February 25, 2025

How to Minimize Skin Hyperpigmentation After Sclerotherapy

How to Minimize Skin Hyperpigmentation After Sclerotherapy

sclerotherapy treatment

Sclerotherapy is the primary, if not only, treatment for getting rid of spider and reticular veins. But like any medical procedure, it does come with potential side effects. One of those is hyperpigmentation of the skin on a patient’s legs.

What is hyperpigmentation?

Hyperpigmentation is a discoloration of the skin, usually a brownish color and splotchy in appearance. It occurs in 9-30% of patients, depending on the chemical makeup of the sclerosing agent and the patient. Hyperpigmentation is more familiar with dark-skinned patients or patients with very dark hair. The good news is that post-sclerotherapy hyperpigmentation is usually temporary, fading within six months. More severe cases can last up to a year, and in a minimal number of patients, about one percent, hyperpigmentation can be permanent.

Tips to Minimize the Potential for Hyperpigmentation

  • Choose your vein specialist carefully.
    Look for a physician who has completed a fellowship in a specialty with advanced training in venous disorders as recognized by the American Board of Medical Specialties (ABMS) and has sought certification by the American Board of Phlebology. The latter demonstrates advanced knowledge and dedication to the treatment of venous disorders.
  • Follow instructions.
    After your treatment, follow your physician’s instructions for wearing your compression hose entirely. Maintaining Proper compression is critical because it minimizes the blood reentering the injected area, improves venous blood flow, and thus, decreases the incidence of post-sclerotherapy hyperpigmentation and telangiectatic matting.
  • Don’t take supplemental vitamins with iron.
    Do not take supplemental iron or multivitamins that contain iron. It has been shown that hyperpigmentation is frequently related to the iron in a patient’s blood.

If you have spider veins, reticular veins, or varicose veins, call 904.901.6575 (VEIN) or complete our online form to request a consultation.

Frequently Asked Questions

Hyperpigmentation is a brownish, splotchy discoloration of the skin that can occur after sclerotherapy. It affects approximately 9–30% of patients and is more common in individuals with darker skin tones or dark hair.

In most cases, no. The discoloration typically fades within six months. More persistent cases may last up to a year, and in rare instances (around 1% of patients), the pigmentation may be permanent.

It’s usually caused by iron from red blood cells leaking into the surrounding tissue if blood reenters the treated vein. This can trigger a visible change in skin tone, particularly in the treated area.

Yes. Different sclerosing agents can carry different levels of risk for pigmentation, which is why it’s important to be treated by an experienced physician who selects the appropriate formulation for your skin and vein type.

No, it is typically a cosmetic issue only. While it may be frustrating, it doesn’t cause harm and generally resolves on its own over time.

If discoloration persists, dermatological treatments like topical lightening agents or laser therapy may help reduce its appearance. Speak with your vein specialist or dermatologist for options.

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