and how long do you have to wear the stocking for?
See More
Sclerotherapy -11 answers
I had sclerotherapy almost 4 weeks ago. My legs now ache and feel heavy as soon as I get up in the morning. I have been wearing support knee highs. How long should this last? Legs didn't feel this way before sclerotherapy.
See More
Sclerotherapy -6 answers
Would I see the results right away after Sclerotherapy treatment? If not, when wil the bruises go away? Is it normal to still see all my treated veins after 10 days?
See More
Sclerotherapy -13 answers
I had a sclerotherapy procedure for spider veins on lateral upper thigh just over two weeks ago at derm dr. Since that time, have noticed an approx. 1" wide area of tons of tiny new vessels just distal to injection sites. How long before this goes away?
See More
Get answers from our experienced doctors.
How it works

Related Articles

Have specific questions?
ASK A DOCTOR