Sclerotherapy
Short answer: Sclerotherapy treats unwanted veins by injecting a solution (a sclerosant) that damages the vein's inner lining, the endothelium. The vein then becomes inflamed, scars and closes, and over weeks to months the body clears it and it fades.
It's used for spider veins (telangiectasias), small reticular veins and some varicose veins. For larger varicose veins, the sclerosant is often whipped into a foam and injected under ultrasound guidance, a technique NICE has assessed in its guidance. The sclerosants in widest use are detergents such as polidocanol and sodium tetradecyl sulfate, which break down the cell membranes of the lining. Hypertonic saline, a concentrated salt solution, works by drawing water out of the cells. It's one option, but not the usual one, and ordinary saline wouldn't close a vein. Several sessions may be needed. Clinical sources list common effects such as pain at the injection site, bruising, temporary lumps, brown staining of the skin and new tiny red veins ('matting'). They list rare complications including skin ulcers, allergic reactions, and clots in deeper veins. This case is general information, not medical advice. The footage shows a needle injecting into small purple veins on a leg.
In collections:Inside the Body
What should you know about Sclerotherapy?
Quick facts. Each one stands alone and has a stable ID you can cite.
Sclerotherapy closes veins by damaging their lining.
Polidocanol is a detergent-type sclerosant.
Video transcript: Sclerotherapy: Closing Veins From the Inside
DID YOU KNOW? Vascular sclerotherapy is a medical procedure used to treat varicose and spider veins. A sclerosing agent, typically a saline solution or chemical like polidocanol, is injected directly into the affected vein. This irritates the vein's inner lining, causing endothelial damage and inflammation. The vein collapses, forms scar tissue, and is gradually reabsorbed by the body. NOW YOU KNOW!
Burned-in captions, read frame by frame (see transcript.md) · 20.7s Reel ·
The write-up
Closing veins from the inside. Sclerotherapy injects a solution that seals small veins shut.
- Exhibit A
Damage on purpose
A sclerosant injures the vein's inner lining, so the vein scars, closes and fades.
- Exhibit B
Detergents lead
Polidocanol and sodium tetradecyl sulfate are detergents that break down the lining's cells.
- Exhibit C
Salt is the alternative
Hypertonic saline works by drawing water out of the lining's cells.
- Exhibit D
Foam for bigger veins
For larger varicose veins, sclerosant foam is injected under ultrasound guidance.
- Exhibit E
Known side effects
Clinical sources list bruising, staining and new tiny veins, and rarely ulcers or clots.
Questions people ask about Sclerotherapy
What does a sclerosant damage?
The endothelium.
Source: Write-up · Exhibit A (Damage on purpose) · StatPearls (NCBI Bookshelf): Sclerotherapy; DermNet: Sclerotherapy
What kind of agent is polidocanol?
It breaks down the lining's cell membranes.
Source: Write-up · Exhibit B (Detergents lead) · StatPearls (NCBI Bookshelf): Sclerotherapy; Sclerotherapy for lower limb telangiectasias, Cochrane review (PMC)
How does hypertonic saline work?
Osmotic injury.
Source: Write-up · Exhibit C (Salt is the alternative) · StatPearls (NCBI Bookshelf): Sclerotherapy; Sclerotherapy for lower limb telangiectasias, Cochrane review (PMC)
How are larger varicose veins often treated with sclerotherapy?
As assessed in NICE guidance.
Source: Write-up · Exhibit D (Foam for bigger veins) · NICE HTG301: Ultrasound-guided foam sclerotherapy for varicose veins, the procedure
Which side effect do clinical sources list?
Along with bruising and new tiny veins.
Source: Write-up · Exhibit E (Known side effects) · DermNet: Sclerotherapy; Cleveland Clinic: Sclerotherapy
Test Your Knowledge
All quizzes →5 questions, all from this case file. Answers are revealed instantly.
What does a sclerosant damage?
- The vein's inner lining
- The skin's surface
- The bone
- The nerve
Show the answer
Answer: A. The vein's inner lining The endothelium. Source: Write-up · Exhibit A (Damage on purpose) · StatPearls (NCBI Bookshelf): Sclerotherapy; DermNet: Sclerotherapy
What kind of agent is polidocanol?
- A detergent
- An antibiotic
- A painkiller
- A vitamin
Show the answer
Answer: A. A detergent It breaks down the lining's cell membranes. Source: Write-up · Exhibit B (Detergents lead) · StatPearls (NCBI Bookshelf): Sclerotherapy; Sclerotherapy for lower limb telangiectasias, Cochrane review (PMC)
How does hypertonic saline work?
- It draws water out of the lining's cells
- It freezes the vein
- It heats the vein
- It dissolves blood
Show the answer
Answer: A. It draws water out of the lining's cells Osmotic injury. Source: Write-up · Exhibit C (Salt is the alternative) · StatPearls (NCBI Bookshelf): Sclerotherapy; Sclerotherapy for lower limb telangiectasias, Cochrane review (PMC)
How are larger varicose veins often treated with sclerotherapy?
- Foam under ultrasound guidance
- Oral tablets
- A cream
- Massage
Show the answer
Answer: A. Foam under ultrasound guidance As assessed in NICE guidance. Source: Write-up · Exhibit D (Foam for bigger veins) · NICE HTG301: Ultrasound-guided foam sclerotherapy for varicose veins, the procedure
Which side effect do clinical sources list?
- Brown staining of the skin
- Hair loss everywhere
- Blue eyes
- Hiccups
Show the answer
Answer: A. Brown staining of the skin Along with bruising and new tiny veins. Source: Write-up · Exhibit E (Known side effects) · DermNet: Sclerotherapy; Cleveland Clinic: Sclerotherapy
Cite this case file
Easterling, Marcus. "Sclerotherapy." The Detail Department (DetailEnjoyer), case file DD-597, last updated Jun 16, 2025. https://detailenjoyer.com/case/sclerotherapy/
Permalink: https://detailenjoyer.com/case/sclerotherapy/ · Last updated
Cite a single fact by its ID, for example DD-597-F01 → https://detailenjoyer.com/case/sclerotherapy/#DD-597-F01
Collection · Inside the Body Case file 6 of 27
Next in Collection · DD-613Sickled Cells →

