Sclerotherapy for Spider Veins

Sclerotherapy with Asclera (polidocanol) eliminates spider veins and small reticular varicose veins on the legs through a series of precise microinjections. At Houston Vein Specialists, a fine needle delivers the sclerosing solution directly into each target vein, causing it to collapse and fade over several weeks. Most patients need two to four sessions spaced four to six weeks apart. Performed in-office in approximately 20 minutes with no downtime, sclerotherapy is the gold standard treatment for cosmetic spider vein removal.

Sclerotherapy at Houston Vein Specialists uses Asclera (polidocanol), an FDA-approved liquid sclerosant, to treat spider veins (telangiectasias) and small varicose veins (reticular veins) that cause cosmetic concern on the thighs, calves, and ankles. The treatment is performed by Dr. David D. Shin or a supervised clinician in the Texas Medical Center suite and requires no anesthesia, no incisions, and no recovery time. During a session, the patient lies on an examination table and the target veins are identified under bright procedural lighting, sometimes aided by a vein light transilluminator for deeper reticular feeders. A very fine-gauge needle is used to inject a small volume of Asclera solution directly into each vein. Polidocanol works by irritating the inner lining of the vessel wall (endothelium), causing it to swell, stick together, and ultimately fibrose. The treated vessels gradually fade and are absorbed by surrounding tissue over three to six weeks following each session. Typical treatment plans involve two to four sessions spaced at least four to six weeks apart, allowing full assessment of each session's results before proceeding. The number of sessions required depends on the extent of spider vein involvement, the size of the feeding reticular veins, and whether underlying venous reflux is contributing to vein formation. At Houston Vein Specialists, an initial assessment is conducted to determine whether surface spider veins are purely cosmetic or whether they represent the visible manifestation of deeper venous insufficiency — an important distinction, because treating spider veins without addressing reflux significantly reduces long-term results. Post-treatment care involves wearing compression stockings for one to two weeks and avoiding high-impact activity and sun exposure to the treated areas for a similar period. Temporary side effects include mild bruising, matting (fine new capillaries at the injection site), and transient darkening of the treated veins before they fade. Serious complications such as deep vein thrombosis or skin ulceration are rare with the low concentrations of polidocanol used for cosmetic treatment. Because sclerotherapy for spider veins is classified as cosmetic, it is not covered by insurance and patients pay out-of-pocket. Houston Vein Specialists' IAC Vein Center accreditation ensures treatment protocols meet nationally established quality and safety standards.