Sclerotherapy Leg Vein Treatment in Petaluma & Hercules

Understanding Sclerotherapy

Sclerotherapy is the gold standard treatment for eliminating unwanted spider veins and small varicose veins on the legs. At Dermatology Associates of the Bay Area, our board-certified dermatologists have extensive experience with sclerotherapy, helping patients achieve clearer-looking legs and renewed confidence in wearing shorts, skirts, and swimwear. Spider veins and small varicose veins are not just cosmetic concerns; they can also cause symptoms such as aching, burning, swelling, and leg fatigue, which sclerotherapy effectively addresses.

What Causes Spider Veins and Varicose Veins

Understanding the underlying causes helps explain why sclerotherapy is so effective. Healthy leg veins have one-way valves that prevent blood from flowing backward. When valves weaken or fail, blood pools in the vein, causing it to enlarge and become visible. Pooled blood increases pressure within the vein wall, leading to further dilation, and enlarged blood-filled veins become visible through the skin as spider or varicose veins.

Several factors contribute to vein problems. Genetic predisposition is the strongest risk factor, as a family history significantly increases the likelihood of developing spider veins. Women are more prone during pregnancy due to both hormonal changes and increased blood volume. Hormonal changes also make women more prone to leg vein development around menopause. Jobs that require extended periods of standing increase venous pressure, as does excess body weight. Age and sun exposure contribute to the fragility of the venous valves and venous tissue, which can lead to both varicose and spider veins.

Types of Veins Treated

Sclerotherapy effectively treats various types of problematic leg veins:

Spider Veins

Appearance: Small, thin veins that appear red, purple, or blue
Size: Less than 1mm in diameter
Pattern: Often appears in web-like or branching patterns
Location: Commonly found on thighs, calves, and around the ankles

Reticular Veins

Appearance: Slightly larger blue or green veins
Size: 1-3mm in diameter
Function: Often, “feeder veins” that supply spider veins
Treatment importance: Treating reticular veins often improves spider vein results

Small Varicose Veins

Appearance: Enlarged, twisted veins that may bulge slightly
Size: 3-5mm in diameter
Symptoms: May cause aching, heaviness, or cramping
Treatment response: These larger veins should be treated by either phlebectomy, laser, or radiofrequency ablation

How Sclerotherapy Works

Sclerotherapy uses a specialized solution injected directly into problem veins, causing them to collapse, seal shut, and gradually fade from view. A fine needle delivers the solution directly into the affected vein, irritating the vein’s inner lining. This controlled reaction causes the vein walls to swell and adhere to each other, sealing the vein shut and rerouting blood to healthy veins. Over weeks to months, the body naturally absorbs the closed vein.

Our dermatologists use various solutions tailored to the size of the vein, patient sensitivity, and treatment goals. These include hypertonic saline as a traditional option, sodium tetradecyl sulfate or polidocanol. Foam sclerotherapy, where the solution is mixed with air, is used for treating larger reticular veins.

Patient and Doctor at dermatology associates of the bay area

The Sclerotherapy Treatment Process

During your consultation, we examine your leg veins, review your prior treatment history, and determine the veins to be treated. We will select the appropriate solution, discussing realistic outcomes and your treatment timeline.

The treatment session begins with cleansing your legs and positioning you for optimal access. We perform multiple small injections using ultra-fine needles, apply immediate compression with cotton balls and tape, and complete the session in typically 30-45 minutes. Most patients describe minimal discomfort during injections.

Post-treatment care includes wearing compression stockings immediately after treatment and ideally for 3 weeks. Immediately following the procedure, we encourage walking to promote circulation and healing, and suggest avoiding strenuous exercise and hot baths for 48 to 72 hours. Follow-up appointments will be made to monitor progress and plan additional treatments.

Treatment Timeline and Results

Immediately after treatment, you’ll see small red marks where injections were made, some mild swelling around treated areas, and treated veins may appear “angry” or brighter or darker.

During the healing process, initial healing and fading of the injection site occur in weeks 1-2. Early fading of the treated veins begins in weeks 3-4. Significant improvement becomes visible in months 2-3, and final results are achieved in months 3-6 as the veins continue to fade.

Expected results include an 80-90% improvement in spider veins after 2-3 treatment sessions, although additional sessions may be required. Multiple treatment sessions spaced 4-6 weeks apart are typically needed for optimal results.

Candidates for Sclerotherapy

Ideal candidates have visible spider veins or reticular veins and realistic expectations that multiple sessions may be needed. There should be no recent history of lower extremity trauma, surgery, or edema.

Patients with a history of blood-clotting or bleeding disorders, deep vein thrombosis, allergy to sclerosing agents, or who take blood thinners are not candidates for this procedure.

Dermatology Associates of the bay area doctors, pa, aesthetician, and staff. Group image outside.

Why Choose Dermatology Associates of the Bay Area?

Sclerotherapy requires precision, expertise, and a thorough understanding of vascular anatomy. Our team of board-certified dermatologists brings extensive experience in safely and effectively treating leg veins.

Choose a trusted dermatology practice committed to exceptional care and beautiful results for your leg vein concerns.

What sets us apart:

Board-Certified Dermatologists – Our dermatologists have completed rigorous training and certification to deliver the highest level of care in vascular and aesthetic medicine. Our medical colleagues recognize our expertise, and as such, we have been recipients of Castle Connolly Top Doctors – including most recently in January 2025
Comprehensive Vein Care – From spider veins to small varicose veins, we offer complete sclerotherapy services with multiple sclerosant options tailored to your specific needs.
Patient-Focused Approach – Every treatment plan is customized to fit your unique vein pattern, skin type, and aesthetic goals for optimal leg appearance.
Advanced Techniques – We use the latest sclerotherapy techniques and the highest quality sclerosing agents for safe, effective vein elimination.

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Frequently Asked Questions

How many sclerotherapy sessions will I need?

Most patients require 2-4 treatment sessions spaced 4-6 weeks apart for optimal results. The exact number depends on the extent of your spider veins, their size, and your individual response to treatment. Some patients experience significant improvement after just one session, while others with extensive vein networks may require additional treatments.

Does sclerotherapy hurt?

Most patients experience minimal discomfort during sclerotherapy. The injections feel like small pinpricks, and some solutions may cause mild burning that lasts 1-2 minutes. The ultra-fine needles we use minimize discomfort, and most patients find the treatment very tolerable.

What should I expect after sclerotherapy?

After treatment, you’ll wear compression stockings and be able to walk immediately. Expect some redness and mild swelling for a few days. Treated veins may initially appear darker before gradually fading over 2-6 months. Most patients return to normal activities the next day.

Are the results of sclerotherapy permanent?

Light walking is encouraged immediately after treatment to promote circulation. Avoid strenuous exercise, running, or heavy lifting for 48-72 hours. After that, you can gradually resume normal activities as tolerated, while continuing to wear compression stockings as directed.

Can I exercise after sclerotherapy?

Results vary depending on the treatment and the severity of your acne. Some patients see improvements in a few weeks, while acne scar treatments may require multiple sessions over several months for the best outcome.

Will insurance cover sclerotherapy?

Sclerotherapy for purely cosmetic spider veins is not covered by insurance.

How do I prevent new spider veins from forming?

While you can’t completely prevent new spider veins if you’re genetically predisposed, you can minimize risk by maintaining a healthy weight, exercising regularly, avoiding prolonged standing, wearing compression stockings when appropriate, and protecting your legs from excessive sun exposure.

What are the common side effects?

Bruising is a common occurrence that can persist for weeks.
Pain, itching, swelling, or redness may occur at the injection site, especially after prolonged standing.
Hyperpigmentation occurs at the injection site in 10-30% of individuals. This usually resolves in 80% of people within 3-6 months, and in a few patients, it can persist for up to 1 year. Sun protection and sun avoidance are essential after treatment
Telangiectatic matting is the development of tiny vessels or a blushed area and may occur at the edge of the treated area.
Sores or ulcers may rarely occur around the injected vessel, but usually resolve in a few days. However, this can lead to scarring.
A superficial blot clot may rarely develop and feel like a hard spaghetti string under the skin. If pain and redness develop, your provider can anesthetize the skin and pierce the clot to remove it.
Very rarely, a deep clot called a deep vein thrombosis may occur if inflammation extends into deeper tissue or if adequate compression has not been achieved. A serious complication of a DVT is a pulmonary embolus, where a clot travels from a DVT to the lung. This can present with symptoms such as shortness of breath, dizziness, or coughing up blood, and requires immediate medical attention.
Superficial Thrombophlebitis, an irritation around the injected vessel, occurs in fewer than 1 in 1,000 patients.
Mild systemic reactions have been reported and include headache, nausea, and vomiting.
Allergic reactions such as hives, asthma, hay fever, and rarely anaphylactic shock and death have been reported.