Sclerotherapy for Varicose Veins: How Does It Work?
- Verónica Pita Marchena
- 25 minutes ago
- 9 min read
Nearly one in three adults experiences varicose veins, leading to discomfort, swelling, and aesthetic concerns. For those in Toronto seeking effective relief, sclerotherapy offers a minimally invasive approach. This treatment involves injecting a special solution directly into the affected vein, causing it to collapse, rerouting blood flow to healthier vessels and providing lasting symptom relief. This guide will walk you through how sclerotherapy works, who makes a good candidate, what to expect before, during, and after the procedure, potential risks, how it compares to other treatments, cost considerations in Toronto, and why Dr. Luis Figueroa at Ontario Vascular is your trusted partner for compassionate vein care.
Here's what we'll cover:
Understanding sclerotherapy and its purpose in treatment
Determining eligibility and the diagnostic process
The journey of the procedure, from preparation to immediate post-treatment care
Potential side effects, recovery expectations, and safety measures
Evidence of effectiveness, anticipated results, and long-term durability
Comparing sclerotherapy with EVLT, RFA, and non-invasive alternatives
Estimating costs, navigating OHIP and private insurance coverage
Discovering the expertise of Ontario Vascular under Dr. Luis Figueroa and how to schedule your consultation
What Is Sclerotherapy and How Does It Treat Varicose Veins?
What Is Sclerotherapy? Definition and History
Sclerotherapy is a precise injection therapy designed to close off abnormal veins, improving leg comfort and appearance. Its roots trace back to the 1930s, initially using hypertonic saline. Over time, advancements led to the development of safer detergent solutions like polidocanol and sodium tetradecyl sulfate. These innovations have cemented sclerotherapy as a vital treatment in vascular surgery and dermatology, paving the way for today's sophisticated ultrasound-guided techniques.
Let's explore the precise mechanism by which targeted injections effectively close off veins.
How Does Sclerotherapy Work? Step-by-Step Mechanism
Sclerotherapy works by gently irritating the vein's inner lining, prompting it to seal shut and redirecting blood flow to healthier veins.
Precise Injection – A very fine needle is used to deliver the sclerosant solution directly into the vein, often guided by ultrasound for accuracy.
Sclerosant Action – The solution causes controlled inflammation of the vein's lining (endothelium).
Vein Closure – This inflammation leads to fibrosis, causing the vein walls to stick together and collapse, preventing further blood pooling.
Blood Rerouting – Blood circulation is naturally redirected to deeper, healthy veins with properly functioning valves, restoring efficient blood return.
Through this process, the treated veins gradually fade as your body naturally absorbs the sealed vessels, preparing you for recovery and renewed comfort.
What Types of Sclerosants Are Used in Sclerotherapy?
A range of sclerosant formulations is available, each suited for different vein sizes and characteristics:
Sclerosant | Formulation | Ideal Use |
Polidocanol | Foam or liquid | Medium to larger varicose veins |
Sodium Tetradecyl Sulphate | Liquid or foam | Fine spider veins and smaller reticular veins |
Dextrose Hypertonic Saline | Aqueous solution | Larger veins, often treated with ultrasound guidance |
Each agent offers unique benefits in terms of effectiveness and patient comfort, allowing for a customized treatment plan for your specific varicose or spider veins, based on their size and location.
How Is Sclerotherapy Different for Varicose Veins vs. Spider Veins?
The sclerotherapy technique and the concentration of the sclerosant are carefully adjusted based on the size and depth of the vein being treated:
Spider Veins (very small, 0.1–1 mm) typically receive a lower concentration of liquid sclerosant to minimize the risk of skin staining.
Varicose Veins (larger, ≥3 mm) often benefit from a foam sclerosant, administered under ultrasound guidance, to treat deeper, larger vessels effectively.
An ultrasound-guided approach ensures the needle is precisely placed within the target vein, significantly reducing the risk of injecting the solution into surrounding tissues.
By tailoring the sclerosant formulation and utilizing advanced imaging when needed, practitioners can safely and effectively treat both cosmetic spider veins and symptomatic varicose veins with precision and patient comfort in mind.
Who Is a Good Candidate for Sclerotherapy?
What Are the Common Causes and Symptoms of Varicose Veins?
Varicose veins develop when vein valves weaken, allowing blood to flow backward and pool. Several factors can contribute to this:
Genetics – A family history of venous issues
Pregnancy – Hormonal shifts and increased pressure
Prolonged Standing – Due to occupation or lifestyle
Obesity – Leading to increased pressure within the veins
Common symptoms include aching, a feeling of heaviness, swelling, itching, or changes in skin color on the legs. Recognizing these signs often prompts an evaluation for sclerotherapy or other suitable treatments.
How Is Varicose Vein Diagnosis Performed? Role of Ultrasound
Diagnosis involves a thorough clinical examination combined with duplex ultrasound imaging to assess valve function and blood flow patterns. Ultrasound mapping is crucial for:
Measuring the duration of blood reflux and the diameter of veins
Identifying any malfunctioning saphenous or perforator veins
Guiding the development of a precise treatment plan
Accurate mapping ensures that sclerotherapy targets all problematic vein segments, maximizing closure rates and minimizing the chance of recurrence.
When Should You Consider Sclerotherapy for Venous Insufficiency?
Sclerotherapy is a strong consideration when:
Symptoms persist despite consistent use of compression stockings
Cosmetic concerns about the appearance of veins impact self-confidence
Ultrasound imaging reveals reflux in superficial veins that are suitable for injection therapy
While individuals with existing deep vein thrombosis or severe arterial disease require specialized assessment, most adults experiencing superficial venous insufficiency can benefit from the minimally invasive nature of sclerotherapy.
What Happens During the Sclerotherapy Procedure?
How Should You Prepare for Sclerotherapy?
Proper preparation helps ensure a safe and comfortable procedure:
Avoid Aspirin or NSAIDs for 3–5 days prior to reduce bleeding risk.
Stay well-hydrated and have a light meal to maintain stable blood sugar levels.
Wear loose clothing that allows easy access to the treatment areas.
These simple steps contribute to a smoother experience and enhance comfort following the procedure.
What Is the Step-by-Step Process During Sclerotherapy?
The procedure typically takes between 30 and 60 minutes and is usually performed with local anesthesia:
Vein Marking – The clinician will mark the target veins with a skin marker.
Sterile Preparation – The skin along the injection path is thoroughly cleaned.
Gentle Injection – A fine needle is used to slowly inject the sclerosant solution into the vein.
Compression Application – Compression bandages or stockings are applied immediately after the injections.
For deeper veins, ultrasound guidance may be utilized. The treated vein segments often collapse immediately, setting the stage for the post-treatment support phase.
What Can You Expect Immediately After Sclerotherapy?
Following the procedure, you might experience:
Mild cramping or a stinging sensation at the injection sites.
Bruising and redness, which typically peak within 3–5 days.
The need to wear compression stockings to aid vein closure and prevent clotting.
It's encouraged to walk shortly after the procedure to promote blood flow. Most patients can return to their normal daily activities within 24–48 hours.
What Are the Side Effects, Risks, and Recovery Timeline of Sclerotherapy?
What Are the Common Side Effects of Sclerotherapy?
Most side effects are minor and temporary, indicating the body's normal healing response:
Bruising and temporary skin discoloration usually resolve within 1–2 weeks.
Mild itching or skin irritation around the injection sites.
Temporary swelling or a feeling of tightness in the treated leg areas.
These effects are a normal part of the process as the vein seals and begins to be reabsorbed.
How Long Is the Recovery Period After Sclerotherapy?
Recovery experiences may vary based on the size and number of treated veins and the patient’s overall health. Full recovery typically takes between 2 to 6 weeks:
Weeks 1–2: Initial bruising and itching should start to subside. Compression stockings are usually worn continuously during this period.
Weeks 3–4: You can gradually resume more strenuous exercise, avoiding heavy lifting.
Weeks 5–6: Skin tone should normalize, and the treated veins will become less visible.
Most individuals can return to work and light activities the day after treatment, with complete recovery achieved within about six weeks.
What Are the Potential Risks and Complications?
While rare, potential complications can include:
Superficial thrombophlebitis (inflammation of a vein with minor clotting).
Hyperpigmentation, appearing as brown lines along the path of treated veins.
Allergic reactions to the sclerosant (extremely uncommon).
It's important to seek prompt follow-up if you experience any unusual symptoms, such as severe pain, significant swelling, or skin ulceration.
Sclerotherapy: A Review of Techniques and Complications - in English
This comprehensive review delves into the various techniques used in sclerotherapy and discusses potential complications. It emphasizes the critical importance of careful patient selection, precise technique, and diligent post-procedure care to minimize risks and achieve optimal results. The review also details the different types of sclerosants available and their specific applications.
These insights align with long-established findings by Goldman (2000) and are further supported by the ESVS 2022 Guidelines
How Effective Is Sclerotherapy and What Results Can You Expect?
What Is the Success Rate of Sclerotherapy for Varicose Veins?
Sclerotherapy typically achieves a 60–80% closure rate per session for small to medium varicose veins, leading to significant improvements in both symptoms and appearance. Additional sessions can further enhance clearance, providing long-term relief for the majority of patients.
Sclerotherapy for Varicose Veins: Efficacy and Outcomes - in English
Sclerotherapy is recognized as an effective treatment for varicose veins, with success rates influenced by vein size and the specific technique employed. Research indicates that sclerotherapy can lead to substantial improvements in both the cosmetic appearance and the symptoms associated with varicose veins, such as pain and swelling. The procedure is minimally invasive, and most patients experience a relatively swift recovery.
Rabe, E., et al., Phlebology (2014)
This research provides strong support for the article's assertions regarding the effectiveness and positive outcomes associated with sclerotherapy for varicose veins.
How Long Do Sclerotherapy Results Last?
Once treated, the veins are permanently sealed and will not reopen. However, new varicose or spider veins may develop over time due to ongoing pressure on the venous system. Many patients enjoy symptom-free legs for five years or longer before considering any necessary touch-up treatments.
When Will You See Visible Improvement After Treatment?
Visible fading of the treated veins typically begins within 3–6 weeks as the sealed veins collapse and are gradually absorbed by the body. The full cosmetic results, along with maximum symptom relief and restored leg comfort, are usually apparent by three months post-treatment.
How Does Sclerotherapy Compare to Other Varicose Vein Treatments?
What Are the Differences Between Sclerotherapy and Endovenous Laser Therapy (EVLT)?
Sclerotherapy utilizes a chemical solution to close veins, whereas EVLT uses heat energy delivered via a laser fiber.
Treatment | Mechanism | Typical Recovery Time |
Sclerotherapy | Chemical sclerosis | 1–2 days |
Endovenous Laser Therapy (EVLT) | Laser-induced thermal closure | 3–5 days |
How Does Sclerotherapy Compare to Radiofrequency Ablation (RFA)?
Radiofrequency ablation uses radiofrequency energy delivered through a catheter to seal veins, achieving closure rates comparable to EVLT. Sclerotherapy is often preferred for smaller veins due to its lower discomfort and cost. RFA is typically used for larger saphenous veins and is performed under local anesthesia.
What Are Non-Invasive Alternatives to Sclerotherapy?
For individuals who prefer to avoid injections, non-invasive management options include:
Compression Stockings to support healthy blood flow.
Regular Exercise and Leg Elevation to encourage circulation.
Lifestyle Adjustments, such as maintaining a healthy weight and minimizing prolonged standing.
While these strategies can help alleviate minor symptoms, they do not eliminate existing varicose veins.
What Are the Costs and Insurance Coverage Options for Sclerotherapy in Toronto?
How Much Does Sclerotherapy Cost in Toronto?
In Toronto, the cost for cosmetic sclerotherapy sessions typically ranges from CAD 300 to 600 per treatment, depending on the complexity of the veins and the number of injections needed. Treatments deemed medically necessary may have different coverage arrangements, potentially reducing out-of-pocket expenses.
Is Sclerotherapy Covered by OHIP or Private Insurance?
Ontario's Health Insurance Plan (OHIP) may cover sclerotherapy if varicose veins are causing significant issues like ulceration, bleeding, or severe pain. Private insurance plans vary, but many offer reimbursement for ultrasound-guided procedures when they are medically indicated.
How Can You Navigate Insurance Claims for Varicose Vein Treatment?
To streamline the insurance claims process:
Obtain an ultrasound report that clearly documents venous reflux and establishes medical necessity.
Request detailed invoices that include procedure codes and diagnoses.
Submit your claims promptly to OHIP or your private insurer, along with supporting physician notes.
Clear documentation and a confirmed diagnosis are key to facilitating approval and minimizing financial hurdles.
Why Choose Dr. Luis Figueroa and Ontario Vascular for Sclerotherapy?
Who Is Dr. Luis Figueroa? Expertise in Minimally Invasive Vein Treatments
Dr. Luis Figueroa is a board-certified vascular surgeon with over a decade of specialized experience in performing minimally invasive vein treatments. Fluent in both English and Spanish, he is dedicated to providing precise technical care combined with a deeply compassionate, patient-centered approach.
What Makes Ontario Vascular a Leading Clinic for Varicose Vein Care?
Located in North York, Ontario Vascular is equipped with advanced ultrasound technology and offers both foam and liquid sclerosant options. Our bilingual support staff serves the diverse communities of Toronto, ensuring a comfortable and accessible experience. Our unwavering focus on patient comfort, safety, and personalized treatment plans sets a high standard for vascular care.
What Do Patients Say About Their Sclerotherapy Experience?
Patients consistently commend Dr. Figueroa for his attentive care, the minimal discomfort experienced during treatment, and the rapid recovery process. Many report a significant reduction in leg pain, visible improvement in vein appearance within weeks, and a renewed sense of confidence, reflecting Ontario Vascular’s commitment to exceptional outcomes.
How Can You Book a Consultation for Sclerotherapy?
Scheduling your appointment at Ontario Vascular is straightforward and supportive. You can contact our clinic by phone or email to arrange a comprehensive, bilingual consultation with Dr. Figueroa. Your personalized treatment journey begins with an expert assessment and tailored sclerotherapy recommendations.
Sclerotherapy presents a proven, minimally invasive method for eliminating varicose veins and relieving leg discomfort through precisely targeted sclerosant injections. With impressive success rates, swift recovery times, and lasting cosmetic enhancements, it stands as a premier treatment option for suitable candidates.
By integrating expert vascular evaluation, cutting-edge ultrasound guidance, and a deeply patient-focused approach, Dr. Luis Figueroa and the team at Ontario Vascular ensure every stage of your journey—from initial assessment to post-treatment follow-up—is seamless and reassuring. If you're ready to achieve healthier legs and enhance your quality of life, reach out today to explore your sclerotherapy options under experienced, compassionate care.
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