Generally, does sclerotherapy for spider veins need to be repeated? or, is it mostly a permanent solution to the problem?

Permanent but recur: Sclerotherapy essentially scars a vein on the inside so that it is permanently closed. However, other surrounding veins are likely to dilate and cause a local recurrence due to incompetent deeper venous valves.

Nothing is permanent: As dr. Placik said, it is permanent but there will be recurrence. Your tendency to get spider veins is inherited, so you will always run the risk of developing new spider veins with time. The ones that are treated will go away permanently but nothing can guarantee that you won't get other spider veins in the future. It's in your dna.

May need repeating: Make sure you see someone who does spider veins frequently like a vein specialist or phlebologist. They can get to the root cause of your spider veins - reticular veins in many cases - and treat those to reduce the risk of recurrence. If you go to someone who just does it on the side, you're less likely to get a durable result. You get what you pay for.

Sclerotherapy rx.: Sclerotherapy is a process and usually requires multiple treatments and is usually something that may need to be done periodically over your lifetime. I always tell patients to think in terms of maintenance . Some veins will always recur over time. You should see a vein specialist for a full venous evaluation and a venous ultrasound to see if you have any underlying reflux valve issue.