1. What is sclerotherapy?

Sclerotherapy is a popular method of eliminating superficial blood vessels commonly known as “spider veins” by injecting a solution, called a sclerosing agent, into the veins. The solution irritates the lining of the blood vessel walls and causes them to seal off and gradually fade. The loss of these abnormal vessels will not harm circulation. Spider veins are usually inherited. They can begin to appear in the teenage years and usually increase with age. Pregnancy and obesity can exacerbate spider vein development.

2. Does sclerotherapy work for everyone?

Sclerotherapy will eliminate, or at least greatly improve, spider veins in the majority of people. There is, however, no guarantee that sclerotherapy will be effective in every case.

3. How many treatments will I need?

The number of treatments needed to eliminate or improve the condition differs from patient to patient, depending on the extent of spider veins present. A single blood vessel may have to be injected more than once, perhaps weeks or months apart, depending on its size. In any one treatment session, a number of vessels can be injected.

4. What are the most common side effects?

While sclerotherapy is a very safe procedure, certain side effects can occur regardless of the skill with which the treatment is performed. These side effects include:
STINGING OR PAIN at the site of injection, swelling of the ankles or feet, or muscle cramps. Muscle cramps almost always occur when the injection solution is hypertonic saline. They usually go away within 10 to 15 minutes after injection.
HYPERPIGMENTATION: Approximately 30% of patients who undergo sclerotherapy notice discoloration after treatment in the form of light brown streaks or bruises. In almost every patient, the veins become darker immediately after the procedure. In rare instances, this darkening of the vein may persist for 6 to 12 months or even longer. It is very rare for any discoloration to be permanent.
SLOUGHING: Sloughing occurs in less than 3% of patients who receive sclerotherapy. Sloughing consists of a small ulceration or sore at the injection site or along the course of the treated vein, that heals slowly. A blister may form, open, and become ulcerated. The scar that follows usually improves in appearance over time.
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. There is no risk of allergic reaction to saline solution.
PAIN: A few patients may experience pain and bruising, usually at the site of the injection, but this varies greatly with the solution used. The vein may be tender to the touch after treatment, and an uncomfortable sensation may run along the vein route. This discomfort is usually temporary, in most cases lasting 1 to 7 days at most.
MATTING: Some people (about a third of patients) may develop a pink blush in the skin immediately surrounding a treated area. This comes from a temporary enlargement of the tiny capillaries. Most disappear by themselves, some go away with additional injection treatment or laser therapy and a few may last.

5. Who should not have sclerotherapy?

People with significant circulatory problems, diabetes, bleeding disorders, or a history of deep vein thrombosis (blood clots) should not have this procedure. Any woman who is pregnant or planning pregnancy should not have this procedure.

6. Are there other types of procedures to treat spider veins and varicose veins?

Vein stripping and/or ligation may also be used to treat large varicose veins. This generally requires a hospital stay and is performed while the patient is under general anesthesia. Laser treatment is now available for treatment of leg veins. This procedure may cause pigmentation and is not effective on larger vessels. Sclerotherapy currently remains the most common treatment for spider veins.

7. Is there anything that I need to do before the procedure?

It is best to avoid all aspirin and aspirin related medications like ibuprofen (including Motrin and Advil) ONE WEEK BEFORE and ONE WEEK AFTER each treatment. Aspirin will increase the chance of pigmentation following the procedure. Please tell your doctor about all medications that you are taking before the procedure.

8. Will there be any special care after the procedure?

Most patients, except those with the finest spider veins, will have the treated areas wrapped with a compression bandage after the procedure. The patient will be instructed to keep the legs wrapped for three days. The purpose is to increase the effectiveness of the procedure and to decrease the chance of any pigmentation.

9. Is there a better time of the year to do sclerotherapy?

The fall and winter are ideal times for this procedure. It is important to avoid the sun after the procedure to minimize pigmentation. It also may be uncomfortable to keep the legs wrapped in the hot weather.

The dermatologists at Contemporary & Cosmetic Dermatology, PC are available to go over these and any other questions you may have regarding sclerotherapy.