What is it?

Sclerotherapy is a procedure that injects a medicine, called a sclerosant, into a problem vein, vascular malformation, or some cysts. The medicine irritates the lining so the space closes, scars down, and shrinks. Ultrasound or live X-ray often guides the needle. The medicine may be a liquid or a foam.

It is used for spider veins, some varicose veins, venous or lymphatic malformations, and selected fluid collections. The needle is removed when the injection is finished. It is not an open operation. More than one session is often needed.

Why do I need it?

A vein or malformation that does not empty normally can cause symptoms or a visible problem. Sclerotherapy may be used to:

• Close spider veins or small varicose veins
• Shrink a venous or lymphatic malformation that causes pain, swelling, or bulk
• Treat a cyst or residual collection that keeps refilling
• Reduce aching, heaviness, or bleeding from a problem vein

How do I prepare?

• Medicines: Tell the team about blood thinners, hormones, and all other medicines. Do not stop them unless you are told to.
• Allergies: Report allergies to sclerosant medicines, contrast dye, numbing medicine, latex, or tape. Tell the team if you have asthma.
• Pregnancy: Tell the team if you are pregnant or might be. Sclerotherapy is usually delayed until after pregnancy.
• The site: Do not put lotion on the treatment area the day of the procedure. Bring compression stockings if you were given them.
• Eating and a ride: You can often eat normally for a simple vein treatment. If sedation is planned, follow the fasting instructions. Arrange a ride if sedation is used.

How is it placed?

• You lie or sit so the team can reach the target. The skin is cleaned. Numbing medicine may be used.
• Ultrasound, or sometimes live X-ray, guides a thin needle or catheter into the vein, malformation, or cyst.
• Contrast may be injected to confirm the needle is in the right place. The sclerosant is then injected. You may feel mild burning or cramping.
• The needle is removed. The provider applies pressure, a bandage, and often a compression wrap or stocking.
• A session often takes 15 to 60 minutes. You are watched briefly. Many people go home the same day.

Care instructions

• Wear the compression stocking or wrap as directed, often for several days to 2 weeks after vein treatment. Take it off only to shower unless told otherwise.
• Walk the day of the procedure. Avoid hard exercise, hot baths, saunas, and long sitting or standing for a few days.
• Bruising, firm cords, and itching can be normal. Brown staining of the skin can last weeks to months. Protect the area from sun.
• You may usually shower after 24 hours. Pat the sites dry. Do not soak until the team says you can.
• Results are gradual. Treated veins fade over weeks. A malformation or cyst may need more than one session.

What to watch out for

Call your care team promptly if you notice:

• A sore or ulcer at an injection site, or skin that turns dark and becomes very painful
• Increasing redness, swelling, or warmth in the calf or thigh
• Severe pain that is not improving, or drainage of pus
• Hives, wheezing, or swelling of the lips or tongue
• Chest pain, trouble breathing, coughing blood, fainting, or sudden vision changes — seek emergency care