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Spider Veins · Varicose Veins · Legs

Clear leg veins.
No needles you'll notice.

Sclerotherapy is the gold standard treatment for spider veins and varicose veins on the legs. A fine solution is injected directly into the affected vessel, causing it to collapse and be cleared by the body over the following weeks. Dr Barker uses polidocanol, a well-established and well-tolerated sclerosant, to treat both superficial spider veins and varicose veins in a single in-room procedure.

Per session R2,950 Spider veins and varicose veins
Sessions needed 1 to 3 Depends on extent and vein type
Solution used Polidocanol Well-tolerated, well-established sclerosant
Post-treatment Compression Stockings worn after each session
About Sclerotherapy

The gold standard
for leg veins

Sclerotherapy has been the treatment of choice for leg veins for decades. It is precise, effective and well-studied, with a strong safety record when performed by an experienced injector. The principle is simple: a sclerosant solution is introduced into the vein through a very fine needle, irritating the inner lining of the vessel and causing it to seal shut. Over the following 4 to 8 weeks, the collapsed vein is absorbed by the body and gradually fades from view.

Dr Barker uses polidocanol, a sclerosant with an excellent tolerability profile and a very low rate of adverse reactions. It is injected in liquid form for fine spider veins and can be prepared as a foam for larger reticular and varicose veins, where the foam displaces blood in the vessel and achieves more thorough contact with the vein wall. The choice of technique and concentration is determined by the size and type of vein being treated.

Both men and women are treated. Leg veins are a common concern regardless of age or activity level and are not a reflection of fitness or health. Sclerotherapy addresses the visible veins that are already present. It does not prevent new veins from appearing over time, though the treated vessels themselves do not return once successfully closed.

What Dr Barker Treats
Superficial · Fine vessels
Spider Veins
Fine red, blue or purple vessels visible just beneath the skin surface, typically appearing in clusters or web-like patterns on the thighs, calves and ankles. Also called telangiectasias. Treated with liquid polidocanol at a fine concentration through a very small needle. Multiple clusters can be treated in a single session.
Deeper · Larger vessels
Varicose and Reticular Veins
Larger, often ropey or bulging veins visible beneath the skin, typically blue or green in colour. Reticular veins are the feeder vessels that often supply clusters of spider veins. Varicose veins are the more significant dilated veins that may be raised and uncomfortable. Treated with foam polidocanol for optimal vein wall contact and closure.
How Polidocanol Works
A precise chemical closure, no heat, no cutting, no downtime

Polidocanol is a detergent sclerosant that disrupts the phospholipid layer of the endothelial cells lining the vein wall. This causes controlled inflammation and fibrosis within the vessel, leading to permanent closure. The body then reabsorbs the sealed vein over the following weeks. In liquid form it targets fine spider veins precisely. When agitated into a foam, the micro-bubbles displace blood and maximise contact with the vein wall, making it the preferred approach for larger reticular and varicose veins. Polidocanol has a built-in local anaesthetic effect, making injections comfortable for most patients.

The Treatment Experience

What to expect

1
Assessment
Dr Barker examines the veins to be treated, determines the appropriate technique and concentration for each vessel type, and confirms suitability. Patients with significant venous insufficiency or deep vein involvement may need a venous duplex ultrasound before proceeding. He will advise clearly if this is the case.
2
Injections
Using a very fine needle, Dr Barker injects polidocanol directly into each vein to be treated. Multiple injections are typically made in a single session, working systematically across the treatment area. The procedure takes 30 to 45 minutes depending on the number and size of veins. Most patients find the injections mildly uncomfortable rather than painful, particularly with polidocanol's anaesthetic effect.
3
Compression stockings
Compression stockings are applied immediately after treatment and must be worn continuously for the first 24 to 48 hours, then during the day for a further 1 to 2 weeks. Compression is an essential part of the treatment, not optional. It keeps the treated vein walls in close contact during the inflammatory and fibrotic process, significantly improving the outcome and reducing the risk of complications including bruising and pigmentation.
4
Recovery
Most patients walk out and return to normal daily activities immediately. Strenuous exercise and prolonged sun exposure to the treated legs should be avoided for 2 weeks. Some bruising, redness and temporary darkening of the treated vessels is normal in the days following treatment. Treated veins will appear darker before they begin to fade.
5
Results
Treated veins gradually fade over 4 to 8 weeks as the body clears the closed vessel. Spider veins typically respond faster than varicose veins. Most patients require 1 to 3 sessions depending on the extent of veins present, with sessions spaced at least 4 to 6 weeks apart to allow full clearance before assessing the result.
Important · Compression Stockings

Compression stockings are a non-negotiable part of sclerotherapy aftercare. Please bring or wear a pair of flat, closed shoes on the day of treatment, as stockings are applied in-room immediately after the procedure. Dr Barker will advise on the correct compression level and duration of wear at the time of treatment. Compression is what makes sclerotherapy work as well as it does.

What Sclerotherapy Addresses
Spider veins on the thighs
Spider veins on the calves and ankles
Reticular feeder veins
Varicose veins (small to medium)
Vein clusters and web patterns
Blue and purple surface veins
Post-pregnancy leg veins
Age-related vein development
Common Questions

Frequently asked questions

Is sclerotherapy painful?
The injections involve a mild stinging sensation, particularly for very fine spider veins where a small needle is used. Polidocanol has a local anaesthetic effect built in, which makes the experience considerably more comfortable than other sclerosants. Most patients find it very manageable. There is no recovery pain. Some aching in the treated leg for a day or two after treatment is normal.
How many sessions will I need?
Most patients with mild to moderate spider veins require 1 to 2 sessions. More extensive veins, or legs with both spider veins and varicose or reticular veins, typically require 2 to 3 sessions. Sessions are spaced at least 4 to 6 weeks apart to allow the treated veins to be fully cleared before assessing what remains. Dr Barker will give an honest estimate at the first session.
Why do I need to wear compression stockings?
Compression is what makes sclerotherapy effective. After injection, the treated vein walls need to remain in close contact as the inflammatory and fibrotic process takes place. Compression achieves this, significantly improving clearance, reducing the risk of pigmentation, bruising and trapped blood (haematoma), and improving the overall quality of the result. It is a non-negotiable part of the protocol, not a suggestion.
Will the veins come back?
Successfully treated veins are permanently closed and do not return. However, sclerotherapy does not prevent new veins from developing over time. The underlying tendency to form leg veins is genetic and influenced by factors like prolonged standing, pregnancy and hormonal changes. Most patients find that a maintenance session every year or two keeps new veins well managed.
What is the difference between sclerotherapy and laser for leg veins?
For leg veins, sclerotherapy is significantly more effective than laser in most cases. Laser treats from the outside in and is limited in its depth of penetration, making it less reliable for all but the finest surface vessels. Sclerotherapy introduces the sclerosant directly into the vessel, ensuring complete contact with the vein wall regardless of depth. Nd:YAG laser is offered at this practice for facial veins and small vascular lesions on the face, where injection is impractical. For the legs, sclerotherapy is the preferred approach.
Can I exercise after sclerotherapy?
Light walking is encouraged immediately after treatment, as it promotes blood flow and reduces the risk of deep vein complications. Strenuous exercise, gym sessions and running should be avoided for 2 weeks to allow the treated vessels to seal properly and reduce the risk of bruising and pigmentation. Swimming should also be avoided for 2 weeks as immersion in water is not compatible with wearing compression and may introduce infection risk at injection sites.
SB
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How many sessions does sclerotherapy take?
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Most patients need 2 to 4 sessions depending on the number and size of veins. Results develop gradually over several weeks.
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The injections cause mild stinging. Most patients find it very tolerable with no anaesthetic needed.
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