Sclerotherapy is a minimally invasive medical procedure used to treat varicose and spider veins, most commonly found on the legs, by collapsing them through the use of a solvent. Sclerotherapy has been used on patients since the 1930s with great success, producing increasingly effective medical, as well as cosmetic, results.
Reasons for Sclerotherapy
Some of the reasons a patient may desire, or a physician may recommend, sclerotherapy may include one or more of the following symptoms:
- Pain, aching or burning sensations in the legs or feet
- Swelling or redness at the site
- Cramping of the legs, especially at night
- Scaly, dry or discolored skin at the site
- Discomfort after sitting or standing for long periods
Individuals troubled by varicose veins may choose, in consultation with their physician, to undergo sclerotherapy either because they find them unattractive or because the diseased veins are causing unpleasant and/or dangerous symptoms.
Who is a candidate for Sclerotherapy?
The vast majority of adults with spider veins or varicose veins make good candidates for sclerotherapy. This vein treatment has been performed safely for many years and has a good record of success. Patients with clotting issues may warrant a more comprehensive evaluation to ensure that they would be good candidates for sclerotherapy.
Women interested in treatment should wait for at least 3 months after giving birth or stopping breastfeeding to schedule their sclerotherapy consultation.
How can I prepare for Sclerotherapy?
During your consultation, your doctor will perform an examination of your legs to observe the severity of your spider veins or varicose veins. A medical history is also necessary to ensure that this vein treatment is right for you, and scheduled at the right time. Your doctor needs to know about:
- The medications you take. This includes over-the-counter medications, vitamins, and herbal supplements. It is important that patients stop taking or avoid the use of products that thin the blood.
- Previous vein treatments you have had done, if applicable.
- Existing medical conditions, such as cardiac conditions.
- History of blood clots.
The Sclerotherapy Procedure
During sclerotherapy, a solution of saline and a sclerosant is injected into the damaged veins. This will cause irritation in the affected veins and produce their eventual collapse. During this procedure, the surgeon is guided through the use of ultrasound to ensure precision. When the weakened veins collapse, they will be reabsorbed into the body and other healthier veins will take their place in the circulatory system.
Sclerotherapy has proven to be a safe procedure and is performed outpatient in the doctor‘s office. Typically, sclerotherapy is performed in less than an hour, although a varying number of injections may be required, depending on the number of veins involved. Patients do not require an anesthetic and usually report little or no discomfort during the procedure, only a mild burning sensation. In some instances, several sclerotherapy treatments may be necessary.
Can I combine Sclerotherapy with other vein procedures?
Yes. Vein specialists sometimes combine therapies to meet the needs of patients who present with multiple vein issues. When you visit Suffolk Vascular & Vein Center, we can develop a treatment plan around your unique needs.
What can I expect from my results?
Patients treated for spider veins and small varicose veins tend to notice a significant difference in the prominence of these conditions in the 3 to 6 weeks after injections. Additional sessions may be needed to eradicate larger veins or wider areas of spider veins. Once the treated veins disappear, they do not come back. That said, sclerotherapy cannot prevent the development of new spider or varicose veins.
Risks of Sclerotherapy
Although sclerotherapy is a safe procedure that has been successfully performed for many years, there are certain risks associated with any medical procedure. Certain minimal, temporary side effects are to be expected, including bruising and discoloration. More serious complications are rare, but may include:
Swelling, warmth and discomfort around the injection site may indicate the presence of an infection for which the doctor may prescribe antibiotics.
A lump of clotted blood may form in a treated vein and require drainage. Rarely, a deeper blood clot may develop, known as a deep vein thrombosis. Since there is danger that such a clot will break off and travel to the chest, resulting in a pulmonary embolism, such a clot requires urgent medical attention. Sudden shortness of breath, chest pain, dizziness or the coughing up of foamy blood are signs of pulmonary embolism and must be addressed immediately.
Tiny air bubbles may rise in the bloodstream. These may not result in any symptoms, but if the patient experiences visual disturbances, headache, coughing or nausea, the physician should be contacted.
Numbness or odd sensations in the affected limb following sclerotherapy should always be investigated.
While rare, it‘s possible for a patient to have a severe allergic reaction to the sclerosant used in the treatment.
Will I need Sclerotherapy again in the future?
It may be necessary to undergo sclerotherapy or other vein treatments again in the future. However, there are preventive measures that may reduce the risk of new veins forming by improving the efficiency of the veins in the legs. The key is to promote the healthiest possible circulation. Many of the tips for prevention simultaneously reduce the pressure in the veins that cause them to swell.
- Do not sit or stand for prolonged periods. If you work a desk job, get up every hour to hour and a half and walk around for five minutes. If you stand a lot, find ways to sit down or elevate the legs periodically.
- Exercise several days a week. A daily, 45-minute walk can boost circulation and also help tone the legs to better support blood flow back to the heart.
- Perform heel-raises to work the calf muscles, as these help push blood up and out of the legs.
- Elevate the legs at least a few times a week.
- Wear compression stockings when walking or performing other tasks if you are prone to varicose veins.
Recovery from Sclerotherapy
Patients are able to return home shortly after sclerotherapy. Most can return to work and resume normal activities the next day, although exercise and strenuous activities are to be avoided a week or two. Compression bandages usually need to be worn for a week or so after the procedure. While it may take up to a month for the patient to see full results, some improvement is usually visible immediately.
In order to promote vascular health and to preserve the positive effects of the sclerotherapy, it is recommended that patients maintain a healthy weight and make exercise part of their daily routine.
How can I maintain my results?
The steps mentioned for the prevention of varicose and spider veins can be implemented by people who want to avoid new veins after having sclerotherapy. It is helpful to stay active and also maintain a healthy weight.
Excess weight exerts pressure on the lower extremities that causes veins to strain to move blood up and out. With weight management and regular movement, the veins do not have to work as hard as they would otherwise, so the risk of new varicose and spider veins lessens.
Is Sclerotherapy painful?
No. Patients can expect to feel a small pinching or stinging sensation from each injection. The sclerosing medication can cause a warm or cramping sensation. These are all short-lived and are not described by past patients as painful as much as uncomfortable.
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