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    Sclerotherapy

    The Procedure | The Benefits | After the Procedure | FAQs | Before & After Photos

    The Procedure

    Sclerotherapy involves the direct injection of a sclerosing agent into the varicose vein using a very fine needle. This chemical solution irritates the vein tissue, causing the lining of the vein to swell, harden and eventually seal off.

    Before treatment, a complete medical history is taken and a thorough medical examination is conducted. This is done to determine how long the problem has existed, the severity of the symptoms, and whether or not the condition is affected by physical activity. It is also done to see if you have undergone prior surgery or other vein therapy. At this time, the physician assesses if your deep vein system is affected. If so, he or she may recommend that you have surgery before undergoing sclerotherapy.

    Preprocedure instructions may include the elimination of certain drugs that contain aspirin to minimize the possibility of excessive bleeding. The physician also decides whether or not the area to be treated should be shaven. Then, each vein to be treated is mapped out and marked using a special pen. After the skin has been thoroughly cleansed with alcohol, the physician injects a small amount of the sclerosing agent directly into the vein. Larger varicose veins are generally treated first.

    Once injected, the sclerosing agent causes the blood within the vein to blanch or turn white. It also irritates the vein itself so that it swells shut, keeping blood from re-entering it post-treatment. When the needle is withdrawn, pressure is immediately applied to the area. Sometimes, the skin is kneaded to help distribute the solution evenly and to reduce bruising. Each varicose vein treated using sclerotherapy may require several injections but should disappear within 2 weeks to 2 months.


    The Benefits

    The benefits to sclerotherapy for varicose veins include:

    • Gets rid of unsightly veins
    • Doesn’t interfere with normal daily activities
    • Safe, virtually painless, in-office treatment
    • Relief of symptoms
    • Nearly immediate visible results

    After the Procedure

    Patients who have had sclerotherapy have reported little discomfort. Some experience a slight to moderate burning sensation immediately after the injection, but this disappears within a few seconds. An ointment to soothe the skin and relieve the burning may be used. And a pressure bandage may be applied to prevent post-injection bleeding. Some physicians prefer to use elastic stockings. Others use compression bandages.

    Sclerotherapy patients are generally advised to return to normal daily activity immediately following the procedure. Vigorous physical activity is discouraged for 24 hours, however. Walking right away after sclerotherapy is encouraged because it increases bloodflow through the remaining healthy veins that bring blood back toward the heart. Elevating your legs usually isn’t recommended unless large varicose veins have been treated.

    Most patients experience no adverse effects from sclerotherapy, but some minor side effects have been reported. These include slight blistering that occurs when small amounts of the injected solution seep into the surrounding areas. This usually goes away with time, and additional treatment with bleaching agents can help.

    Bruising around the treated area can result if the veins are unusually weak but eventually disappears. Fair-skinned people tend to bruise more than dark-skinned people. Clots sometimes develop at the site of the injection. Although not a major cause for concern, it may be necessary to remove these clots within 2 weeks to better allow the healing process to progress normally.

    A small percentage of patients develop a network of tiny pink vessels that turn white when pressure is applied. This condition, referred to as "matte telangiectasia," usually disappears without treatment. But sometimes injection treatment is needed. Occasionally, patients have allergic reactions to the injected solution. When this occurs, a health care provider uses antihistamines and other medications to offset the reaction right away. When large varicose veins are treated, wearing support hose is recommended to prevent recurrence.


    FAQs

    What is sclerotherapy?
    Sclerotherapy is a procedure during which a physician uses a syringe with a very fine needle to inject a small amount of solution (a sclerosing agent) directly into the vein. After injection, a pressure bandage is applied to the site to compress the vein.

    Which veins can be injected?
    Spider veins and moderately sized varicose veins can be injected with the sclerosing agent.

    Is the injection procedure painful?
    It's usually painless because the solution injected isn’t very concentrated. Still, you may feel a slight stinging or burning sensation as it’s injected.

    What are the potential complications of the procedure?
    Though rare, serious complications of sclerotherapy include:

    • Allergy from the sclerosing agent. This doesn’t occur with the use of hypertonic saline.
    • Ulceration. This will eventually heal, leaving a small scar, or may be removed surgically.
    • Deep vein thrombosis. The risk is very low, but it occasionally follows sclerotherapy of larger varicose veins. Deep vein thrombosis is more likely in patients predisposed to blood clotting through inherited thrombophilia. Lack of exercise, air travel, recent surgery and other factors increase the possibility of this condition.

    The following complications occur more frequently:

    • Staining or brown pigmentation at the site treated or along the vein path. This occurs in about 30% of patients. In most cases, this goes away naturally but may take several months.
    • Clots within the treated veins. These aren’t dangerous but can feel quite tender in larger veins. Clots can be removed using a needle, but left alone they’ll eventually be absorbed by the body.
    • Temporary bruising at the injection sites. This is quite common but goes away within a week or so.

    Will I have any bandages or elastic wraps after injection?
    Foam tape bandages and a temporary pressure dressing are usually applied for a few days at the physician's discretion. For larger treated veins, pressure bandages may be required for several days. Support hose should be worn to help prevent future vein problems.

    Will my insurance cover sclerotherapy?
    Most insurance companies don’t pay for sclerotherapy if it’s done for cosmetic reasons. Some insurance companies do pay for treatment if you feel pain or discomfort that impedes normal daily activity. Each insurance company is different. We recommend that you check with your insurance agent to determine coverage.


    Before & After Photos

    Before & After Photos: Sclerotherapy

     


     

     

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