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Legs_on_the_beachWhat is sclerotherapy?

Sclerotherapy is a medical procedure used to eliminate spider veins. Sclerotherapy involves an injection of a solution directly into the vein. The solution irritates the lining of the blood vessel, causing it to swell and stick together, and the blood to clot. Over time, the vessel turns into scar tissue that fades from view.

Sclerotherapy is a well-proven procedure and has been in use since the 1930s.

Am I a candidate for Sclerotherapy?

Prior to the procedure, you will have an initial consultation with a the Doctor who will decide if you're a good candidate for sclerotherapy.

You are not eligible for sclerotherapy treatment with the Doctor if:

  • You are pregnant, breastfeeding or bedridden.
  • You have diabetes or chronic venous insufficiency.
  • You have had a blood clot in your leg or lungs in the past.
  • You are on treatment with Warfarin.
  • You have cancer or are on chemotherapy.
  • If you have some reason to cause impaired healing.

You can have sclerotherapy if you take birth control pills.

How is sclerotherapy done?

A solution is injected by the Doctor directly into each small spider vein with a very small needle and syringe.  The number of spider veins injected in one session is variable, depending on the size and location of the veins, and the your overall medical condition. Mild discomfort may occur, and a burning sensation may be felt for 1 to 2 minutes when larger veins are injected. The sclerotherapy procedure itself takes about 60 minutes.

Each injection site will be strapped, and the strapping left on until the next morning. If you have elastic compression stockings, the Doctor will ask you to bring them along and put them on straight afterwards.

How successful is sclerotherapy in treating spider veins?

Sclerotherapy works well for most patients with spider veins. It is estimated that as many as 50 to 80% of injected varicose veins may be eliminated with each injection session. A few (less than 10%) of the people who have sclerotherapy on their veins do not respond to the injections at all. In these instances a different method, such as laser therapy, may be tried. In general, spider veins respond to sclerotherapy in 3 to 6 weeks. If the veins respond to the treatment, they will not reappear. However, new veins may appear over time. If needed, you may return for injections.

Although this procedure works for most patients, there are no guarantees for success.

What do I need to do before the procedure?

Prior to sclerotherapy, certain medications should be avoided. Talk to the Doctor about all medicines (including over the counter drugs, herbs, and dietary supplements) you are taking.

Tetracycline or Minocin, both antibiotics, may possibly cause a staining of the skin if taken 7 to 10 days before or after sclerotherapy. Ask the doctor about other antibiotic medications you may take, or ask for safe guidelines for discontinuing these medications. If you are required to take an antibiotic before any invasive procedure, such as dental procedures, colonoscopy or surgery, please inform the Doctor.

Do not take aspirin or other anti-inflammatory medications for 48 hours before and after sclerotherapy, because these medications may interfere with the action of the sclerosing agent. Panado is permitted. Ask the doctor for specific guidelines before discontinuing any medication prior to sclerotherapy.

Prednisone (steroids) also decreases the effectiveness of the sclerosing agent. Ask the doctor who prescribed your prednisone if it can be safely discontinued for 48 hours before the sclerotherapy procedure.

No lotion is to be applied to the legs before or after sclerotherapy. It is recommended that you bring a pair of shorts to wear during the vein treatment procedure.

If you have compression hosiery from previous treatments, please bring them with you so we can make sure they will provide adequate support after the sclerotherapy procedure.

What are the side effects of sclerotherapy?

Certain side effects may be experienced after sclerotherapy. There are milder effects, such as itching, which can last for one or two days after the procedure. Raised red areas may appear at the injection sites and should disappear within a few days. Brown lines or spots on the skin may be noted at the site of the injection, possibly caused by a form of iron that escapes from the injected veins. In most cases, they disappear within 3 to 6 months, but can be permanent about 5% of the time. Bruising may occur around the injection site and can last several days or weeks. Other side effects rarely develop after sclerotherapy. If you have any of these side effects, please contact the Doctor immediately:

  • Inflammation within five inches of the groin
  • Sudden onset of a swollen leg
  • Formation of small ulcers at the injection site
  • Red streaking, especially in the groin area
  • Neovascularization -- the development of new, tiny blood vessels -- may occur at the site of sclerotherapy treatment. These tiny veins can appear days or weeks after the procedure, but should fade within three to twelve months without further treatment.
  • Allergic reactions to the sclerosing agent may occur at the time of the injection and are rarely serious.

Call the Doctor with any concerns or questions you may have after the sclerotherapy procedure.

What happens after the treatment?

After the treatment you will be able to drive yourself home. You are encouraged to spend the rest of the day resting. The next morning you may resume your regular activities and are encouraged to walk. You will be instructed to wear support hosiery or compression stockings to "compress" the treated vessels.

After the procedure, avoid aspirin, ibuprofen and other anti-inflammatory medications for at least 48 hours. Panado may be used if needed.

Do not take hot baths or sit in a whirlpool or sauna, nor apply hot compresses or any form of heat to the injected areas for 48 hours after treatment. In addition, avoid direct exposure to sunlight (sun bathing and tanning beds) jogging, high-impact aerobics and swimming for 7 to 10 days after the procedure.

Showers are permitted, but the water should be cooler than usual. The injection sites may be washed with a mild soap and lukewarm water.