SCLEROtherapy.
Sclerosing solution injection for leg spider and reticular veins; Candela GentleMax laser for fine facial telangiectasias. Larger varicose veins go to a vein specialist.
Two modalities, for two vein types.
Visible small veins fall into a few categories — and not all of them are addressed the same way. Spider veins (telangiectasias) are the fine red, blue, or purple webs visible at the skin surface, typically on legs or face. Reticular veins are the slightly larger blue-green veins that often feed networks of spider veins on the legs. Varicose veins are large, bulging, rope-like veins typically on the legs, often associated with venous insufficiency.
Spider and reticular veins are cosmetic concerns we treat at Reviv. Larger varicose veins are referred to vein specialists for ultrasound-guided evaluation and treatment — that scope of care belongs in a vascular surgery or phlebology practice, and we say so honestly when patients arrive with concerns that fall outside our scope.
For spider and reticular veins on the legs, sclerotherapy injection is the gold-standard approach. For very fine facial veins, laser is typically the better fit. We carry both.
Injection or laser, matched to the vein.
Vein therapy at Reviv Med Spa in Millbrae is performed by our Medical Director Dr. Gayle Misle, MD, and our Aesthetic Nurse Megan Sosnick, RN — both with extensive training in sclerotherapy injection technique and Candela GentleMax laser settings. We carry two modalities and match the tool to the vein.
- Sclerotherapy injection Asclera (polidocanol), Sotradecol
- Fine-needle delivery of a sclerosing solution directly into the target vein; the solution irritates the wall, the vein collapses, the body reabsorbs it. Best fit for leg spider and reticular veins.
- Laser vein therapy Candela GentleMax Pro
- Laser energy selectively absorbed by hemoglobin in the vein, causing thermal coagulation and reabsorption. Best fit for very fine facial veins and some smaller leg vessels not suited for injection.
Your visit: consultation review (vein pattern, history, photographs of areas of concern), treatment plan recommending modality and number of sessions, then 30 to 60 minutes of treatment. For sclerotherapy, medical-grade compression stockings are worn for 3 to 7 days. The series is typically 2 to 4 sessions spaced 4 to 6 weeks apart for full clearance.
Four areas, two modalities.
In your consultation we'll identify which veins are within our cosmetic scope and which need a vein-specialist evaluation.
Leg spider veins
The fine red, blue, or purple webs visible on thighs, calves, and ankles — sclerotherapy injection.
Leg reticular veins
Slightly larger blue-green veins that often feed networks of spider veins.
Facial telangiectasias
Fine surface veins on cheeks, nose, and around the eyes — Candela GentleMax laser.
Decolletage and chest
Small fine veins on the chest — laser modality.
What we treat — and what we don't.
Spider veins (telangiectasias)
The fine, surface-visible vein webs on legs or face — the primary indication for both modalities.
Reticular veins
The blue-green feeders just under the skin that often supply spider-vein networks.
Recurrent vein development
Vein disease is progressive — touch-up sessions every few years address new vessel growth.
What we do not treat
Large bulging varicose veins or veins with ultrasound-confirmed reflux — those go to a vein specialist for ultrasound-guided procedures.
Reticular Legs Telangiectasia Asclera Compression Walking Improvement Spider veins Reticular Legs Telangiectasia Asclera Compression Walking Improvement Spider veins Reticular Legs Telangiectasia Asclera Compression Walking Improvement What to know, in four lines.
- 01
Sclerotherapy and laser are different tools for different veins. Leg spider and reticular veins respond best to injection; very fine facial veins are better fits for laser. We carry both.
- 02
Treated veins darken before they fade — this is the desired response. Final result is visible 4 to 8 weeks after the last session of a series.
- 03
Compression stockings for 3 to 7 days after sclerotherapy improve clearance and reduce pigmentation along treated vessels. We provide guidance on grade and length.
- 04
Larger varicose veins go to a vein specialist for ultrasound-guided evaluation. We say so honestly when concerns fall outside our cosmetic scope.
From day zero, to full clearance.
Injection day. 30 to 60 minutes for the planned area. Mild bruising at the injection sites is typical. Compression stockings on, walking encouraged.
Bruising resolves over 1 to 2 weeks. Treated veins typically darken before they fade — this is the desired response, not a complication.
Veins begin fading visibly. We schedule the next session at week 4 to 6 once the prior treatment is judged.
Full clearance from a session is best evaluated 6 to 8 weeks after. Most patients need a series of 2 to 4 sessions for full clearance.
What it actually costs.
Vein therapy at Reviv is priced per session and varies by area treated and modality. Larger leg sclerotherapy sessions cost more than focal facial laser work. Vein treatments are not currently listed in our membership tier table. Final cost depends on the pattern and density of veins — and the pattern and density we quote in writing at consultation, before any treatment begins.
Who it's for — and who it isn't.
- Adults with leg spider or reticular veins seeking cosmetic clearance
- Patients with fine facial telangiectasias on cheeks, nose, or around the eyes
- Patients who can wear compression stockings for 3 to 7 days after sclerotherapy injection
- Patients comfortable with a 2- to 4-session cadence and a darken-then-fade timeline
- Pregnant or breastfeeding patients
- Patients with deep vein thrombosis history or hypercoagulable disorders
- Tan skin or recent self-tanner (laser modality), recent isotretinoin, or photosensitizing medications
- Large varicose veins or significant venous insufficiency — referred to a vein specialist
Your vein therapy team.
Dr. Gayle Misle, MD
Founder of Reviv Med Spa & Laser Treatment. Leads our injection programs with extensive training in sclerotherapy technique and patient screening.
Megan Sosnick, RN
Aesthetic Nurse and Practice Manager. Performs sclerotherapy injections and Candela GentleMax laser vein settings alongside Dr. Misle.
What people say about Reviv.
The whole team takes their time. No upselling, no pressure — just a thoughtful plan and beautiful results. The space itself feels like a sanctuary.
I've tried four other med spas in the Bay Area. Reviv is the only one where I feel genuinely listened to. Worth the drive from the city.
Conservative, honest, and skilled. They told me I didn't need half of what I was considering — and the things they did do were perfect.
No vein-therapy-tagged reviews yet — these are recent reviews from across our practice.
Read all reviewsFrequently asked.
What is the difference between sclerotherapy injection and laser vein therapy?
They use different mechanisms and fit different veins. Sclerotherapy injection works best for spider and reticular veins on the legs (the visible blue-purple network of small veins) — a fine needle delivers sclerosing solution directly into the vein. Laser is the better fit for very fine facial veins (telangiectasias on the cheeks, nose, around the eyes) where injection is not practical. Some leg veins also respond to laser. We assess and recommend the right modality for each vein.
How many sessions do I need?
Most patients need 2 to 4 sessions for full clearance, spaced 4 to 6 weeks apart. Each session treats more of the network. Some areas with denser vein clusters need additional sessions. Single-session results are visible but partial.
How much does vein treatment cost?
Pricing is per session and depends on the area treated and the modality used. Larger leg areas cost more per session than focal facial work. Vein treatments are not currently listed in our membership tier table.
Does it hurt?
Sclerotherapy injection feels like a small pinch followed by a brief sting as the solution is delivered — most patients rate it 2 to 3 out of 10. Laser feels like a brief snap with each pulse — 3 to 4 out of 10. Topical numbing is optional for laser. Neither requires a numbing cream that takes hours to set up.
Is there downtime?
Minimal. After sclerotherapy you wear compression stockings for 3 to 7 days and walk regularly. After laser there is mild redness for 24 to 48 hours. Treated veins darken before they fade — this is the desired response. Both modalities allow normal activity (work, light exercise) the next day.
Will the veins come back?
Treated veins are gone permanently. However, vein disease is progressive — new veins can form over time, especially with genetic predisposition, prolonged standing, pregnancy, or weight changes. Touch-up sessions every few years address new vessel growth. Patients with chronic venous insufficiency may also benefit from medical evaluation by a vein specialist.
Why compression stockings after sclerotherapy?
Compression keeps treated veins collapsed during the early reabsorption phase, improves clearance, and reduces the risk of pigmentation along treated vessels. We provide stocking guidance and recommend medical-grade compression for the first 3 to 7 days post-injection.
Are there side effects?
Common: bruising at injection sites (resolves 1 to 2 weeks), darkening along the treated vein before fade (resolves 4 to 8 weeks), mild ache the day of treatment. Less common: persistent darkening (post-inflammatory hyperpigmentation, especially in higher Fitzpatrick types — typically resolves with time). Rare: allergic reaction to sclerosing solution (we screen at consultation), small ulceration if solution extravasates, deep vein thrombosis (very rare). We screen carefully and use technique designed to minimize each.
When will I see final results?
Treated veins darken over 1 to 2 weeks then fade over 4 to 8 weeks. We schedule the next session at week 4 to 6 once the prior treatment is judged. Final result of a series is best evaluated 6 to 8 weeks after the last session.
Who should not get sclerotherapy or laser vein therapy?
Sclerotherapy: pregnant or breastfeeding patients, patients with deep vein thrombosis history or hypercoagulable disorders, allergy to the sclerosing solution. Laser: tan skin or self-tanner, recent isotretinoin, photosensitizing medications, pregnancy. Both: active skin infection at treatment area. Patients with significant varicose veins (large bulging veins, not spider veins) are referred to a vein specialist for ultrasound-guided evaluation rather than treated with cosmetic sclerotherapy at our scope.
Patients come to us from across the peninsula.
Reviv Med Spa is at 31 S El Camino Real in Millbrae, California — easy to reach from across the Bay Area peninsula. Patients come to us from Burlingame, San Mateo, Hillsborough, San Bruno, Foster City, and the broader peninsula including Atherton, Belmont, Brisbane, Daly City, Half Moon Bay, Menlo Park, Pacifica, Palo Alto, Portola Valley, Redwood City, San Carlos, and South San Francisco. Off the 101, just south of SFO. Free parking on site.