Direct Vision Sclerotherapy in Los Angeles & Walnut
Direct Vision Sclerotherapy — also called Standard Sclerotherapy or Microsclerotherapy — is the gold standard minimally invasive treatment for spider veins and small surface varicose veins. At Vein Care Medical Center in Los Angeles & Walnut, Dr. Michael D. Landau uses this precise, in-office technique to eliminate blue reticular veins and visible superficial veins by injecting a specialized sclerosing solution directly into each targeted vessel. The result: treated veins collapse, harden through a process called sclerosis, and are gradually absorbed by the body over the following weeks.
Request an AppointmentHow Direct Vision Sclerotherapy Works
Using a very fine needle, Dr. Landau injects an FDA-approved sclerosant solution — Sotradecol® or Asclera® — directly into the unwanted vein under direct visual guidance. The solution damages the inner lining of the vein wall at the injection site, causing the vessel to harden and close. Over the following weeks to months, the treated vein fades and is naturally reabsorbed by the body, leaving clearer, smoother-looking skin.
Unlike surgical vein removal, Direct Vision Sclerotherapy requires no incisions, no stitches, and no anesthesia beyond what is inherent in the injection itself. Multiple veins can be treated in a single session, making it an efficient option for patients dealing with scattered or widespread surface vein concerns.
What Conditions Does Direct Vision Sclerotherapy Treat?
At Vein Care Medical Center, Dr. Landau commonly uses Direct Vision Sclerotherapy to treat:
- Spider veins (telangiectasia) — tiny red or purple thread-like veins visible at the skin surface
- Reticular veins — blue-green, slightly larger feeder veins beneath the skin
- Small varicose veins that are visible but not bulging
- Unsightly veins on the legs, ankles, or other areas of the body
For larger, deeper varicose veins caused by venous insufficiency, Dr. Landau may recommend an initial treatment with EVLA, Radiofrequency Ablation, or another endovenous procedure, followed by Direct Vision Sclerotherapy for the remaining surface veins.
Is the Procedure Painful?
Most patients at Vein Care Medical Center report that Direct Vision Sclerotherapy is well tolerated. The injections may produce a brief stinging or burning sensation lasting no more than a minute, which most patients compare to the sensation of a mosquito bite. No sedation is required, and the procedure is performed entirely in-office. You can drive yourself home and resume your normal routine immediately after your appointment.
What to Expect After Treatment
After Direct Vision Sclerotherapy, some redness, mild swelling, or bruising at the injection sites is normal and resolves within days. Treated veins do not disappear overnight — the fading process typically takes several weeks to a few months as the body absorbs the closed vessels. Dr. Landau will discuss realistic expectations and may recommend additional sessions to achieve the best possible cosmetic outcome. Wearing compression stockings as directed will support healing and improve results.
Schedule Your Spider Vein Consultation in Los Angeles or Walnut
If spider veins or small surface varicose veins are bothering you — whether for cosmetic reasons or because they are causing discomfort — Vein Care Medical Center can help. Call (323) 934-9191 to schedule a consultation with Dr. Landau at our Los Angeles or Walnut office. Together, we will develop a personalized treatment plan to restore clearer, healthier-looking legs.
Direct Vision Sclerotherapy — Frequently Asked Questions
What is the difference between Direct Vision Sclerotherapy and foam sclerotherapy?
Direct Vision Sclerotherapy uses a liquid sclerosant injected under direct visual guidance into small, superficial veins. Foam sclerotherapy uses the same sclerosant but in a foamed form, which is particularly effective for larger veins because foam displaces blood from the vessel and maintains better contact with the vein wall. Dr. Landau uses both techniques depending on the size and type of vein being treated.
How many sclerotherapy sessions will I need?
The number of sessions varies based on the number, size, and distribution of veins being treated. Many patients see significant improvement after one to three sessions. Dr. Landau will evaluate your veins during your consultation and give you a realistic estimate of how many treatments will be needed to achieve your goals.
How soon will I see results after Direct Vision Sclerotherapy?
Treated veins begin fading gradually as the body absorbs them. Smaller spider veins often start to fade within three to six weeks, while larger reticular veins may take two to three months to clear. Final results are typically visible within three to six months after your last treatment session.
Are the results of sclerotherapy permanent?
The veins that are successfully treated with sclerotherapy are permanently closed and will not return. However, new veins can develop over time due to genetic predisposition, hormonal changes, or lifestyle factors. Periodic maintenance treatments may be recommended to address any new vessels that appear.
What should I do before my sclerotherapy appointment?
Dr. Landau’s team will provide specific pre-treatment instructions. Generally, you should avoid applying lotion to the legs on the day of treatment, wear loose comfortable clothing, and bring compression stockings to wear after your session. Avoid anti-inflammatory medications like ibuprofen for a few days before treatment if possible. Your care team will review all instructions with you at consultation.
Is Direct Vision Sclerotherapy covered by insurance?
Insurance coverage depends on whether the treatment is medically necessary or cosmetic. Sclerotherapy performed solely to improve the appearance of spider veins is generally not covered by insurance. However, if the veins are causing symptoms related to underlying venous insufficiency, coverage may apply. Vein Care Medical Center will help you understand your options and offers CareCredit financing for cosmetic treatments.
Can sclerotherapy be combined with other vein treatments?
Yes — and in many cases, combination treatment produces the best results. When larger trunk veins are driving the formation of spider veins, Dr. Landau typically addresses the underlying insufficiency first with EVLA or Radiofrequency Ablation, then follows up with Direct Vision Sclerotherapy to eliminate the remaining surface veins. This comprehensive approach provides more complete and longer-lasting results.