Varicose veins and spider veins affect an estimated 40% of women and a smaller – but, significant, number of men. For some the problem is simply their unsightly appearance but others experience symptoms associated with these dilated veins. Fortunately, most of these unwanted veins – including large varicose veins – can be removed non-surgically by Sclerotherapy.

What is Sclerotherapy?
Sclerotherapy is the most consistently effective non-surgical procedure to eradicate unwanted, non-functional varicose veins and spider veins. Although used primarily to remove veins of the legs and thighs, unwanted veins at other sites – including facial veins and prominent veins of the hands and feet – can also be treated by Sclerotherapy.

How is Sclerotherapy performed?
Using a very small needle, a sterile solution (called a sclerosant) is injected into the vein. The purpose of the solution is to produce irreversible alteration to the vein wall. If this is achieved, the vein will be absorbed, weeks to months after treatment, as is illustrated in the photos below.

Is there any harm in removing these unsightly veins?
No. Varicose veins and spider veins are non-functional and their removal does not adversely affect circulation.

Does the removal of varicose and spider veins by Sclerotherapy result in the appearance of new veins?
No. The removal of varicose veins and spider veins does not, in and of itself, stimulate the development of new veins. By the time varicose veins and spider veins have appeared, normal veins, in the same vicinity, have taken over their function without the need for the body to develop new veins in response to their removal. However, anyone who has had varicose veins and spider veins is likely predisposed to this condition and can expect new varicose veins and spider veins to develop in the future, whether or not pre-existing veins have ever been treated.

Can anyone be treated?
With few exceptions, almost anyone with unwanted varicose veins and spider veins can be treated by Sclerotherapy. Women who are pregnant or nursing are, usually, not treated with Sclerotherapy. Treatment is postponed until after delivery and lactation are completed – except under unusual circumstances.

What can I expect after Sclerotherapy?
Usually mild redness, swelling and tenderness appear along the course of the treated veins. This may persist for days, weeks to months depending upon the size and location of the underlying vein. Less commonly, there may be some bruising. After Sclerotherapy, the vein may feel firm within the skin until it has been completely absorbed – this can take weeks to months, depending upon the size of the vein.

Are there restrictions after Sclerotherapy?
No. After Sclerotherapy all normal activities may be resumed, without any limitations. Compression hosiery may be required, for a one to a few weeks after Sclerotherapy.

How many Sclerotherapy treatments are required?
The number of treatments required depends upon the number and extent of unwanted veins. Usually a vein will respond after one treatment. However, because there is a limit to the quantity of sclerosant that can be administered during any one treatment, if there are numerous veins present, several treatments may be necessary. If more than one treatment session is required, they can be scheduled at intervals of 24 hours.

Should I wait until after I have all of my pregnancies before treating my veins?
No, this is a common misconception. There is no need to wait until having all of your anticipated pregnancies before beginning Sclerotherapy. In fact, it is wise to treat varicose veins and spider veins prior to pregnancy; otherwise, they usually become more apparent and more symptomatic as pregnancy progresses.

Are there any side effects associated with Sclerotherapy?
Sclerotherapy, as with any medical intervention, has the potential for unwanted side effects. Fortunately, serious side effects from Sclerotherapy are rare. The most common change associated with Sclerotherapy is temporary discoloration along the course of the treated vein. It appears as a tan or brown line and should be expected in almost everyone who is treated by Sclerotherapy. It disappears spontaneously, but can take months or longer. Less commonly, dilated capillaries or redness can develop adjacent to treated spider veins. These usually fade spontaneously and only uncommonly persist. A rare complication is the development of an erosion or ulcer at a treatment site, which can take weeks to months to heal, often resulting in a scar.

Is Endovenous Ablation an option instead of Sclerotherapy?
Sometimes. The introduction of Endovenous Ablation has made the need for surgery very rare. For varicose veins that are present along the posterior (back) of the leg and along the medial (inside) of the leg and thigh, Endovenous Ablation is often the treatment of choice. However, for most other varicose veins and their branches, Sclerotherapy remains a treatment of choice.

“You cannot go wrong with this dermatologist. Dr. Green and his staff are the very best! They go out of their way to assure patient satisfaction. I have used many services in the Bethesda location, and have always been more than satisfied. I highly recommend Dr. Green.” 

Susan E.

Dr. David Green, M.D.

Dr. David Green is a Board certified Dermatologist in Bethesda, Maryland. Dr. Green specializes in Dermatology, Dermatologic Cosmetic and Laser Surgery and the treatment of Varicose Veins and vascular disorders.

He is Certified by the American Board of Dermatology, is a Fellow of the American Academy of Dermatology, and a Member of the American Society for Dermatologic Surgery, and the American College of Phlebology. He treats patients from Maryland, Washington DC, Virginia and throughout the Mid Atlantic region.


Dr. David Green proudly offers services in his Bethesda, Maryland office.

4800 Montgomery Ln.,
Suite LL50
Bethesda, MD 20814
Phone: 301.907.7250


10.32.09: Delegation and Assignment of Performance of Cosmetic Medical Procedures and Use of Cosmetic Medical Devices. This is a Maryland safety regulation that governs who can legally perform medical cosmetic procedures.  Dr. Green administers all injectable treatments (including Botox™, Juvederm™, Voluma™, Kyblella™, and other fillers & Sclerotherapy) and laser treatments.