Sclerotherapy is the removal of veins by injecting a substance, usually saline, foam or glycerin, into the vein. The substance coats the inner lining of the vein, causing the vein to be reabsorbed gradually by the body. We most commonly perform sclerotherapy with foam for large varicose veins and with glycerin or sodium tetraderyl sulfate for spider veins. We often combine sclerotherapy with laser to achieve the most effective, most rapid and least uncomfortable removal of leg veins. All patients should have a minimum of a venous Doppler exam prior to proceeding with any vein treatment of any type. This exam is performed painlessly in our office at the time of the consultation at no extra cost. An abnormal Doppler exam suggests that deep veins that cannot be seen on the surface are leaky and need to be treated also. Failure to recognize and treat deep veins will lead to rapid reoccurrence of spider and varicose veins on the surface.