We do not routinely prescribe topical agents after treatment, however, there are certain instances to consider a trial. Sclerotherapy is injected into the spider and varicose veins as a chemical irritant. However, this can be associated with hyperpigmentation especially in larger veins where the sclerosant can trap the blood inside the collapsed vein. Blood contains hemosiderin which can leak out of the treated vein into the surrounding tissue. Oxidation of these pigments can cause bronzing of the skin (hemosiderin staining), which can last up to 12 months. It’s difficult to predict who will be prone to staining, however with proper technique, the occurrence can be minimized. For this reason, it is important to wear compression stockings post-treatment and follow up as recommended with your vein specialist. During your visit, your doctor will also be able to determine if any topical agents are advisable. Most commonly, medications containing hydroquinone have been prescribed for skin lightening directly targeting melatonin producing skin-cells. The medication is for short-term use only and is generally well-tolerated, though efficacy is not proven. Any potential side effects of hydroquinone-containing medications should be discussed with your treating physician. Exfoliants such as chemical peels can also be considered but carry a risk of causing inflammation and potentially further pigmentation.