Sclerotherapy

If your veins are unsightly or uncomfortable, they can be treated by injection of a solution that will cause them to disappear or become much smaller. This procedure is called sclerotherapy. Both Spider Veins and Large Veins can be treated with Sclerotherapy.

Millions of men & women are bothered by spider veins - those small yet unsightly clusters of red, blue or purple veins that most commonly appear on the thighs, calves and ankles. In fact, it's estimated that at least half of the adult female population is plagued with this common cosmetic problem.

Today, many surgeons are treating spider veins with sclerotherapy. In this rather simple procedure, veins are injected with a sclerosing solution, which causes them to collapse and fade from view. The procedure may also remedy the bothersome symptoms associated with spider veins, including aching, burning, swelling and night cramps.

Although this procedure has been used in Europe for more than 50 years, it has only become popular in the United States during the past decade. The introduction of sclerosing agents that are mild enough to be used in small veins has made sclerotherapy predictable and relatively painless.

If you're considering sclerotherapy to improve your condition, this information will give you a basic understanding of the procedure - when it can help, how it's performed and what results you can expect. It won't answer all of your questions, since a lot depends on your individual circumstances. Please ask the doctor if there is anything about the procedure you don't understand.

The best candidates for sclerotherapy

Men & women of any age may be good candidates for sclerotherapy, but most fall in the 30-to-60 category. In some women, spider veins may become noticeable very early on - in the teen years. For others, the veins may not become obvious until they reach their 40s.

If you are pregnant or breastfeeding, you may be advised to postpone sclerotherapy treatment. In most cases, spider veins that surface during pregnancy will disappear on their own within three months after the baby is born. Also, because it's not known how sclerosing solutions may affect breast milk, nursing mothers are usually advised to wait until after they have stopped breastfeeding.

Spider veins in men aren't nearly as common as they are in women. Men who do have spider veins often don't consider them to be a cosmetic problem because the veins are usually concealed by hair growth on the leg. However, sclerotherapy is just as effective for men who seek treatment.

What to expect from sclerotherapy

Sclerotherapy can enhance your condition and your self confidence, but it's unrealistic to believe that every affected vein will disappear completely as a result of treatment. After each sclerotherapy session, the veins will appear lighter. Two or more sessions are usually required to achieve optimal results.

You should also be aware that the procedure treats only those veins that are currently visable; it does nothing to permanently alter the venous system or prevent new veins from surfacing in the future.

Before you decide to have sclerotherapy, think carefully about your expectations and discuss them with the doctor.

The procedure

A typical sclerotherapy session is relatively quick, lasting only about 15 to 30 minutes. After changing into shorts, your legs may be photographed for your medical records. You will be asked to lie down on the examination table and the skin over your spider veins will be cleaned with an antiseptic solution. Using one hand to stretch the skin taut, the doctor or nurse will begin injecting the sclerosing agent into the affected veins. Bright, indirect light and magnification help ensure that the process is completed with maximum precision.

Approximately one injection is administered for every inch of spider vein - anywhere from five to 40 injections per treatment session.

During the procedure, you may listen to music, read, or just talk to your practitioner. You will be asked to shift positions a few times during the process. As the procedure continues, you will feel small needle sticks and possibly a mild burning sensation. However, the needle used is so thin and the sclerosing solution is so mild that pain is usually minimal.

Risks related to the procedure

Serious medical complications from sclerotherapy are extremely rare when the procedure is performed. However, they may occur. Risks include the formation of blood clots in the veins, severe inflammation, adverse allergic reactions to the sclerosing solution and skin injury that could leave a small but permanent scar.

A common cosmetic complication is pigmentation irregularity - brownish splotches on the affected skin that may take months to fade, sometimes up to a year. Another problem that can occur is "telangiectatic matting," in which fine reddish blood vessels appear around the treated area, requiring further injections.

You can reduce the risks associated with treatment by choosing a doctor who has adequate training in sclerotherapy and is well versed in the different types of sclerosing agents available. A qualified doctor can help you select which type of sclerosing medication is most appropriate for your needs.

Planning your treatment

During your initial consultation, your legs will be examined. Your doctor may draw a simple sketch of your legs, mapping out the areas affected by spider veins or other problems. During the examination, you will be checked for signs of more serious "deep vein" problems, often indicated by swelling, sores, or skin changes at the ankle. A hand-held Doppler ultrasound device is used to detect any backflow within the venous system.

If such problems are identified, your surgeon may refer you to a different specialist for further evaluation. Problems with the larger veins must be treated first, or sclerotherapy of the surface veins will be unsuccessful.

Your doctor will ask you about any other problems you may have with your legs, such as pain, aching, itching or tenderness. You will also be asked about your medical history, medications you take, or conditions that would preclude you from having treatment. Individuals with hepatitis, AIDS or other blood-borne diseases may not be candidates for sclerotherapy. Patients with circulatory problems, heart conditions, or diabetes may also be advised against treatment.

It's important to be open in discussing your history and treatment goals with the doctor. Don't hesitate to ask any questions or express any concerns you may have. The doctor should explain the procedure in detail, along with its risks and benefits, the recovery period and the costs. (Medical insurance usually doesn't cover cosmetic procedures.)

Preparing for your procedure

You will receive specific instructions from the physician on how to prepare for your treatment. Carefully following these instructions will help the procedure go more smoothly.

You'll be instructed not to apply any type of moisturizer, sunblock or oil to your legs on the day of your procedure. You may want to bring shorts to wear during the injections, as well as your physician-prescribed support hose, and slacks to wear home.

When scheduling your procedure, keep in mind that your legs may be bruised or slightly discolored for some weeks afterward. You probably won't be comfortable wearing shorts, a swimsuit or a mini skirt until after your legs have cleared up a bit.

After the procedure

Tight-fitting support hose may be prescribed to guard against blood clots and to promote healing. You may be instructed to wear the support hose for 24 hours or more.

It's not uncommon to experience some cramping in the legs for the first day or two after the injections. This temporary problem usually doesn't require medication.

You should be aware that your treated veins will look worse before they begin to look better. When the compression is removed, you will notice bruising and reddish areas at the injection sites. The bruises will diminish within two weeks. In many cases, there may be some residual brownish pigmentation which may take up to a year to completely fade.

Getting back to normal

Although you probably won't want to wear any leg-baring fashions for about two weeks, your activity will not be significantly limited in any other way from sclerotherapy treatment.

You will be encouraged to walk to prevent clots from forming in the deep veins of the legs. However, during the period of time to complete your treatment program, prolonged sitting and standing should be avoided, as should squatting, heavy weight lifting and "pounding" type exercises, including jogging.

A one-month healing interval must pass before you may have your second series of injections in the same site. After each treatment, you will notice further improvement of your legs' appearance.