Are there any side effects involved?

Like all treatments, it is important to be aware of all of the possible side effects associated with sclerotherapy treatment

Following treatment most of our patients experience bruising and mild to moderate aching in their legs for the first day or two after treatment. This aching can be relieved by walking and taking over the counter pain relief. Redness experienced at the injection sites will generally disappear within a day or two.

Other potential side affects you should be aware of prior to commencing treatment include:

Brown spots or lines on the skin

These pigmented areas are caused by the trapped blood that follows successful sclerotherapy treatment. Around 5% of patients experience pigmentation that may be related to iron supplementation or rarer medical conditions. When patients with pigmentation are seen as second opinion, a careful inspection using high resolution ultrasound usually reveals a vein that has not been fully closed; treatment in this case makes the pigmentation fade.  With effective expert treatment, pigmentation is usually temporary if it occurs. At Vein Doctors Group high resolution ultrasound assisted treatment using endovenous laser ablation and ultrasound guided sclerotherapy for underlying veins minimises persistent pigmentation and inflammation.

Tender lumps in the treated area

These lumps are created when blood is trapped in the injected vessel. This is not a cause for concern – they are not blood clots and are actually a sign that the treatment has been effective.  These lumps can be released instantly during your next visit as part of routine treatment.


You may experience the formation of fine, closely grouped red blood vessels close to the injection site of larger vessels – approximately 16% of patients experience this side effect. This matting may either spontaneously resolve or disappear with injection treatment. Rarely matting can persist long-term.

You can reduce your risk of this side effect by discontinuing your consumption of cigarettes and increasing your muscle tone and exercise to lose weight prior to treatment. Further the oral contraceptive pill can increase the risk of matting. Certain skin types and being overweight can make someone at more risk of this cosmetic complication.

One of the most important ways to avoid the development of matting is effective technique by experienced doctors specialised in treating veins using ultrasound guided techniques targeting the root of the problem. Matting is a condition that we encounter mostly when seeing patients for second opinions that have not had appropriate treatment directed at the root of the vein problem.


Very rarely, small ulcerations can occur at the site of injection within two weeks of treatment. These can be quite painful and can be due to sensitivity to the concentration of the sclerosing agent used.  It is important to seek medical attention immediately if you develop ulcerations. Ulcers can range from 4-6 mm diameters and take 6-8 weeks to heal and could leave a small scar. Large ulcers are from intra arterial injections.To date, over many years and thousands of vein treatments our doctors have never experienced an intra arterial injection, meaning that their complication rate for this serious complication is much lower than the scientific published rate.

Allergic Reactions

Very rarely a patient may experience an allergic reaction to a certain sclerosing agent. Although serious, this can be treated instantly with an adrenaline injection and antihistamine therapy. It is uncommon for patients to require hospitalisation. Even though this complication is very rare, our doctors maintain their emergency skills and our emergency equipment is also maintained. Both Dr. Lekich and Dr. Hannah have a background in Emergency Medicine.


Inflammation of the treated blood vessels is published to occur in around 1% of patients who undertake sclerotherapy.  Whilst this condition can be uncomfortable it is generally resolved quickly with anti-inflammatory treatment, compression stockings and walking. By using expert and effective ultrasound techniques, this complication is very infrequent.


Some patients experience migraines and visual disturbances following therapy. These can easily be managed with over the counter pain relief or traditional migraine treatment.

Deep Vein Thrombosis

This condition is a rare occurrence. Published rates are 1/2000 risk. The risk of this condition can be minimised by walking and using compression stockings. This risk as other complications do not feature in our practice.

Intra-Arterial Injection

Already discussed regarding “ulcers” this extremely uncommon complication results in muscle and skin damage and there have been case reports where amputation of part or whole of the limb is required. At Vein Doctors Group our doctors, who are Australasian College of Phlebology trained, have had the highest formal training possible in Australia and on an international level,  to perform this modern form of varicose vein treatment. With the use of high resolution ultrasound directing treatment, the risk of this serious complication would be very unlikely. To date in a high volume varicose vein practice, our doctors have not experienced an intra arterial vein injection. Dr Lekich is also a barrister and has had on occasion to provide medico legal reports for this serious complication noting that basic principles have not been followed in managing patients and this serious complication.

Micro Sclerotherapy