Sclerotherapy for Spider Veins

Sclerotherapy for spider veins and small varicose veins at Wall Street Dermatology using sclerosing solutions including Polidocanol (Asclera), hypertonic saline, and sodium tetradecyl sulfate. A fine needle injects solution directly into the vein, causing it to collapse and be reabsorbed by the body over 3–6 weeks. Sessions run 5 minutes to 1 hour depending on extent. Average of 3 sessions recommended. Priced at $1,500–$2,500 per session.

Wall Street Dermatology provides sclerotherapy as the primary treatment for spider veins (telangiectasia) and small reticular varicose veins. Sclerotherapy involves injecting a sclerosing chemical solution directly into the target vein through a very fine-gauge needle, causing irritation and damage to the inner endothelial lining of the vessel wall. The damaged endothelium triggers an inflammatory coagulation response that causes the vessel to seal shut and fibrose; blood flow is redirected to deeper, healthier veins, and the treated vessel is gradually reabsorbed and cleared by the body over 3–6 weeks, fading from view. The clinic uses three sclerosing agents depending on the vein characteristics, size, location, and patient history: Polidocanol (marketed as Asclera, FDA-approved for sclerotherapy) — a non-ionic detergent-type sclerosant that is associated with lower discomfort and reduced risk of hyperpigmentation compared to ionic alternatives; hypertonic saline — a high-osmolarity solution that causes osmotic damage to the endothelium, widely used and inexpensive but associated with a transient burning sensation on injection; and sodium tetradecyl sulfate — a detergent sclerosant effective for larger spider and reticular veins, available in concentrations titrated to vessel size. The choice of agent and concentration is determined by Dr. Tzu based on the patient's vein type, skin tone, and medical history. A single session can treat multiple vessels and may run from 5 minutes for a limited area to approximately 1 hour for extensive coverage. Most patients require an average of 3 sessions for satisfactory clearance, scheduled 3–6 weeks apart to allow vein clearance before retreating. Pricing is $1,500–$2,500 per session depending on the extent of treatment.