A Straightforward Fix for a Common Concern
Sclerotherapy is a simple injection treatment that clears visible leg veins over a series of sessions, with no incisions required.
Sclerotherapy in Palo Alto treats spider veins and small reticular veins that show up most often on the thighs, calves, and ankles. It’s one of the most established vein treatments available, and for most patients, it works without surgery, incisions, or significant downtime.
We won’t get into every reason spider veins develop here, since that deserves its own dedicated explanation. What matters for this page is the treatment itself: a solution injected directly into the affected vein, causing it to fade over the following weeks. Your provider examines your specific veins at consultation and builds a session plan around what you’re actually dealing with, rather than a generic number of treatments for everyone.
Details
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Benefits
No incisions, anesthesia, or significant downtime
Treats multiple veins in a single session
Well-established treatment with decades of clinical use
Improves both appearance and mild vein-related discomfort
Can be repeated as new veins appear
Results typically look natural, without visible scarring
Conditions It Treats
Spider veins on the legs
Small reticular (feeder) veins
Visible vein clusters
Mild aching or heaviness tied to superficial veins
Cosmetic concerns from prior pregnancies
Veins that have worsened with age or prolonged standing
Areas It Treats
Thighs
Calves
Ankles
Backs of the knees
The Injection Itself
Sclerotherapy in Palo Alto uses an ultrafine needle to inject a specialized solution directly into the targeted vein. That solution irritates the vein’s inner lining, causing it to collapse and stick together. Over the following weeks, your body naturally reabsorbs the collapsed vein, and blood reroutes through healthier vessels nearby, which is why results appear gradually rather than immediately.
Each session typically addresses several veins, with your provider selecting the number and size of vessels to treat based on your goals and how your skin responds. Larger reticular veins sometimes require a slightly different approach than fine spider veins, so your provider tailors technique and solution concentration to the specific vein in front of them, not a single standard injection for every patient.
What to Expect
The Provider Behind the Plan
Julia Schall, MPA-C, is an NCCPA board-certified physician assistant with close to 10 years of experience in aesthetic dermatology. Her approach to injectable treatments, including sclerotherapy, favors precision and a clear explanation of what to expect at each step. She reviews your specific veins before recommending a session plan, rather than applying the same approach to every patient who comes in.
Let’s Talk About What You Actually Want
Every treatment plan starts with a conversation, not a script. Tell us a little about your goals, and we’ll take it from there.
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Frequently Asked Questions
Sclerotherapy is a medical procedure performed to eliminate spider veins (tiny veins), NOT varicose veins (large, ropey veins). During sclerotherapy procedure, a sclerosing solution is injected precisely into the problem veins, causing irritation to the inner lining, causing it to sclerose (harden) and ultimately causing the vein to collapse and no longer carry blood. Over time, the treated vein is absorbed by the body and fades away over a few weeks or months.
In general, the sclerotherapy procedure is an excellent choice for individuals with spider veins who are not pregnant or have a history of blood clots in the treatment area. Most vein specialists prefer sclerotherapy for spider veins over laser treatments, particularly on the legs.
After cleansing the area, your provider will use a very fine needle to inject the solution into the affected vein(s). Pressure will be placed on the areas throughout treatment with gauze to reduce bruising and refilling.
This depends on the patient and how many areas they would like treated, but usually appointments are scheduled for about 45 minutes.
Most patients do not find it uncomfortable.
Sclerotherapy is a remarkably safe and effective technique. Common side effects are usually temporary and well tolerated. These include itching, tenderness, skin bruising, and pigmentation, as well as the growth of fine vessels in the treated area. Fortunately, serious complications like allergic reactions, skin ulcers, and blood clots are rare.
Sclerotherapy can be administered in the legs as long as the veins aren’t very large, such as with advanced varicose veins. If you would like varicose veins to be treated, we would recommend consulting with a vascular surgeon.
Initially, small, scattered areas of bruising and redness should be expected. As the initial bruising subsides, some veins may disappear completely, others may show little to no improvement. Some veins may survive but become much thinner and weaker and more susceptible to closure with the following session. Uncommonly, the emergence of new, finer
pinkish vessels may form near successfully treated larger veins. These veins can be easily treated during a follow-up treatment session. Most patients should expect an improvement of at least 50-60%, over a few weeks after a single treatment.
You should not expose your legs to the sun for 2 weeks. You must wear your compression stockings for 2 full days and then for 2 weeks while upright. Since there will be bruising, please avoid sun exposure until all marks and bruising have faded. You will be able to immediately return to your daily routine. We even encourage you to continue your normal fitness routine (except high-impact exercise), as it will help speed along recovery.
Expect results within three to six weeks after your first treatment. Slightly larger veins can take several months, and many patients require more than one treatment. After your sclerotherapy procedure, the successfully treated veins do not return, but this does not mean that new veins may not occur. Your provider will discuss lifestyle changes to help you prevent new spider veins from forming.
Every 4 to 6 weeks for up to 2 to 4 sessions.
Avoid tanning during the weeks leading to sclerotherapy. Do not take any aspirin or NSAIDs (such as ibuprofen, Advil, Motrin), vitamin E, or herbal supplements that increase your chances of bruising. Don’t shave within 24 hrs of the treatment as the solution used for cleansing purposes may cause some stinging. We also recommend that you bring a pair of black or dark shorts that you can wear during leg vein sclerotherapy. Bring your compression stockings with you to your appointment in order to wear them immediately after treatment.
Wear your compression stockings for 48 hours immediately following treatment and then as long and as often as you can for the next 2-week period. Walk, bike, exercise (except no high-impact or heavy weight-bearing exercise) as often as you would like. Avoid any long car or air travel for two weeks after treatment.
When laser therapy is used for spider veins, not only does it tend to be much more painful than that of a sclerotherapy treatment, but also less effective in getting reliable outcomes.
Most patients need 2 to 4 sessions, spaced several weeks apart, depending on how many veins you’re treating and how they respond. Some smaller veins clear after a single session, while more extensive clusters typically require a full series to achieve complete results.
Most patients describe each injection as a brief pinch or mild burning sensation, rather than significant pain. Sessions are well tolerated without numbing cream, though your provider can discuss comfort options if you’re especially sensitive to needles or have a larger area to treat.
Yes, for several days following each session. Compression stockings support the healing process and help improve your results by keeping blood flow moving efficiently through healthier veins nearby. Your provider will give you specific guidance on how long to wear them based on your treatment.
Sclerotherapy injects a solution directly into the vein, while laser treatment uses heat to collapse it from outside the skin. Sclerotherapy tends to work well for a broader range of vein sizes, including larger reticular veins, while laser is often reserved for the smallest, most superficial vessels.
Your provider examines your specific veins before recommending a session plan, rather than applying a standard package to every patient. As an independently owned, clinician-led practice, sclerotherapy in Palo Alto at ENA focuses on getting your results right over multiple sessions rather than rushing you through a single treatment.
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