Sclerotherapy
Sclerotherapy is a minimally invasive procedure that effectively treats varicose veins and spider veins. It's often considered the treatment of choice for varicose veins and spider veins. Sclerotherapy is a procedure used to shrink and collapse abnormal veins by injecting an FDA-approved chemical agent into the vein that destroys the vein.
Varicose veins appear as swollen and bulging veins in the legs. As the vein valves weaken or become damaged, blood pools in the veins, causing them to swell. Varicose veins are painful and can lead to serious health issues if left untreated. By shrinking the veins, sclerotherapy can reduce the effect of vein damage, making them less visible and painful.
Spider veins are web-like veins. Spider veins are more of a cosmetic issue than a physical health issue.
People with varicose veins and spider veins should consider sclerotherapy when these symptoms are present:
Leg aching
Leg heaviness
Itching & Burning
Leg Ulcer
Eczema
Skin Discoloration
Muscle Cramps
Undesirable appearance of veins
Benefits of Sclerothearpy
Minimally invasive, non-surgical
High success rate, up to 80% closure with each treatment
Office-based procedure
No general anesthesia
No downtime
Fewer side effects than traditional vein “stripping”
Sclerotherapy Effectiveness
You can expect to see the results for small varicose and spider veins in 3 to 6 weeks. Larger veins may require three to four months and multiple sessions might be needed.
Once your problematic veins are treated, they won't come back. However, new veins may appear over time. Our vein specialists recommend you follow conservative therapy to protect and maintain your leg health. At home measures include:
Wearing compression stockings when feasible
Follow a healthy diet
Maintain a healthy weight
Avoid smoking
Exercising frequency
Elevating your legs at the end of the day
Procedure
The procedure is done by a board-certified vein specialist and is completed within 15 to 30 minutes. The vein provider uses a very fine needle to inject the sclerosant into the vein. The solution irritates the lining of the blood vessel and causes it to collapse.
Over time, the vessel turns into scar tissue and fades away. Depending on the size and location of the treated veins, the number of veins injected in one session will vary.
Up to 80% of treated veins will be eliminated with each sclerotherapy session. Several sessions are sometimes required to eliminate the majority of veins.
Fig. 1: Ulstra sound is used to precisely locate the affected vein(s)
Fig. 2: The sclerosant drug is injected into the affected caricose vein(s) causing the vein(s) to collapse
The sclerosant drug is inject into the affected surface vein(s) causing the vein(s) to collapse
Pre-Treatment Instructions:
Bring your compression stockings with you for each appointment.
Bring comfortable shoes for walking.
Avoid using lotions on your legs the day of your sclerotherapy session.
Drink 64oz of water and avoid alcohol the day prior to your sclerotherapy session.
Drink 32oz of water and avoid caffeine/coffee the day of your sclerotherapy session.
Report any medication, allergies, or changes in your medical condition before your session.
Post-Treatment Instructions:
After sclerotherapy a compression stocking will be applied. After walking for 10-20 minutes, you will be able to drive yourself home.
You will be instructed to wear compression stockings continuously for 2 days (sleep in them for 2 nights). Thereafter, you will put your stockings on in the morning and take them off at night for 5 additional days. 7 days of stockings TOTAL. You don’t need wear them while showering.
You may resume most of your regular activities immediately, excluding running, jumping and other strenuous activities that involve your core muscle group (torso area). Do not lift more than 40 pounds for 1 week. You may resume normal workouts after 1 week.
Avoid air travel for 1 week following a sclerotherapy session.
Avoid hot tubs, baths, lakes or swimming pools for 1 week.
Walk at least 30-60 minutes per day following the procedure.
Use Ibuprofen (up to 600mg 3 times within a 24-hour period) or Tylenol (up to 1000mg 3 times within a 24-hour period) for discomfort.
Sclerotherapy Effectiveness
You can expect to see the results for small varicose and spider veins in 3 to 6 weeks. Larger veins may require three to four months and multiple sessions may be needed.
Once your problematic veins are treated, they won’t come back. However, new veins may appear over time. Our vein specialists recommend you follow conservative therapy to protect and maintain your leg health. At home measures include:
Wear compression stockings when feasible
Follow a healthy diet
Maintain a healthy weight
Avoid smoking
Exercise frequently
Elevate your legs at the end of the day
What to expect after Medical Sclerotherapy
Expect bruising, which can be extensive. This is temporary and resolves gradually over several weeks.
Soreness or tenderness at injection sites is normal for 1-2 days. You may experience a stinging or burning sensation that lasts minutes to hours directly following the procedure. This is a sign that the medication is working in the vein. Walking and wearing compression stockings are recommended.
One or more areas of pain, redness and swelling may occur and usually are delayed by several days to weeks after the procedure. Blood can become trapped in closing veins as they heal and this can cause tender, sometimes lumpy areas in treated veins. If you develop tender spots you may want to begin taking an over-the-counter pain medication such as acetaminophen (Tylenol) or an NSAID (Ibuprofen, Advil, Motrin, Aleve, Naproxen). NSAIDs tend to be more effective at reducing the inflammation that causes pain. Always check with your primary care provider before taking any new medication. Consult the medication packaging instructions regarding maximum dosing or ask your pharmacist. Using this medication daily for 1-2 weeks can help reduce inflammation and speed your recovery even if it does not take the pain away entirely. Expect this pain to improve gradually over several weeks. Continue to wear your compression stockings during the day and continue walking a minimum of 40 min throughout the day as long as you are having discomfort. Call the office for an appointment if you are having significant pain or extreme discomfort. An US evaluation may be recommended to verify the source of your pain and guide your treatment.
Lasting numbness in the treatment area is not uncommon. This gradually improves over weeks to months.
Brown, tan or yellow staining of the skin (hyperpigmentation) may occur over the treated vein as it is being absorbed. This will lighten gradually over 6-24 months.
Generally, you will notice improvement in your symptoms over several weeks.
Optimal cosmetic improvement generally takes longer. 8) Vein disease is chronic and progressive. New veins will become unhealthy over time Expect to follow up with your vein specialists at Physicians Vein Clinics.
Sclerotherapy FAQs
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A: Swelling can occur over treated veins which is normal and a sign of successful treatment. Therefore, it is common to notice multiple areas of swelling after treatment. You may also notice lumpiness and tenderness in the areas of swelling. Call the clinic if you notice generalized swelling of the leg, calf, ankle and/ or foot after treatment, particularly if it is more pronounced in one leg compared to the other.
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A: Numbness is not uncommon after vein procedures. Skin nerves can be affected during the procedure which can cause numbness, tingling or “pins and needles”. This is not worrisome and generally improves gradually over several months
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A: You can expect significant bruising after vein procedures. This resolves slowly over 4-6 weeks. You may try an over-the-counter bruise remedy such as Arnica from your local pharmacy. Ask the pharmacist any questions you may have regarding this medication.
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A: Yes, new veins can appear when unhealthy veins are treated. These are existing veins that become congested and visible. Sometimes they are so small and numerous they give a “matting” appearance. Matting typically improves or completely resolves within 6-12 months.
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A: You may remove any bandages on the day following your procedure or anytime thereafter.
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A: You can shower the day following your procedure.
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A: Migraines can be triggered by vein procedures. Treat these as you normally would. You may have migraines with future treatments and should plan to have migraine medication on hand at the time of treatment.
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A: Call 911 anytime you think you may need emergency care. If you faint or pass out, difficulty breathing or can’t catch your breath, sudden chest pain, shortness of breath or cough up blood.
Call the clinic or seek immediate medical care for: sores or wounds at injection sites. Signs concerning for a deep blood clot-pain or generalized swelling in the leg, calf, ankl. Vision or balance issues. Pain doesn’t resolve with medication. Signs of infection pus draining from injection area, redness and pain around injection site.
