Prof. Dr. Ali Serdar Fak
Cardiac SurgeryVerified
- 29+years exp.
English · Turkish
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Vascular Surgery
Sclerotherapy of varicose veins
What sclerotherapy of varicose veins is, how liquid or foam sclerosant closes small and medium veins, which veins it suits and which need laser or surgery, what the evidence says, approximate costs in Turkey against the UK, US and Germany, how many sessions are needed, recovery with compression, risks and how to check a clinic.
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Dr. Bülent İlçöl
Cardiac SurgeryVerified
- 25+years exp.
English · Turkish
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Sclerotherapy of varicose veins in Turkey: what it is and how it works
Sclerotherapy of varicose veins is a minimally invasive treatment in which a medicine called a sclerosant is injected into a vein through a very fine needle. The medicine irritates the inner lining of the vein so that its walls stick together and the vein closes. Blood is rerouted through healthier veins, and over weeks to months the body gradually absorbs the closed vein. The sclerosant may be a liquid, used for small spider and reticular veins, or a foam made by mixing it with gas, which fills larger veins and can be guided with ultrasound. It needs no incision and no general anaesthesia.
This guide explains which veins sclerotherapy suits, how many sessions to expect, what the evidence says, approximate costs in Turkey compared with the UK, US and Germany, the role of compression stockings, risks and how to choose a clinic. Vascular care is covered in our cardiology treatments in Turkey.
Which veins can sclerotherapy treat, and which cannot?
Sclerotherapy works best on spider veins (telangiectasias, under 1 mm), reticular veins (the blue-green veins just below the skin, 1 to 3 mm) and small to medium varicose veins. Ultrasound-guided foam can also close larger branches and recurrent veins after previous surgery. It is not the first choice when the large saphenous trunk vein is badly leaking, because that vein usually needs thermal ablation (laser or radiofrequency), glue or surgery; sclerotherapy is then added for the visible branches. Before any treatment a duplex ultrasound scan shows which veins are leaking and where, and this scan should be part of an assessment for varicose veins, not only for spider veins.
Does sclerotherapy of varicose veins work?
For small and medium veins the evidence is good. Reviews and clinical guidelines support sclerotherapy as an effective treatment for spider veins and reticular veins, and ultrasound-guided foam sclerotherapy has been compared with surgery and endovenous ablation in trials and found to close many veins, although recurrence rates after foam alone are higher than after thermal ablation for large trunk veins. Some veins need a second or third session, and a few do not close fully. New veins can appear over time because the tendency to develop varicose veins continues. NICE guidance in the UK lists foam sclerotherapy as an option for varicose veins when endothermal ablation is unsuitable. A trustworthy clinic will promise improvement, not a guarantee that no veins will ever return.
Sclerotherapy of varicose veins cost in Turkey compared with the UK, US and Germany
These figures are approximate ranges for a course or session, not hospital quotes. A written plan, after your examination and ultrasound, confirms the price.
| Country | Approximate cost per session |
|---|---|
| Turkey | €100 – €700 |
| United Kingdom | €250 – €1,200 |
| United States | €300 – €1,500 |
| Germany | €250 – €1,000 |
What changes the price: the number and size of veins, whether liquid or ultrasound-guided foam is used, whether a duplex scan is included, the number of sessions and the cost of compression stockings. Many clinics quote per session, so the total depends on how many sessions are planned; ask for the likely number of sessions and whether follow-up is included. Cosmetic spider-vein treatment is often not covered by insurance, whereas medically necessary vein treatment may be.
Sclerotherapy, laser or vein removal: which treatment suits which vein?
| Treatment | Suited to | Typical limits |
|---|---|---|
| Sclerotherapy (liquid or foam) | Spider veins, reticular veins, small to medium varicose branches | Repeat sessions; less durable for large trunk veins |
| Laser or radiofrequency ablation | Leaking large saphenous trunk veins | Heat; usually needs local anaesthetic and a longer visit |
| Surgical vein removal | Large, twisted or recurrent varicose veins | Incisions, longer recovery |
For the heat-based route see our guide to laser treatment for varicose veins, and for surgical options read about varicose veins removal. If vein problems extend to narrowing in leg arteries, see arterial angioplasty and stenting, which treats a different condition.
Who is a good candidate for sclerotherapy, and who should not have it?
Good candidates are adults with visible spider or small varicose veins who are otherwise well and can wear compression afterwards. It is not suitable if you are pregnant or breastfeeding, have a history of deep vein thrombosis or a clotting disorder (unless a specialist agrees), have a known allergy to the sclerosant, have severe peripheral arterial disease, or are unable to walk. A hole between the heart chambers (patent foramen ovale) with a history of migraine with aura is a consideration with foam, and should be raised at the consultation. Leg pain, swelling, skin changes or ulcers need a vascular assessment, not a cosmetic session.
What happens during a sclerotherapy session, step by step?
Your leg is examined and, for varicose veins, scanned with duplex ultrasound. The skin is cleaned and no anaesthetic is usually needed, as the needle is very fine. The doctor injects small amounts of sclerosant into each vein; with foam, ultrasound shows it filling the vein. You may feel stinging or cramping for a moment. After the injections the leg is covered with a pad and compression bandage or stocking, and you are asked to walk for 15 to 30 minutes. A session lasts about 15 to 45 minutes depending on how many veins are treated.
How many sessions, how long in Turkey, and what is recovery like?
Spider veins often need two to four sessions, spaced four to six weeks apart; varicose veins may need one to three. Because sessions are spread out, a single trip normally treats the main veins, and any further sessions are done at a later visit or by a clinic near home. A short stay of one to three nights is typical.
- Day 0–2: wear compression day and night if advised; walk daily; avoid hot baths and heavy exercise.
- Weeks 1–2: compression stockings daytime; mild bruising, lumps and brown lines may appear.
- Weeks 4–12: treated veins fade; trapped blood (lumpy hardness) can be released by the doctor.
- Months 3–6: full result is judged; further sessions planned if needed.
Most people go back to work the next day. Flying is often allowed after a short check, with walking and fluids on the flight.
Sclerotherapy before and after: what results should you expect?
Photographs of good results show spider veins and small varicose veins faded or no longer visible after a course of treatment, taken at the same angle and lighting three to six months afterwards. Results vary: some veins disappear, some fade, and some darken before they clear. Photographs do not show the bruising and brown marks that appear in the first weeks, nor the new veins that may develop later. Ask the doctor to show results on similar-sized veins and for the number of sessions that were needed.
Risks and side effects of sclerotherapy
Common effects are stinging, bruising, itching, temporary brown pigmentation along the vein, small lumps and matting (a fine network of new tiny veins). Less common problems include skin ulcers if the medicine leaks outside the vein, superficial thrombophlebitis, visual disturbance or migraine after foam, allergy and, rarely, deep vein thrombosis, stroke-like symptoms or a clot reaching the lung. The NHS and national vascular societies advise that treatment is performed by a trained doctor, with ultrasound for larger veins and with compression afterwards. Seek urgent help for sudden breathlessness, chest pain, a swollen painful calf or neurological symptoms. Ask which doctor will manage a complication after you go home.
How to choose a clinic for sclerotherapy, and red flags
Choose a vascular, cardiovascular or dermatology specialist who performs a duplex ultrasound when veins are larger than spider veins, explains the sclerosant used and gives written aftercare. Red flags are treatment of large varicose veins without a scan, a promise that veins will never return, a fixed price for an unknown number of sessions, no compression plan and pressure to pay in advance. Read how our process works and send photographs through the free quote page for a plan and price.
Questions to ask the clinic:
- Which sclerosant and which form (liquid or foam) will you use?
- Will I have a duplex scan before treatment?
- How many sessions are likely, and is follow-up included?
- What compression do I need, and for how long?
- Who will help if I have a problem after I fly home?
Hospitals with Cardiac Surgery in Turkey
Frequently asked questions
It is an injection treatment in which a sclerosant, as liquid or foam, closes small and medium veins so blood flows through healthier ones. The closed vein is gradually absorbed by the body.
It works well for spider veins, reticular veins and small varicose branches, often needing more than one session. Large leaking trunk veins are usually better treated with laser, radiofrequency or surgery, and new veins can still form.
As an approximate range, a session costs about €100 to €700 in Turkey against roughly €250 to €1,200 in the UK. The total depends on the number of veins, foam or liquid, ultrasound and how many sessions you need.
Spider veins often need two to four sessions four to six weeks apart, while larger varicose veins may need one to three. The doctor decides after examining the veins and, if needed, an ultrasound scan.
You can usually walk and work the next day. Compression stockings are worn for days to weeks, and bruising, lumps or brown marks settle over weeks. Avoid hot baths and heavy exercise for a short time.
Most people feel brief stinging or cramping as the medicine is injected through a very fine needle. No general anaesthetic is needed, and discomfort afterwards is usually mild.
Common effects are bruising, itching, temporary brown discolouration and small lumps. Rare complications include skin ulcers, thrombophlebitis, allergy and blood clots, so treatment should be performed by a trained doctor.
Treated veins that close usually stay closed, but you may develop new veins over time because the tendency to varicose veins continues. Some veins also need extra sessions to close fully.
Sclerotherapy suits small and medium veins and spider veins, while laser or radiofrequency ablation is usually used for a leaking main trunk vein. A duplex ultrasound shows which approach fits your veins.
One to three nights is typical for a first session and a check. Because sessions are spaced weeks apart, further treatment may need a later visit or a clinic near home.
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