Sclerotherapy

What is Sclerotherapy?

Sclerotherapy is a treatment of spider and varicose veins that involves the injection of a solution into a vein, which irritates the inside of the vessel wall, causing it to collapse and completely disappear. This procedure has been used to treat spider veins since the 1930’s and before that for larger vessels.

Does Sclerotherapy work for everyone?

The majority of persons who have sclerotherapy will be cleared of their varicosities; or at least see a 50-90% improvement. In very rare instances, a patient’s condition may become worse after sclerotherapy treatment, and develop a group of fine red blood vessels near the injection site of a larger vessel. However, even in those cases, 90% of those veins will disappear on their own, and some will go away with additional treatments.

Are there other treatment methods?

There are no other methods that are nearly as effective as sclerotherapy. Laser treatment is only effective for small veins on the face and occasionally for fine red blood vessels on the legs. We have a laser in the office which we choose to use on a very rare occasion.

How many treatments will I need?

The number of treatments needed to clear or improve the condition differs from patient to patient. The two main determining factors are the extent of varicose and spider veins present and how each person individually responds to treatment. Typically, an area of veins needs to be reinjected 2-3 times in order for the vein to collapse. Most patients come in for treatment every 1-3 weeks.

How do I prepare for my sclerotherapy session?

We recommend that you wear loose fitting pants and avoid applying moisturizing creams to your legs on the day of your visit. It is not an issue if you are bruised or tan.

What should I expect during a sclerotherapy treatment?

After your initial consultation, your treatment will begin. First your legs are cleaned with rubbing alcohol. Then with sterile disposable tiny needles we start to do the injections. Some patients experience an occasional slight burning sensation during the injections. When we finish doing the injections your legs will be cleaned off again and hydrocortisone cream will be applied to the area of treatment. This cream helps diminish any itching sensation and also helps decrease swelling and pain. Finally, your legs will be wrapped with ace-wraps to immediately help compress the veins so that they will disappear as quickly as possible.

What do I need to do after my sclerotherapy session?

At the end of your treatment the area on your legs that was treated will be wrapped with an ace-wrap. You will need to wear the ace-wrap for at least four hours, and maximally until bedtime. After you remove the ace-wrap you will put on a graduated compression stocking, supplied in our office, and will sleep in it only for the first night. You will then wear it for the next two days, but remove it at bedtime. It is recommended that you do not swim for the first 48 hours or to enter a sauna or hot tub. Otherwise there is no restricted activity. In fact, we encourage walking. It is also recommended that, while sitting, you keep your legs elevated as much as possible.

What are the side effects of sclerotherapy?

Bruises and red raised bumps at the injection site

Depending on how you heal, these bruises and bumps will completely go away in 5-14 days.

Itching

You may experience mild itching along the vein route. This itching can occur immediately after treatment and can be intermittent for 1-2 days.

Pain

Few patients experience any pain after treatment. At times, the bruises or swelling can be tender to the touch. However, this all resolves in a few days.

Hyperpigmentation

A low percentage of patients, more commonly with people with darker skin tones, might notice a discoloration of light brown markings where the veins once were. This pigmentation typically resolves within a few months. We also prescribe bleaching creams when necessary to help diminish these marks.

Ulceration

These are extremely rare and occur 1/10-15,000 injections. They are typically less than a centimeter in size and look like a cigarette burn. They can occur when some of the solution escapes into the surrounding skin or enters a tiny artery at the treatment site. These can be successfully treated.

Allergic Reactions

As with any medication, one can be allergic to the sclerosing agent. Severe reactions are extremely rare, but do need to be treated immediately.