Vein Treatment in the San Francisco Bay Area

Sclerotherapy is the gold standard for spider vein removal and a treatment of choice for small varicose veins. A minimally-invasive procedure, sclerotherapy permanently removes faulty veins after only two to four sessions.

What Is Sclerotherapy?

Sclerotherapy is the most common treatment for varicose and spider veins. It involves injecting medications, called sclerosing agents, into problem veins. Sclerosing agents work by irritating vein walls, causing them to gradually shrink and be replaced with scar tissue. Sclerotherapy has a long history and remains the best treatment for spider veins on the legs and feet. It can even help treat mild cases of varicose veins. Besides diminishing the appearance of spider and varicose veins, it can also relieve itching, cramping, burning, and pain associated with faulty veins.

Sclerotherapy does not require anesthesia and takes only 15 to 45 minutes. Doctors typically give one injection for every inch of vein, and anywhere from five to 40 injections per treatment session are needed. The provider applies a cotton ball and compression tape to each area being treated. Two or more sessions may be required to remove a vein completely, and compression stockings are necessary for best results.

Preparing for Sclerotherapy

You will first schedule an appointment with the Appearance Care Center™. Our team will look at your medical history, perform tests and discuss your concerns to determine if this procedure is right for you. If you are an eligible candidate, will provide instructions on how to prepare for your procedure. Sclerotherapy is an in-office procedure that usually does not require the use of local or general anesthetics. You will be able to drive yourself home on the same day after your procedure and resume your routine within a day.

Preparation usually involves:

  • not taking blood-thinning medications and supplements before your procedure
  • not shaving your legs 24 hours before your procedure
  • wearing loose-fitting or short bottoms on the day of your procedure
  • purchasing compression stockings to wear after recovery


There is little to no downtime after sclerotherapy. Most patients are able to get back to work on the same day of their procedure. It’s important to walk soon after your procedure to prevent blood clot formation. This is why we advise patients to postpone flights and long travel when having this procedure.

Other important aspects of aftercare include avoiding overexertion, wearing a compression stocking and limiting sun exposure. You will likely be instructed to wear compression stockings for a week or more after treatment to prevent bruising, bleeding, clots and deep vein thrombosis.


How Sclerotherapy Works

Sclerotherapy is a minimally invasive procedure performed in a doctor’s office. A dermatologist or surgeon first cleans the treatment area and injects a sclerosing agent directly into the vein. If the problem veins are deep, ultrasound may be used. Sclerosing agents are chemical irritants and include:

  • Hypertonic saline
  • Ethanolamine oleate
  • Sodium tetradecyl sulfate
  • Polidocanol
  • Chromated glycerin

When injected onto a vein, sclerosing agents irritate its walls, causing the vein to close shut. This stops blood flow, and the vein gradually dies and is replaced with scar tissue (sclerosis). Several treatments may be necessary before the veins are completely removed, with sessions taking place weeks apart.

Veins are blood vessels that carry deoxygenated blood from organs back to the heart. Those that develop into spider veins or varicose veins are superficial, meaning they are near the surface of the skin. Because the deep vein system carries most blood to the heart, there is little risk from closing superficial spider or varicose veins. Once these veins are closed, the blood is directed to healthy veins.

Who Is a Good Candidate?

Most adults over the age of 20 can undergo sclerotherapy. But like most medical procedures, it is not for everyone. You may not be a good sclerotherapy candidate if you:

  • are pregnant or breastfeeding
  • have a history of blood clots
  • are diagnosed with thrombosis
  • have late-stage peripheral arterial disease
  • are bedridden
  • are diagnosed with hyperthyroidism
  • are allergic to sclerosing agents

Having realistic expectations, understanding procedure limits and being able to follow your physician’s instructions are critical components of being a good candidate. If our team decides this procedure is not for you, we may suggest alternatives like Laser Vein Ablation or Intense Pulse Light (IPL) Photorejuvenation.

Is sclerotherapy safe?

This is a remarkably safe procedure. A multi-center registry of over 12,000 sclerotherapy sessions found that accidents occurred in only 0.4% of cases. Adverse events are rarely reported and usually resolve on their own.

Is sclerotherapy effective?

Fewer than 10% don’t see improvement with sclerotherapy. The majority of our treated patients notice a reduction in pain and less visible veins with each session.

Can sclerotherapy cause blood clots?

Tiny and visible blood clots may form in and near the treated veins. However, these pose no real danger, unlike blood clots that form inside the deep veins.

Can sclerotherapy be done on the face?

Yes, this treatment may be performed on the face. However, we don’t recommend this as the skin on your face is much thinner and thus more prone to scarring and discoloration following sclerotherapy. For spider veins on the face, laser therapy is more suitable.

Does insurance cover sclerotherapy?

Most insurance companies see sclerotherapy for spider veins as a cosmetic procedure. However, your insurance provider may cover sclerotherapy for varicose veins, especially if your condition is causing you significant pain and impairing normal functioning.

Are the results permanent?

Successfully treated veins are gone permanently. A small number of patients develop new spider or varicose veins near the treatment site. This is due to neovascularization — the formation of new veins. Others develop problems with veins in other areas. These problems require additional sclerotherapy sessions.

Book an Appointment

Contact the Appearance Care Center™ for a consultation by filling in your personal information here or by dialing (415) 567-7200. During your initial appointment, you will meet with Dr. Corey S. Maas or one of our trained nurses to discuss your concerns and goals. Our medical team will also check if you have underlying deep vein problems to decide if sclerotherapy is your best option.

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