At Madison Medispa in Waunakee, WI, we offer a full range of treatment services for Varicose and Spider Veins, but the treatment we use the most is called sclerotherapy. How does sclerotherapy work?


How Does Sclerotherapy Work?

Sclerotherapy is a minimally invasive treatment for varicose and spider veins. Before we get into more details about this treatment, learning more about these issues will help you make an informed decision regarding your treatment, care, and recovery.

Varicose vs Spider Veins

Faulty or weak valves along the vessel wall account for the majority of spider and varicose veins. This condition is often referred to as venous insufficiency. When the valves inside your veins begin to break, it becomes hard for blood to flow naturally and in the right direction, up and out of your leg. Instead, gravity ends up pulling the blood back down the vein in the wrong direction, and results in pooling of blood within the affected veins.  Varicose veins and Spider veins are caused by the same problem.  It’s simply that bigger veins have bigger valves and when they break it results in bigger varicose veins.  Smaller veins have smaller valves and when they break they are typically called spider veins.


Varicose Veins

Varicose veins occur in the large superficial veins of the leg. They are large and often appear in the form of a large, twisted bulge under the surface of the skin. In most cases, these veins will appear to have a bluish hue. Varicose veins typically develop along the medial aspect of your thigh and calf with branches extending out laterally or posteriorly.  They may cause large bursts of spider veins around your ankles, and on the top of your feet.  Pregnant mothers may develop varicose veins around the buttocks or lower pelvic regions.


Spider Veins

Spider veins are relatively small compared to the varicose veins, and they only affect the superficial veins within the dermis and epidermis. Spider veins are manifest as small purple, red, or blue-colored branches or spider webs on the surface of your skin. Unlike varicose veins which are only in the legs, spider veins may also occur in other areas of your body, such as your face, cheeks, and nose.


What Are the Causes of Spider and Varicose Veins?

Venous insufficiency is the primary cause of spider and varicose veins. The factors responsible for this problem are described below:



Medical research has shown a significant relationship between the prevalence of spider veins and genetics. According to statistics, more than 90% of patients with this problem come from a family with a history of varicose or spider veins.

Despite this, there is no clarity on how genetic factors contribute to this issue. Still, there are concerns that an individual’s genetics play a significant role in weakening the walls of the veins and causing venous insufficiency.



Excess body weight pressurizes the veins. Many patients with varicose or spider veins are overweight. Extra weight places additional pressure on venous valves and impairs normal venous function. Losing weight is considered a significant benefit to helping reduce or slow development of varicose and spider veins, as it reduces venous pressures and improves the venous function.


High Levels of Progesterone

Progesterone, which is a sex hormone in females, contributes a lot to vein health. Progesterone has been shown to cause vein wall laxity and valve leaflet softening which results in leaky valves.  This may happen around the time of your period and in the first trimester of pregnancy.  Factors such as menopause, pregnancy, progestin-rich birth control, and hormone replacement therapy can lead to elevated levels of progesterone.



Veins are the blood vessels that take deoxygenated blood back to the heart and lungs. Doing so, they must work against gravity, and if you stand or sit for long hours, venous circulation may be significantly reduced.  People who stand or sit for long hours at work are at a higher risk of developing varicose or spider veins.


When Should I Seek Treatment?

Spider veins and Varicose veins manifest themselves differently. For instance, since spider veins are superficial, you may not experience any health-related complications like leg swelling or pain. Advanced spider veins may cause skin irritation such as dry and itchy skin, and may also cause restlessness and cramping at the end of the day.

Varicose veins may have several severe physical symptoms. The common symptoms of varicose veins include pain, leg swelling, itching around the affected areas, heavy leg sensation, restless legs, skin discoloration, burning or throbbing sensation in the lower legs, and bruises around the affected veins.  Left untreated, some people develop recurrent clotting or bleeding from their veins, and some people develop ulcers around their ankles where the venous back pressure is the greatest.

What Treatment Is Like

Treatments takes between 30 to 90 minutes to complete. Different factors such as the type of the affected veins influence the time it takes to inject the affected vein. For example, spider veins will take 30 to 60 minutes, while varicose veins may take up to 90 minutes.

The treatment is minimally invasive since it targets the affected veins only. All your doctor will do is identify the affected vein and inject it with a sclerosing solution that will cause it to scar down to a tiny cord and disappear with time.


FAQs About Sclerotherapy


1. How Does Sclerotherapy Work?

This treatment is aimed at addressing the issue of varicose and spider veins. A sclerosing solution is injected into the broken veins, damaging the vein wall and causing it to scar down to a small cord which is then dissolved by your body over the next few weeks. The primary goal of this treatment is not only to get rid of the broken veins but also to encourage proper blood flow.


2. What are the Medications Typically Used For Treatment?

The most commonly used sclerotherapy solutions are sodium tetradecyl sulfate and polidocanol.  They are both basically fancy soap solutions.  When they are injected into a vein they cause inflammation of the lining of the vein wall which causes the vein to spasm, scar down, and eventually disappear.


3. Is this Treatment Effective?

When performed by a skilled provider, especially one that does screening ultrasound evaluations for all patients, the sclerotherapy has success rates >90%.  However, vein disease is a chronic condition, and it is likely that you will develop additional broken veins over the upcoming years which will need additional treatment.  It is important to note that each patient’s needs and conditions are unique. Your doctor will guide you on the number of sessions needed after examining your specific condition.


4. Do I Have to go to a Hospital for Treatment?

The treatment is typically carried out in a clinic. Although your treatment will not require using any form of general anesthesia, local anesthetic is typically used to make the treatment more comfortable, especially for patients with larger varicose veins.


5. Am I a Good Candidate for this Treatment?

If you want a non-surgical approach to address your varicose or spider veins, then sclerotherapy is a perfect option. Anybody, both female and male, and with different skin tones, can use this treatment. If you are pregnant, your spider or varicose veins may disappear after giving birth, so it is advisable to wait at least 3-months after childbirth before you seek treatment. Nevertheless, a thorough consultation and diagnosis are needed to determine your suitability for this treatment.


6. Are There Different Types of Treatment?

The common types of this treatment include ultrasound-guided, liquid, and foam sclerotherapy. The ultrasound-guided option allows doctors to identify the exact veins to be treated. On the other hand, the liquid approach is a standard treatment used to treat reticular veins, spider veins, and smaller varicose veins. However, if you have long, large varicose veins, then your doctor will likely suggest using the ultrasound-guided foam approach.


7. When Should I Expect to See Results From this Treatment?

The results of this treatment vary from person to person. If the condition has affected the large veins, it will take a longer time before the results start to show compared to someone whose condition is on the smaller veins. Whether you are being treated for spider veins or varicose veins, you should start seeing significant results in 3 to 6 weeks. The treated vein will collapse into a relatively solid and invisible cord that dissolves over time.


The Benefits of Ultrasound-Guided Foam Treatment

The most obvious benefit of this treatment is to get rid of the unwanted veins. But, with there being several options of doing that, why should you choose this particular treatment?


The Most Important Treatment There Is For Patients With Varicose Veins!!!

Many doctors offer treatments for the large trunks, such as surgery or thermal ablation.  Many doctors offer treatments for the little spider veins.  The problem is that very few doctors offer Ultrasound-guided Foam Sclerotherapy for all the medium-sized branches that comprise the majority of broken veins in people who have vein disease!  This means that if you don’t go to a doctor who offers ultrasound-guided sclerotherapy, you will likely have lots of large bulging branches left over after your surgery or thermal ablation procedure, and if you have spider veins, your treatment may not be effective because the medium-sized feeder veins are still in your leg and preventing the small veins from completely closing down!  Always ask for a provider who offers ultrasound-guided foam slcerotherapy as part of your treatment plan!


Minimally Invasive

This treatment involves the injection of a foam sclerosing solution into the affected veins under the guidance of ultrasound technology. Compared to other approaches, the ultrasound-guided treatment option is precise and highly effective.


Fast Recovery

Patients undergoing this treatment are put in a compression stocking and can walk immediately after the treatment. However, it is important to keep your leg elevated for a few hours for a fast recovery.


Long-Lasting Results

The treatment takes typically 60 to 90 minutes, but with long-lasting results. It is very effective, especially if you are being treated for any form of recurrence following previous procedures like vein stripping. The ultrasound-guided foam treatment offers both symptomatic and cosmetic improvement.


How Should I Prepare for Treatment?

There are no special things you absolutely need to do, but if you would like to minimize bruising, do not take aspirin, naproxen sodium, or ibuprofen 2 to 3 days before the treatment. If possible, avoid using ointments or lotions on you legs on the day of treatment.


How Do I Care for My Skin After Treatment?

It will take some time before the results of the treatment start to show. For faster recovery, avoid strenuous activities during the first few weeks after the treatment. Your doctor may advise you to apply a bandage or even wear a stocking to help sustain compression on the affected areas. Also, avoid exposing the treated area to the sun, as it may lead to the development of dark spots around the treated area.  If you are going outside, apply sunscreen on the treated area to protect. (It is always advisable to apply sunscreen all times on any part of your skin that is exposed.)


Get in Touch With Sclerotherapy Expert Today!

If you are tired of trying home remedies for treating unwanted veins with no success, get in touch with us at Madison Medispa in Waunakee, WI today. We use the most technologically advanced approaches to treat both varicose and spider veins successfully. Learn more here. We are looking forward to helping you look and feel better!