My doctor said my vein is too large to have sclerotherapy performed first, is this true?

Question: I have a few visible spider veins on my lower leg that I want treated with foam sclerotherapy. However, the doctor wants me to do endovenous laser treatment before the sclerotherapy. According to him, my vein is way too large and if I do the sclerotherapy first, they will reappear. Is this true?

Answer: The short answer is yes. If the veins you want treated are too large, the sclerosant, regardless of agitating it or not, will simply wash out of the treated area. Additionally, if the veins you want treated are tributaries of larger veins that are abnormal, then the sclerotherapy will also fail because of the build up of pressure in the larger veins. You can certainly try the sclerotherapy first. But usually this is a waste of time and money. You can liken it to pulling leaves off a tree to trim it.