Sclerotherapy

Sclerotherapy is a popular and safe method for eliminating varicose veins and superficial telangiectasias (spider veins) in which a sclerosing agent solution is injected into the veins. The sclerosing agent causes the vein to collapse and be reabsorbed by the body during the natural healing process. No medical technique is perfect and no two people are alike. Accordingly, the treatment of spider and varicose veins will not create miracles. There is no cure, but good control is achievable. It is best when treating small vessels to stop when 60% to 80% improvement is achieved because large numbers of treatments (over six) in a short period of time can create highly resistant, very small red spider veins (matting, second generation vessels).

The number of treatments needed to clear or improve the condition varies from patient to patient, depending on the extent of varicose, and spider veins present. Generally one to six treatments are recommended. The average number of treatments is three to four.

 

The most common side effects experienced with Sclerotherapy are:

  • Itching- depending upon the type of solution used, you may experience mild itching along the path of the vein. The itching normally lasts one to two days.
  • Temporary Hyperpigmentation- If stronger solutions are used, approximately 30% of patients who undergo Sclerotherapy notice a discoloration of light brown streaks after treatment. This is rare with milder solutions. With stronger solutions, the veins become darker immediately after the procedure. In rare instances, this darkening of the vein may persist for four to twelve months.
  • Sloughing- is a small ulceration at the injection site, which heals slowly. This occurs in less than 3% of patients- when stronger solutions are used. It may begin as a blister that opens and becomes a small ulcer. The scar that follows usually returns to a normal color after several months.
  • Allergic Reactions- Very rarely, a patient may have an allergic reaction to the sclerosing agent used. The risk of an allergic reaction is greater in patients who have a history of allergies.
  • Pain- A few patients may experience moderate to severe pain and some bruising, usually at the site of the injection. The veins may be tender to the touch after treatment, and an uncomfortable sensation may run along the vein route. This pain is usually temporary, in most cases lasting one to at most seven days, and is caused by superficial blood clots, which can be easily drained.

Other possible side effects include a burning sensation during injection of some solutions, neovascularization (the

development, usually temporary, of new tiny blood vessels), transients phlebitic-type reactions (swelling of the vein might cause ankles to swell), temporary superficial blebs or wheals (similar to hives), and very rarely, wound infection, poor healing, or scarring.

Phlebitis, inflammation of the vein, is a very rare complication, seen approximately in one out of every one hundred patients treated for varicose veins greater than three to four millimeters in diameter. The possible dangers of phlebitis include the possibility of a pulmonary embolus (a blood clot to the lungs) and post-phlebitis syndrome, in which the blood clot is not carried out of the legs, resulting in permanent swelling of the legs.

 

What to do before your appointment:

  • Be advised that aspirin, aspirin containing drugs, Vitamin E, and other blood thinning medications can result in increased bleeding during and after the procedure. If you are concerned about bleeding and bruising, avoid these products a few days prior to the procedure. Before discontinuing the use of these medications please consult with the physician who prescribed them.
  • DO NOT shave your legs for two days prior to your appointment.
  • Eat a light breakfast, lunch, or snack one hour or so before your appointment.
  • Bring loose fitting shorts to wear during the procedure and slacks, sweatpants, or a long skirt to wear out of the office.
  • Remember to bring the recommended support hose or ace bandages or you can purchase them here in the office. You will need to wear them immediately after the procedure.
  • On the day of the procedure DO NOT apply any moisturizers to the area to be treated.

 

Care of the Treated Area:

  • Do not stand in one place for long durations for the remainder of the day following the procedure.
  • Combine walking with leg elevation during the first three days post injections.
  • Maintain your normal daytime activities and walk AT LEAST ½ HOURS PER DAY – the more the better.
  • If your legs become painful after the injections – WALK.
  • If you were treated only for spider veins, do not remove your stockings for fourteen days, except to shower or use the restroom. This helps the treatment work more effectively.
  • Do not take hot baths or sit in a hot tub for two weeks unless your legs hurt, and in that case, baths can help relieve the pain.
  • Avoid strenuous activity involving the treated area for the first 48 to 72 hours.

Patients with active throbophlebitis, those with active infection, poor circulation or those that are confined to bed should not be treated. Patients with a history of pulmonary embolus (clots in the lungs), or histories of extreme swelling of the feet and legs should be treated cautiously. The occurrence of pulmonary embolus, neurological damage or a very large ulcer (scar) occurs very, as do serious allergies. I have read the above and understand the potential benefits and limitations of injection treatment for spider and varicose veins.

 

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"I love what I do because I get to combine my God-given artistic ability with technical skills and passion for helping people."

– Peter Paul Rullan, M.D.