Mathew Nokes, MD Mathew Nokes, MD
Spider Veins Image

Sclerotherapy is often associated with the cosmetic treatment of spider veins and rightfully so, it has been used to treat veins for over 100 years! This minimally-invasive treatment is also used to close small veins that aren’t apparent on the skin surface. Sclerotherapy is a quick, effective and virtually painless varicose vein treatment.

Diagnosing Vein Disease

The first step to treatment is diagnosing the problem. Patients often complain of leg pain and achiness, leg heaviness, swelling, and sometimes restless legs. Some patients present with obvious bulging varicose veins and some do not. To reach an accurate diagnosis we use ultrasound. This allows us to view the vein and how it functions. If the flow in the veins is determined to be traveling backwards, the vein is not functioning properly. This is called reflux. Once all veins in the leg have been evaluated, a treatment plan is assembled. sclerotherapy is often one of the last treatments in a patient’s plan as it is important to close down larger veins before treating small veins with sclerotherapy.


Sclerotherapy involves injecting a sclerosing agent into the target vein. This causes damage to the inner lining of the vein causing it to shrink and scar. Eventually, as the vein is turned into scar tissue, the body absorbs what is left of the vein. The two most common sclerosing agents used are STS (sodium tetradecyl sulfate) and polidocanol. These drugs are often foamed to increase the surface area and contact of the drug in the vein. As the foamed chemical is injected, blood is displaced allowing the sclerosing agent to make contact with the vein wall.

After each sclerotherapy procedure it is important to wear 20-30 mmHg strength compression stockings. This compresses the vein so as it scars down it closes off. The compression stockings also help to keep blood flowing through normal veins. This reduces the risk of developing superficial or deep vein clots. You can resume normal daily activities right after the procedure but strenuous exercise needs to be avoided for one week after the varicose vein treatment. Most patients experience very little post procedure pain. A follow up ultrasound is scheduled around a week after sclerotherapy to ensure the veins closed and no DVT is present.

Utah varicose vein treatment is easier and more effective than ever before. If you suffer from the daily hindrance of varicose veins, schedule a free screening!

Mathew Nokes, MD

Mathew Nokes, MD

Interventional Radiologist

About the author:

Dr. Matthew E. Nokes is fellowship trained in interventional radiology. His expertise includes treatment of disorders of the arterial and venous circulation and acute stroke intervention.