Sclerotherapy

Sclerotherapy is a medical procedure used to eliminate varicose veins and spider veins . "Sclerotherapy involves an injection of a solution (generally a salt 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.

In most cases, the salt solution is injected through a very fine needle directly into the vein. At this point, you may experience mild discomfort and cramping for one to two minutes, especially when larger veins are injected. The procedure itself takes approximately 15 to 30 minutes. You should plan to wear shorts during the injection. The number of veins injected in one session varies, and depends on the size and location of the veins, as well as the general medical condition of the patient.

You may experience certain side effects after sclerotherapy. There are milder effects, such as itching, which can last for one or two days after the procedure. Also, you may experience raised, red areas at the injection site. These should disappear within a few days. Bruising may also occur around the injection site and can last several days or weeks.

Other side effects include:

Larger veins that have been injected may become lumpy and hard and may require several months to dissolve and fade.
Brown lines or spots may appear at the vein site. In most cases, they disappear within three to six months.
Neovascularization, or the temporary 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.

Should any of the following side effects occur, contact your provider immediately. These include:

Inflammation within five inches of the groin
A sudden onset of a swollen leg
Formation of small ulcers at the injection site.

Allergic reactions to the sclerosing agents may occur at the time of the injection and are rarely serious. If you have a history of allergies, you have a greater chance of experiencing an allergic reaction to the agents. A minor allergic reaction will cause itching and swelling. To avoid any serious complications, your doctor will test the agents on a small area before applying the solutions to a larger area.

After the treatment you will be able to drive yourself home and resume your regular daily activities. Walking is encouraged. You will be instructed to wear support hosiery to "compress" the treated vessels. If you have compression hosiery from previous treatments, you are encouraged to bring them with you to be certain they still have adequate compression. Department store support stockings will not be adequate if a heavy compression stocking is needed. Your doctor's office can recommend where to purchase heavy compression stockings.

Following the injections, avoid aspirin, ibuprofen or other anti-inflammatory medications for at least 48 hours. Tylenol may be used if needed.

Also, you should avoid applying the following to the injected areas for 48 hours after treatment:

Hot baths
Hot compresses
Whirlpools or saunas
Direct exposure to sunlight

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

How Effective Is Sclerotherapy?
Studies have shown that as many as 50%-80% of injected veins may be eliminated with each session of sclerotherapy. Less than 10% of the people who have sclerotherapy do not respond to the injections at all. In these instances, different solutions can be tried. Although this procedure works for most patients, there are no guarantees for success. In general, spider veins respond in three to six weeks, and larger veins respond in three to four months. If the veins respond to the treatment, they will not reappear. However, new veins may appear at the same rate as before. If needed, you may return for injections.