Sclerotherapy & Spider Vein Treatment

The aim is to close spider veins, reticular veins and selected small varicose branches so they fade over time. It is used for cosmetic concerns, small symptomatic veins and residual branches after treatment of larger refluxing veins. When a deeper source of reflux is feeding the visible veins, that source usually needs treating first, or the result will not last.

• Cosmetic spider veins and reticular veins
• Small symptomatic surface veins
• Residual branches after ablation of larger refluxing veins

A history of DVT, pregnancy, allergies and certain medications influence timing and technique, so these are checked before treatment.

The clinician reviews symptoms, previous thrombosis, pregnancy, medications and allergies, and arranges duplex ultrasound when varicose veins, swelling or skin changes suggest underlying reflux. Little other preparation is required; avoid applying moisturiser to the legs on the day, and bring or arrange compression stockings if advised.

Microsclerotherapy

Very fine needles inject small surface veins, with magnification and specialised lighting assisting accuracy.

Ultrasound-guided sclerotherapy

Ultrasound guides treatment of larger or deeper veins that are not visible through the skin. Foam sclerosant may be used because it displaces blood and contacts more of the vein wall.

Liquid or foam sclerosant is injected through a fine needle. The vein contracts, closes and is gradually absorbed over the following weeks. Sessions are performed in the rooms without anaesthesia, and the number of injections per session is kept within safe dose limits.

Walking is encouraged immediately, while prolonged immobility and strenuous exercise are limited briefly. Compression stockings may be worn for a period after injections. Treated veins can initially look darker or feel firm, and bruising, tenderness and small lumps of trapped blood are common before the veins fade over weeks to months. Review appointments assess the response and plan any further sessions.

• Bruising and temporary pigmentation
• Matting (a blush of tiny new vessels)
• Trapped blood and localised inflammation
• Skin ulceration at an injection site
• Allergic reaction
• Visual disturbance or migraine-like symptoms
• DVT and, very rarely, pulmonary or neurological complications
• Rare arterial injury

Most effects are minor and temporary; the rare serious risks are discussed before consent.

Observation is reasonable when spider or reticular veins are not troublesome. Surface laser may suit selected very fine vessels, while treatment of larger refluxing veins may be needed before cosmetic sclerotherapy will provide a durable result. The approach should be based on examination and, where indicated, duplex ultrasound.

Sclerotherapy usually improves veins gradually over several weeks or months rather than making them disappear immediately. Several sessions may be required, and complete clearance cannot be guaranteed. Patients should understand the likely number of treatments, the interval between sessions and the temporary appearance of bruising, trapped blood or pigmentation.

New vessels can develop over time because treatment does not remove the underlying tendency to form them. Matting and pigmentation are recognised risks and may take months to settle. The consultation should consider skin type, medication, pregnancy plans and any history of thrombosis, and should explain whether compression or activity restrictions are recommended after each session.

Yarra Vascular Surgeons checks whether visible veins are isolated or driven by deeper reflux before any injections begin, and combines careful technique with realistic expectations and staged follow-up to optimise the cosmetic result.

Sclerotherapy can close spider veins, reticular veins and selected varicose tributaries so they gradually fade. Book an assessment to confirm whether underlying reflux needs treatment first.