Sclerotherapy is performed after the larger vessels are closed. In most cases, we have to fix the underlying vein issues first, prior to treatment with sclerotherapy. Sclerotherapy is used to treat either the intermediate sized vessels or the smaller spider veins, when they can be accessed with a small needle. Sclerotherapy works by breaking down the endothelium, the cells lining the inside of the blood vessels, which slowly causes the blood vessels to shut down. This vessel is naturally reabsorbed by the body over several months and slowly disappears. Some of these procedures will be done under ultrasound, which will be covered by insurance in most instances. The smaller spider veins are typically not covered by insurance and are done on a cash pay basis. We have several options for cash pay sclerotherapy and are flexible on payment options. You will typically start seeing results within as little as a few weeks, but for optimal results it may take up to 6-12 months depending on the extent of the superficial venous disease. In our practice, we use Asclera (polidocanol) which is the only solution approved by the FDA for treatment of venous disease.