Last Updated on January 31, 2026 by Giorgia Guazzarotti
Does sclerotherapy hurt? Imagine finally being able to wear that summer dress without spending ten minutes in the mirror wondering if anyone’s going to notice the veins on your legs. Or getting through a long day at work without that constant aching and heaviness that makes standing feel exhausting. For a lot of people dealing with spider veins or varicose veins, sclerotherapy opens the door to exactly that kind of relief. But first, there’s the whole needle situation to think about. In this article, we’re covering what the science actually says about sclerotherapy pain, what happens during the treatment, and how it stacks up against other ways to deal with unwanted veins.
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What Is Sclerotherapy?
Let’s talk about what sclerotherapy really is, because once the whole process makes sense, the pain question gets easier to answer. Sclerotherapy is a minimally invasive medical procedure for the treatment of spider veins. Basically, a vein specialist uses really thin needles to inject a chemical solution directly into problem veins. This sclerosing agent irritates the vein’s inner lining, making it collapse and eventually fade as the body reroutes blood flow through healthier veins.
The whole thing sounds scarier than it actually is. These are fine needles (seriously small) delivering the sclerotherapy solution into unwanted veins. How many veins get treated in one session depends on what’s going on with each person’s legs, but most sclerotherapy sessions wrap up in 30 to 45 minutes. The patient stays awake the whole time, lying on an exam table while the vascular specialist works on the treated area.
Pain During Sclerotherapy: How Much Does It Hurt?
Here’s where it gets interesting. Clinical trials that actually measured pain during sclerotherapy found it causes way less discomfort than most people expect. One randomized study comparing different vein treatment options found that foam sclerotherapy had an average post-procedure pain score of just 1.60 on a scale of 0 to 10. That’s genuinely pretty low, especially compared to more invasive procedures for vein issues.
Most patients describe what they feel as brief stinging or a mild burning sensation that only lasts a few seconds when the needle goes in and the special solution gets injected. Some people feel a slight cramping along the vein being treated. The key thing is that the discomfort is fleeting. It doesn’t build or stick around during the injection itself.
What’s kind of interesting is that vein doctors usually don’t bother with numbing agents before sclerotherapy, and there’s actually a practical reason for this. Using local anesthesia would mean one needle stick to numb everything, then another needle stick for the actual treatment. That’s two injections instead of one, which seems pretty pointless when the sclerotherapy procedure itself causes such minimal discomfort. Some vascular vein centers will offer topical numbing cream for people who are really anxious about needles, but honestly, most people find they don’t need it.
After the Procedure: What to Expect
The pain situation changes a bit once the treatment session ends. While the injection itself is quick and relatively painless, the treated veins need time to do their thing: collapse, get reabsorbed by the body, and fade from view. During this whole process, there’s usually some discomfort involved.
Research shows that post-procedure pain from sclerotherapy is mild but tends to last longer than that brief stinging during injection. People typically experience tenderness at the injection site, some aching along the treated area, and maybe bruising and swelling. This discomfort usually hangs around for anywhere from one to seven days, though occasionally it can stick around for a few weeks while the body processes the treated veins.
The good news is that this post-treatment discomfort responds really well to over the counter pain relievers like ibuprofen. Most people find it’s manageable enough that they can get back to regular activities the same day or the next day. Clinical trials found that patients treated with foam sclerotherapy returned to normal activities in about one day and were off work for roughly three days on average – way less downtime than surgical vein treatments require.
How Sclerotherapy Compares To Other Treatment Options
If pain is a major concern, here’s something reassuring: sclerotherapy is actually one of the least painful options out there for treating spider veins and smaller varicose veins. When researchers compared sclerotherapy to endovenous laser ablation (another popular minimally invasive treatment for vein disease), they found that procedure-related pain was noticeably higher in the laser therapy group.
Traditional surgical treatments like vein stripping? Those involve way more pain and much longer recovery times. Endovenous thermal ablation procedures also tend to cause more discomfort than sclerotherapy. For treating small spider veins and certain types of varicose veins, sclerotherapy remains the gold standard partly because it’s so well-tolerated by most people.
Laser treatment can work well for some vein issues, particularly for people with needle phobia or an allergic reaction to the sclerotherapy solution. But for most people dealing with unwanted veins, especially small varicose veins and spider vein treatment, sclerotherapy offers an effective treatment with minimal pain and downtime.
What Affects How Much It Hurts
Not everyone experiences sclerotherapy the same way, and a bunch of different factors can influence how much discomfort happens:
- The size of the vein matters. Larger veins sometimes need more injections or a stronger concentration of the sclerosing agent, which can mean slightly more sensation during and after treatment. Where the problem veins are located also plays a role, since some areas of the leg are naturally more sensitive than others.
- Personal pain tolerance obviously matters too. What one person calls mild discomfort might feel more intense to someone else. For people who are particularly sensitive to pain or get anxious about medical procedures, it’s worth talking to a healthcare professional about options for making the experience more comfortable. Some vein treatment centers offer distraction techniques, topical numbing, or just take extra time to help nervous patients feel at ease.
- The skill of the vein doctor matters more than most people realize. A board-certified vein specialist who does sclerotherapy all the time will be faster and more precise with injections, which translates directly to less discomfort. This is one of those areas where experience really counts.
Managing Discomfort And Getting Best Results
For anyone moving forward with sclerotherapy, there are things that help minimize discomfort and get optimal results after a sclerotherapy treatment session:
- Wearing compression stockings for about two weeks. These aren’t exactly comfortable, but they’re a required part of getting the best outcome. The compression helps keep treated veins closed and promotes better blood flow through healthy veins.
- Hot baths and hot tub soaks are off the table for a while after treatment, since heat can interfere with healing.
- Avoid intense exercise for the first couple of weeks for the same reason. But walking is actually encouraged: it helps prevent blood clot formation and supports healthy circulation.
Side Effects: Is It A Safe Procedure?
Common side effects of sclerotherapy include some bruising, temporary dark spots on the surface of the skin where veins were treated, and that tenderness we’ve been talking about. These temporary side effects typically resolve on their own within a few weeks to months. Serious side effects like allergic reactions or active deep vein thrombosis are rare, especially when working with a qualified vascular specialist.
The Bottom Line
So does sclerotherapy hurt? The honest answer is that it causes some discomfort, but for most people, it’s brief and totally manageable. For people considering sclerotherapy for unsightly spider veins or symptomatic varicose veins, the pain factor probably shouldn’t be the dealbreaker. The procedure has a strong success rate, minimal downtime, and brings significant improvement in both appearance and symptoms for most patients. For a lot of people dealing with vein health issues, the short-term discomfort of this minimally invasive procedure is absolutely worth it for the long-term results.
