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Haroun Gajraj: Stop Before You Inject Spider Veins Around the Ankle

Haroun Gajraj/LinkedIn

Nov 21, 2025, 14:26

Haroun Gajraj: Stop Before You Inject Spider Veins Around the Ankle

Haroun Gajraj, Phlebologist and Board Member of the British Association of Sclerotherapists, posted on LinkedIn:

“STOP: BEFORE YOU INJECT SPIDER VEINS AROUND THE ANKLE…
Consider these 4…

The ankle region is one of the RISKIEST areas in Sclerotherapy.

Even experienced practitioners can face complications that lead to months of patient pain.

Here are the 4 crucial factors that make this zone a clinical minefield:

1. Arterial Vulnerability

This zone is uniquely prone to inadvertent injection into tiny arterioles, or sometimes arteries, with potentially disastrous consequences.

2. Protracted Pain
Extravasation of sclerosant can easily inflame a superficial sensory nerve, leading to sharp pain that persists for weeks, and often months.

3. Slow Healing
Any resulting scabs or skin ulcers typically take a considerably longer time to heal compared to other areas of the leg.

4. Venous Reflux
Spider veins here are more strongly associated with underlying venous reflux, meaning superficial treatment alone may not address the root cause.

If you are treating this area, you must know the correct technique and mitigation strategies to protect your patient and your practice.

I have shared my full approach and detailed advice in a video. Watch the expert technique and full warning here.

I’m REALLY interested to hear from other experienced specialists.

For experienced practitioners: Which specific sclerosant and concentration do you prefer for the ankle, and why?

Let’s discuss best practices in the comments!

Acknowledgment: Injection technique demonstrated by Zola Mzimba board member of The British Association of Sclerotherapists

Disclaimer

This content is for educational purposes only and is intended for medical professionals (Sclerotherapists, Phlebologists, etc.). It does not constitute specific medical advice, diagnosis, or treatment for any individual. Always rely on your own clinical judgment, training, and patient assessment before performing procedures.”

Haroun Gajraj