What are the main causes of varicose veins and spider veins?

Varicose veins and spider veins develop when valves in the veins become weakened or damaged, causing blood to pool. Common causes include genetics (family history), aging, pregnancy, prolonged standing or sitting, obesity, and hormonal changes. Women are more susceptible due to hormonal fluctuations during pregnancy, menopause, or from birth control use.

How do I know if I need treatment for my varicose veins?

You should consider treatment if you experience symptoms such as leg pain, aching, heaviness, swelling, cramping, restless legs, skin discoloration, or itching around the veins. Even without symptoms, large or bulging varicose veins may benefit from treatment to prevent complications. A consultation with Dr. Figueroa at VeinCentre can determine if treatment is right for you.

What is sclerotherapy and how does it work?

Sclerotherapy is a minimally invasive treatment where a specialized solution is injected directly into spider veins or small varicose veins. This solution irritates the vein walls, causing them to collapse and seal shut. Blood is then rerouted through healthier veins, and the treated vein is gradually absorbed by the body over several weeks. It's highly effective with a 90%+ success rate.

Are varicose vein treatments covered by OHIP?

Yes, consultations at VeinCentre are OHIP-covered. Treatment coverage depends on medical necessity. If your varicose veins cause symptoms like pain, swelling, or skin changes, treatments like radiofrequency ablation or VenaSeal may be covered by OHIP. Cosmetic treatments for spider veins are typically not covered. Dr. Figueroa will assess your condition and discuss coverage options during your consultation.

How long does a typical vein treatment appointment take?

Treatment duration varies by procedure type. Sclerotherapy typically takes 30-45 minutes, VenaSeal Glue Ablation takes 30-45 minutes, and Radiofrequency Ablation (RFA) takes 45-60 minutes. These are outpatient procedures performed in our Toronto or Richmond Hill clinics, allowing you to return home the same day.

Is vein treatment painful?

Modern vein treatments are minimally invasive and well-tolerated. Local anesthesia is used to numb the treatment area, so you'll feel minimal discomfort during the procedure. Most patients describe feeling only slight pressure or mild sensations. Sclerotherapy involves small needle injections that feel like tiny pinches. Post-treatment discomfort is typically mild and manageable with over-the-counter pain relief.

What is the recovery time after vein treatment?

Recovery is quick with modern vein treatments. Sclerotherapy and VenaSeal allow immediate return to normal activities with no compression stockings required after VenaSeal. Radiofrequency Ablation typically requires 1-2 days before returning to work and wearing compression stockings for 1-2 weeks. Walking is encouraged immediately after all procedures to promote healing. Most patients resume regular activities within days.

Can varicose veins come back after treatment?

Treated veins do not reopen once successfully closed. However, new varicose veins can develop in other areas over time due to ongoing genetic factors, aging, or lifestyle conditions. The recurrence rate is low with modern treatments—RFA and VenaSeal have 95%+ success rates. Maintaining a healthy weight, staying active, and wearing compression stockings when needed can help prevent new vein problems.

How many treatment sessions will I need?

The number of sessions depends on the severity and extent of your vein condition. Many patients see significant improvement after just one treatment session. Spider veins may require 2-3 sclerotherapy sessions spaced several weeks apart for optimal results. Larger varicose veins treated with RFA or VenaSeal typically require only one session per vein. Dr. Figueroa will create a personalized treatment plan during your consultation.

What should I expect during my first consultation?

During your OHIP-covered consultation at VeinCentre, Dr. Figueroa will review your medical history, examine your legs, and may perform an ultrasound to assess vein health and blood flow. You'll discuss your symptoms, treatment goals, and concerns. Dr. Figueroa will explain which treatment options are best suited for your condition—whether sclerotherapy, radiofrequency ablation, or VenaSeal—and answer all your questions about the procedure, recovery, and expected results.

The Complete Guide to Sclerotherapy in Ontario: How It Works, Foam vs. Liquid, Pain, Cost & Recovery

Sep 4, 2025

7 min read

Updated: Aug 25

Spider veins (telangiectasias), bluish reticular veins, and small surface varicose veins affect millions of Canadian men and women. Beyond their visible, web-like appearance on the thighs, calves, and ankles, these diseased surface vessels can cause uncomfortable symptoms such as localized burning, aching, tenderness, and night-time throbbing.

Among all available vascular treatments, Sclerotherapy remains the international gold standard for eliminating spider and reticular veins safely, quickly, and effectively.

Unlike invasive surgical procedures or surface thermal lasers that can struggle with deeper feeder veins, sclerotherapy delivers a specialized medical solution directly into diseased vessels, sealing them shut from the inside with virtually zero downtime.

This comprehensive clinical guide, created by board-certified Vascular Surgeon Dr. Luis Figueroa and the specialized clinical team at VeinCentre, covers everything you need to know about sclerotherapy in Ontario: the physiological mechanism of action, liquid vs. ultrasound-guided foam techniques, pain expectations, recovery protocols, pricing, and how it integrates with comprehensive vein care.

1. What Is Sclerotherapy & How Does It Work?

Sclerotherapy is a minimally invasive medical procedure used to treat spider veins, reticular veins, and localized tributary varicose veins.

The Mechanism of Action

Healthy veins return blood to the heart via microscopic one-way valves. When these valves malfunction or surface capillaries stretch, blood pools backward, creating visible red, purple, or blue networks on the skin.

During a sclerotherapy session:

Targeted Micro-Injection: A specialized, Health Canada-approved prescription sclerosant medication (such as Sodium Tetradecyl Sulfate [STS] or Polidocanol) is injected directly into the diseased vein using ultra-fine micro-needles.
Endothelial Cell Disruption: The sclerosant solution displaces blood inside the vessel and produces a controlled, sterile chemical irritation along the endothelial lining (the inner cellular wall of the vein).
Vessel Collapse & Closure: This chemical reaction causes the vein walls to swell, adhere to one another, and permanently seal shut, eliminating backward blood pooling.
Natural Reabsorption: Over the following 3 to 8 weeks, the closed vessel naturally breaks down into harmless microscopic scar tissue and is completely reabsorbed by the body’s metabolic processes.
Circulatory Rerouting: Blood is immediately and automatically redirected into healthy, deeper veins, improving overall leg circulation.

2. Liquid Sclerotherapy vs. Ultrasound-Guided Foam Sclerotherapy (UGFS)

At VeinCentre, sclerotherapy is not a one-size-fits-all treatment. We utilize two distinct modalities depending on the caliber, depth, and anatomical origin of your veins.

Comparison Table: Liquid vs. Foam Sclerotherapy

Clinical Factor	Visual Liquid Sclerotherapy	Ultrasound-Guided Foam Sclerotherapy (UGFS)
Primary Target Veins	Superficial spider veins (<1 mm) and broken capillaries	Deeper reticular feeder veins (1–3 mm) and tortuous branch varicosities
Delivery Technique	Direct visualization under polarized medical light	High-resolution real-time Duplex ultrasound guidance
Sclerosant Form	Pure liquid solution	Micro-foam mixture (liquid agitated with physiological gas)
Key Advantage	High precision for fine aesthetic networks	Displaces blood completely; treats deep hidden veins without surgical cuts
Typical Session Time	20 to 30 minutes	30 to 45 minutes
Post-Care Stockings	20–30 mmHg for 3 to 7 days	20–30 mmHg for 7 to 14 days

Why Foam Sclerotherapy is a Game-Changer for Deeper Veins

When treating veins located beneath the skin surface, liquid sclerosant can become diluted by flowing blood. By transforming the medication into a velvety micro-foam, the foam physically pushes blood out of the vessel. This allows 100% of the active medication to remain in direct contact with the vein wall, achieving complete closure with significantly lower concentrations of medication.

3. Does Sclerotherapy Hurt? What Patients Actually Feel

One of the most common concerns patients have before their first appointment is whether sclerotherapy injections are painful.

The Realistic Patient Sensation

The Needle Poke: Sclerotherapy utilizes micro-fine needles (typically 30 to 32 gauge)—which are as thin as an acupuncture needle and significantly smaller than standard blood-draw needles. Most patients describe the initial entry as a minor, momentary mosquito bite or light pinch.
The Sclerosant Sensation: As the solution enters the vessel, you may feel a mild tingling, slight cramp, or gentle warming sensation that lasts for 15 to 30 seconds before dissipating completely.
No Anesthesia Needed: Because the discomfort is minimal, no general anesthesia, nerve blocks, or tumescent numbing shots are required.
Post-Session Sensation: Immediately after treatment, legs feel slightly tight or fatigued, similar to the feeling after a moderate gym workout.

4. The Patient Experience: Step-by-Step at VeinCentre

From your initial diagnostic evaluation to your final cosmetic follow-up, our clinical pathway is structured for safety, comfort, and clinical precision.

Step 1: Vascular Ultrasound & Clinical Evaluation

Before performing cosmetic injections, board-certified Vascular Surgeon Dr. Luis Figueroa conducts a clinical exam and an OHIP-covered Diagnostic Duplex Ultrasound. This step is critical to ensure that surface spider veins are not being fueled by underlying saphenous vein reflux (such as the Great Saphenous Vein). If underlying reflux is present, treating the main trunk with RFA or VenaSeal first prevents spider veins from rapidly recurring.

Step 2: The In-Office Treatment Session

You will rest comfortably in our clinical suite in Toronto or Richmond Hill. Using specialized transillumination lights or ultrasound guidance, Dr. Figueroa or our expert nurse injectors systematically inject the target vessels. Multiple veins can be treated in a single 20- to 30-minute session.

Step 3: Compression Application & Walking

Immediately after the injections, cotton rolls and medical-grade graduated compression stockings (20–30 mmHg) are applied to the treated leg. You will walk around our clinic for 10 to 15 minutes before driving home independently.

5. Recovery Timeline & Post-Treatment Care

Recovery after sclerotherapy is straightforward and does not disrupt your work or family life.

Day-by-Day Recovery Roadmap

Timeline	What to Expect	What to Do / Activity Guidelines
Day 1 (Treatment Day)	• Minor redness and raised welts along injection sites (like small bug bites) • Mild leg tightness	• Wear compression stockings continuously for first 24–48 hours • Walk 20–30 minutes immediately • Drive home independently and resume desk work
Days 2 to 7	• Welts disappear; mild local bruising develops along treated veins • Veins may look darker before they begin to fade	• Wear compression stockings during daytime hours • Maintain daily walking routines • Avoid hot baths, saunas, hot tubs, and intense heavy lifting
Weeks 2 to 4	• Bruising resolves completely • Treated spider veins begin to break down, fade, and lighten significantly	• Protect treated areas with broad-spectrum mineral sunscreen (SPF 50+) • Full return to vigorous gym workouts, running, and swimming
Weeks 6 to 8	• Optimal cosmetic clearance achieved (70% to 90% improvement) • Skin appears clearer, smoother, and even-toned	• Follow-up check at VeinCentre to assess if a secondary touch-up session is desired

Essential Aftercare Rules:

Wear Your Compression Stockings: Graduated compression (20–30 mmHg) keeps the treated vein walls pressed flat against each other, preventing trapped blood pockets and minimizing post-inflammatory hyperpigmentation.
Avoid Heat Sources for 2 Weeks: Stay away from hot tubs, saunas, steam rooms, and hot baths. Heat causes vasodilation, which can cause freshly sealed veins to reopen.
Avoid Sun Exposure: Protect your legs from direct ultraviolet (UV) sunlight for 2 to 4 weeks following treatment to prevent brown staining (hemosiderin pigmentation).
Walk Daily: Walking activates the calf muscle pump, keeping deep venous circulation active and healthy.

6. Sclerotherapy Costs & Insurance Coverage in Ontario

Understanding how sclerotherapy is billed ensures complete financial peace of mind.

Pricing Breakdown

Treatment Type	Price Range (Ontario)	OHIP Coverage	Notes
Diagnostic Specialist Consultation & Duplex Ultrasound	$0 (with referral)	100% Covered by OHIP	Full diagnostic assessment by Vascular Surgeon Dr. Luis Figueroa
Visual / Cosmetic Sclerotherapy	$300 – $600 per session	Private (Out-of-Pocket)	Treats superficial spider and reticular veins
Ultrasound-Guided Foam Sclerotherapy (UGFS)	$300 – $600 per session	Private (Out-of-Pocket)	Treats deeper branch varicosities and feeding reticular networks

How to Offset Treatment Expenses:

Extended Health Benefits (EHC): While cosmetic injections are private, private insurance plans (Sun Life, Manulife, Canada Life) frequently cover 80% to 100% of Prescription Compression Stockings prescribed by Dr. Figueroa.
Health Spending Accounts (HSA): If you have an employer-provided HSA or own an incorporated business in Ontario, sclerotherapy fees can be covered using pre-tax dollars.
Medical Expense Tax Credit (METC): Out-of-pocket medical fees paid to a licensed physician qualify for deductible tax credits under the Canada Revenue Agency (CRA) on your annual tax return.

7. Sclerotherapy vs. Surface Lasers vs. Surgery

Feature	Sclerotherapy (Liquid & Foam)	Surface Skin Lasers (Nd:YAG)	Surgical Vein Stripping
Best Used For	Spider veins, reticular veins, and feeder branches	Very fine facial telangiectasias (<0.5 mm)	Severe hospital-based truncal disease (Rarely used today)
Feeder Vein Capability	Excellent (Can treat deep reticular sources)	Poor (Cannot penetrate deep enough)	Extracts large saphenous trunks only
Skin Burn / Hyperpigmentation Risk	Very Low	Moderate (Higher in darker Fitzpatrick skin types)	High risk of surgical scars
Discomfort Level	Mild pinprick	Repeated hot rubber-band snap	Severe surgical pain (General anesthesia)
Cost Effectiveness	Highest value per surface area treated	Higher cost per pulse; requires many sessions	Fully funded by OHIP, but high downtime costs

8. Frequently Asked Questions (FAQ)

How many sclerotherapy sessions will I need?

Most patients achieve a 70% to 90% reduction in visible veins after 2 to 4 sessions, spaced 4 to 6 weeks apart. The exact number depends on the total density, surface area, and whether your veins are purely aesthetic or fueled by deeper reticular networks.

Can spider veins come back after sclerotherapy?

Veins that have been successfully treated and reabsorbed by the body are permanently gone and cannot return. However, sclerotherapy does not change your genetic predisposition or prevent your body from forming new spider veins over the years. Periodic maintenance sessions every 2 to 3 years help keep your legs clear.

What are the small brown marks after treatment, and do they go away?

Temporary brown staining (hemosiderin staining) occurs in a small percentage of patients when tiny amounts of iron from broken-down blood cells deposit in the skin. In the vast majority of cases, this fades naturally over a few months. Wearing your compression stockings and avoiding sun exposure minimizes this risk.

Can I have sclerotherapy while pregnant or breastfeeding?

No. At VeinCentre, we defer all elective sclerotherapy until at least 3 months after you have completed pregnancy and fully ceased breastfeeding to ensure hormonal stability and patient safety.

Reveal Smooth, Clear, and Confident Legs

You do not have to live with tired, aching legs or visible spider veins. Sclerotherapy provides safe, rapid, and clinically proven results in the hands of experienced vascular specialists.

Schedule Your Assessment Today:

Phone: (289) 809-1333
Locations: Toronto & Richmond Hill, Ontario
Medical Director: Dr. Luis Figueroa, Vascular Surgeon

Disclaimer: The information provided in this guide is intended solely for educational purposes and does not substitute for personalized clinical evaluation. Individual candidacy, treatment plans, and exact pricing are established during an in-person vascular consultation and duplex ultrasound examination.