Sclerotherapy: Cost, Results Timeline and Recovery

Sclerotherapy is an injection procedure: a provider injects a solution called a sclerosant directly into the vein being treated.

The Asclera label's word for what the drug does to those veins is "sclerose", and the American Academy of Dermatology (AAD) says treated spider veins usually disappear in 3 to 6 weeks.

The injections are small.

The Asclera label specifies 0.1 to 0.3 mL per injection and no more than 10 mL per session, at a 0.5% concentration for spider veins and 1% for reticular veins.

Each of the three sclerosants below carries a US label, and they are approved for different veins:

• Asclera (polidocanol; Methapharm; initial US approval 2010) is FDA-approved to sclerose uncomplicated spider veins up to 1 mm and reticular veins 1 to 3 mm in the legs; it has not been studied in veins over 3 mm.
• Sotradecol (sodium tetradecyl sulfate) is labeled for small uncomplicated varicose veins of the legs with competent valves.
• Varithena (polidocanol injectable foam; initial US approval 2013) is a different polidocanol product, approved for incompetent great saphenous and accessory saphenous veins and visible varicosities of the GSV system — varicose-vein disease, not cosmetic spider veins.

That last distinction matters when a clinic advertises sclerotherapy: Varithena and Asclera share an active ingredient, polidocanol, but are labeled for different problems, and the cosmetic spider-vein use described on this page is the one on Asclera's label.

Sclerotherapy treats visible leg veins.

On Asclera's label that means uncomplicated spider veins 1 mm or smaller and reticular veins 1 to 3 mm in diameter, both in the legs; the drug has not been studied in veins over 3 mm.

Sotradecol's label covers small uncomplicated varicose veins whose valves still work.

Larger or symptomatic vein disease is a different field: the National Heart, Lung, and Blood Institute (NHLBI) explains that varicose veins result from weak or damaged vein walls and valves that let blood flow backward, a pattern called reflux, and that they are commonly assessed with duplex ultrasound.

Candidacy is a medical screen, not a formality.

Asclera is contraindicated for patients with a known allergy to polidocanol and for patients with acute thromboembolic disease.

Sotradecol's label carries a longer contraindication list, including valvular or deep vein incompetence, acute thrombophlebitis, bedridden patients and asthma.

A licensed provider weighs these against your vein history before anything is injected.

Start with what we could not confirm: a national price.

ASPS's 2025 procedural statistics release does not report counts or fees for minimally invasive procedures, so there is no current ASPS average fee for sclerotherapy, and this page will not invent one.

Pricing therefore comes from the clinic in front of you, and it is worth asking each one exactly how it charges — per session, per area, or as a package — before you compare.

For a fuller breakdown, see how much sclerotherapy costs.

The treatment's structure explains what drives the total.

The number of sessions is a main price driver: the American Academy of Dermatology (AAD) says 2 to 3 sclerotherapy treatments may be needed, and the Asclera label spaces repeat sessions 1 to 2 weeks apart.

The label also caps a session at no more than 10 mL of Asclera, so a course that needs more than that cannot be delivered in a single session.

When you get a quote, ask what a full course is expected to include — the sessions, the compression the Asclera label requires afterwards, and any follow-up visits — rather than the price of a single appointment.

The AAD's guidance on leg veins says 2 to 3 sclerotherapy treatments may be needed, and the Asclera label separates repeat sessions by 1 to 2 weeks.

Timelines differ by the vein treated: the AAD says spider veins usually disappear in 3 to 6 weeks, while varicose veins take 3 to 4 months.

Keep those two figures apart — the 3 to 6 week expectation belongs to spider veins, not to larger varicose veins.

Disappearing is not the end of the story, either.

NHLBI notes that new varicose veins may form even after treatment and that a person may need treatments more than once.

That is a statement about recurrence over time, not a verdict on any single session — it is one of the things to ask a provider about when you plan a course.

The AAD notes that no anesthesia is required for sclerotherapy.

On pain itself, the best-sourced numbers come from Asclera's pivotal EASI study (Asclera, n=180): injection-site pain was reported by 24% of Asclera patients, against 9% on placebo.

That is a trial average across study patients, not a prediction for any individual.

The recovery period is mostly about compression and movement.

The Asclera label requires a 15 to 20 minute walk under observation after treatment, to watch for allergic reaction, and compression afterwards — 2 to 3 days for spider veins and 5 to 7 days for reticular veins — to reduce the risk of deep vein thrombosis.

The AAD's description of sclerotherapy aftercare runs longer: most patients wear compression stockings for 2 to 3 weeks.

The two sources measure different things — the label states the drug's minimum compression requirement, while the AAD describes the stocking period around the procedure as a whole — so follow the plan your own provider sets.

The clearest side-effect data come from the same EASI study (Asclera, n=180), where injection-site reactions were common, and each was more frequent on Asclera than on placebo:

These rates come from one trial of 180 people on Asclera, with the placebo rates alongside for context.

Asclera's postmarketing reports add skin hyperpigmentation and injection-site necrosis.

Sotradecol's label reports at least six deaths, including four from anaphylactic shock, and carries contraindications including valvular or deep vein incompetence, acute thrombophlebitis, bedridden patients and asthma.

Laser treatment is another option med spas offer for leg veins, and the head-to-head evidence is small and genuinely mixed.

A 2002 randomized split-leg study (Lupton, Alster and Romero, Dermatologic Surgery, n=20) found that leg telangiectasias — small dilated surface vessels — responded better and in fewer sessions to sclerotherapy with sodium tetradecyl sulfate than to a long-pulsed 1064 nm Nd:YAG laser; its authors wrote that laser treatment is most useful for telangiectatic matting, needle phobia or sclerosant allergy.

A 2012 randomized split-leg study (Munia and colleagues, 30 women) found the two even on effectiveness: telangiectasias were treated equally well with a 1064 nm Nd:YAG laser and sclerotherapy after three sessions, with a significant difference in pain between the methods. (The 2012 study's sclerotherapy arm used a 75% glucose solution, which is not an FDA-approved US sclerosant.) Neither study is large, and they do not agree — there is no settled winner.

The AAD's description of laser leg-vein treatment shows what the practical differences look like: small spider veins may vanish immediately after laser treatment, while larger ones darken and can remain 1 to 3 months; complete clearing may take 3 or more treatments; and the treated area needs sun protection for 3 to 4 weeks afterwards.

Which option fits a given person depends on the veins involved, the medical history — including any allergy to sclerosants — and how a person tolerates needles, and nothing on this page can make that call.

Bring both options to a licensed provider and ask what each would mean in your case.

Two checks come before any comparison shopping.

First, who may inject sclerosants at a med spa is decided under state law, and our research found no federal rule that sets who may perform cosmetic sclerotherapy — so ask each clinic who will perform the injection, with what training, and under whose supervision, and check your state's rules.

Our guides to med spa laws by state and injector credentials explain how those rules work.

Second, the sclerosant itself: ask which product the clinic uses and whether it carries a US label for the veins you have.

Asclera's approved veins are uncomplicated spider veins up to 1 mm and reticular veins 1 to 3 mm in the legs; Sotradecol is labeled for small uncomplicated varicose veins with competent valves; Varithena is approved for saphenous-vein disease rather than cosmetic spider veins.

Then the questions that follow from the rest of this page:

• How many sessions do you expect for my veins, and how far apart?
• What compression plan will I follow, and for how many days?
• Will my circulation be assessed first — for example with duplex ultrasound, which NHLBI describes as a common way varicose veins are assessed?
• What is watched for right after the injection, and how long will I stay under observation?
• What is the total expected cost of a course, and what does each session include?

Those answers are also how you compare one clinic against another.

For the broader screen — who the medical director is, the provider's training with your treatment, genuine products and devices, a real consultation, and how to compare prices — work through our how to choose a med spa checklist.