My Spider Veins Look Darker After a Cosmetic Sclerotherapy Session: Is This Normal?

Spider veins are incredibly common, but they can take a heavy toll on confidence. Many people find themselves hiding their legs under long pants or avoiding the beach because of these stubborn clusters. If you’ve finally taken the leap and started treatment, seeing those veins turn darker can be alarming.

If you are two months out from your first session and wondering why your veins haven't disappeared yet, here is what you need to know about the healing process and your next steps.

1. The "One-and-Done" Myth

Spider vein treatment is a journey, not a single event. It almost always requires multiple sessions to achieve clear results.

In fact, it is very common for veins to look darker or more pronounced in the first 4–8 weeks following a session. This happens because the blood inside the treated vein has coagulated, and the vein wall is collapsing.

To check if a vein has successfully closed, you can gently apply light pressure; a closed vein will typically feel "fixed" or won't blanch (fade) the way an open vein does.

2. The Role of Underlying Veins

Sometimes, spider veins are just the "tip of the iceberg." They can be multi-layered and fed by deeper, larger blue veins known as reticular or varicose veins. If these "feeder veins" aren't addressed, the surface spider veins may take longer to fade or may require more intensive treatment.

3. The Power of Compression

During your recovery, external compression is your best friend. Wearing compression stockings plays a critical role in keeping the vein walls compressed so they can shut down permanently.

The Rule of Thumb: More consistent compression generally leads to faster recovery and fewer residual veins.

4. Post-Procedure Skin Care

For patients prone to hyperpigmentation, what looks like a "residual vein" might actually be hemosiderin staining(pigment left behind as blood breaks down). To help this fade:

• Sun Protection: Wear sunscreen religiously to prevent the pigment from darkening.

• Apply Moisturizing Lotion: Keep the skin moisturized with Hyaluronic acid.

• Apply Serum with Brightening Agents: Use serums containing Niacinamide, hydroquinone, or Vitamin C to help speed up the fading of post-treatment shadows.

What is the next step?

If you are at the two-month mark, the best next step is retreatment. Your provider will assess how the veins responded to the first round and layer the next treatment to further collapse the vessels. Consistency is the key to getting those legs "shorts-ready!"