Sclerotherapy for Spider Veins: What to Know Before Treatment

Published September 27, 2026 · Tru Essence Spa · 5 min read

Spider veins and small varicose veins are among the most common cosmetic concerns on the legs. They can make people self-conscious about wearing shorts or skirts, and some veins also ache, itch or throb after a long day. Sclerotherapy is a well-established, minimally invasive treatment that helps these veins fade. Here is how it works, who is a good candidate and what recovery involves.

Spider Veins vs. Varicose Veins

Spider veins are small, thin red, blue or purple vessels close to the surface of the skin. They often appear in branching or web-like patterns on the thighs, calves and ankles, and sometimes on the face. Varicose veins are larger, bulging veins that can look rope-like and are often blue or purple under the skin. They are sometimes accompanied by pain, heaviness, swelling or cramping in the legs.

Both develop when small valves inside the veins weaken, allowing blood to pool instead of flowing efficiently back toward the heart. Varicose and spider veins are about three times more common in women than in men. Contributing factors include genetics, prolonged standing, pregnancy, hormonal changes, excess weight, lack of exercise, smoking, a history of blood clots in the deep veins and deep vein valve failure.

How Sclerotherapy Works

During sclerotherapy, a provider uses a very fine needle to inject a solution, called a sclerosant, directly into the unwanted vein. The solution irritates the lining of the vein, causing it to scar and close. Blood then reroutes through healthier veins, and the collapsed vein is gradually reabsorbed into the surrounding tissue, which makes it fade from view.

Sclerotherapy has been used for decades and remains a standard treatment for spider veins and small varicose veins. It does not require incisions or general anesthesia, and most people walk out of the office and resume normal daily activities the same day.

Who Is a Good Candidate?

• People with spider veins or small to medium varicose veins on the legs
• People in generally good health who can walk comfortably after treatment
• People who are not pregnant or breastfeeding
• People with realistic expectations about the number of sessions needed

Larger bulging varicose veins, leg swelling, skin changes around the ankles or a history of blood clots may point to an underlying problem with the deeper veins. In those cases, an ultrasound evaluation by a vein specialist may be recommended before or instead of cosmetic treatment. Treating the underlying cause first gives better and longer-lasting results.

What Happens During Treatment

1. Assessment. Your provider examines the veins, reviews your medical history and medications and discusses expectations.
2. Preparation. The skin is cleansed. You will usually lie on your back or stomach depending on the area.
3. Injections. A series of small injections is placed into the targeted veins. You may feel a brief pinch or mild cramping. Treated veins often begin to blanch or disappear immediately.
4. Compression. Depending on the veins treated, you may be asked to wear compression stockings afterwards.

A session typically takes 15 to 45 minutes, depending on how many veins are treated.

Preparing for Your Appointment

• Do not apply lotion, oil or self-tanner to your legs on the day of treatment.
• Wear loose, comfortable clothing, or bring shorts, and bring your compression stockings if you have been asked to purchase them.
• Tell your provider about all medications and supplements, including blood thinners, hormones and anti-inflammatory medicines; you may be advised to adjust some of them beforehand.
• Avoid significant sun exposure or tanning of the legs before treatment.

Recovery and Aftercare

Recovery is usually straightforward. Common instructions include:

• Walk. Light walking immediately after treatment and in the following days supports healthy circulation.
• Wear compression as directed, often for several days to a couple of weeks.
• Avoid strenuous exercise, heavy lifting and high-impact workouts for a few days.
• Avoid heat such as hot baths, hot tubs and saunas for a short period after treatment.
• Protect treated areas from the sun to reduce the risk of temporary darkening of the skin.

Side Effects to Know About

Most side effects are mild and temporary:

• Bruising, redness or small raised areas at injection sites
• Itching or tenderness along the treated vein
• Brown lines or spots (hyperpigmentation) along treated veins, which usually fade over months
• Telangiectatic matting, a cluster of very fine new red vessels near the treated area, which often resolves on its own

Less common but more serious complications include skin ulceration at an injection site, inflammation of a treated vein and, rarely, blood clots in deeper veins. Contact your provider promptly if you notice significant swelling, warmth or pain in the leg, or shortness of breath or chest pain, which require urgent medical attention.

When Will You See Results?

After sclerotherapy, treated spider veins tend to fade within a few weeks, although it can take longer to see full results, particularly for larger veins, which may take a few months. Many people need more than one session to achieve the clearance they want, and sessions are usually spaced several weeks apart to allow the treated veins to be absorbed. Treated veins that have closed do not return, but new spider veins can develop over time, so some people schedule occasional maintenance treatments.

Helping Prevent New Veins

You cannot change your genetics, but you can support healthy circulation:

• Stay active; walking and calf exercises help pump blood back toward the heart.
• Maintain a healthy weight.
• Avoid standing or sitting for long periods without moving; take short breaks to walk or flex your ankles.
• Elevate your legs when resting.
• Consider compression stockings if your job requires long periods on your feet.
• Protect your skin from the sun, which can contribute to spider veins on the face.

Vein Treatment at Tru Essence

Tru Essence Cosmetic & Medical Spa offers sclerotherapy for spider and varicose veins as part of our Medical Spa services, with laser options also available for certain small facial veins through our laser skin treatments. The spa is physician-led, and each plan begins with an assessment of your veins and health history. If you are preparing for your first visit, read what to expect at your first consultation.

Conclusion

Sclerotherapy is a proven, minimally invasive way to reduce the appearance of spider veins and small varicose veins, with little downtime and gradual, natural-looking results. Good candidates, careful technique, compression and sun protection all contribute to the best outcome. If you have larger or symptomatic veins, a medical evaluation will make sure any underlying vein problem is addressed first.