What is Sclerotherapy?
Bye-bye unsightly and unwanted veins. With sclerotherapy we can treat the majority of unwanted veins with a simple noninvasive treatment. Spider veins and varicose veins can be an inherited tendency or arise from weight fluctuations, pregnancy, or trauma.*
When the valves within the veins weaken, blood pools inside the veins, expanding them and pushing them closer to the skin surface. Often, the legs might ache or feel heavy and tired as a result of these veins.*
Sclerotherapy involves injecting a solution such as hypertonic saline or sotradecol in the form of foam sclerotherapy into the vein as an irritant. As it travels through the abnormal vein, the solution irritates and shuts the vein down. The body absorbs the dying veins and they are effectively treated long term.*
Treatments are done every 2-3 weeks apart. We ask patients to wear support stockings for 36 hours after each procedure. Treating these inefficient veins allows the overall vascular system to function more efficiently*.
How Does Sclerotherapy Work?
Sclerotherapy involves using tiny needles to inject a sclerosing solution (either hypertonic saline or asclera foam) into spider, reticular and some varicose veins, causing them to collapse and fade. Not only should your leg’s appearance improve dramatically, but the bothersome symptoms associated with spider veins should also significantly improve, including burning, aching, swelling and night cramps.*
Who Are the Best Candidates for Sclerotherapy?
Men and women dealing with unsightly or uncomfortable veins who are otherwise in good health are good candidates for sclerotherapy. If you are pregnant we advise postponing sclerotherapy. Some of the veins present during pregnancy may spontaneously collapse months after delivery, making treatment easier and in some cases, unnecessary*.
What to Expect During a Sclerotherapy Session?
Sclerotherapy is a technique used to shut down cosmetically unsightly or painful spider and varicose veins. It is most commonly used to treat veins in the legs and hands, and occasionally on the face, chest or back. During the procedure, a thin needle is inserted into the vein and a solution of highly concentrated salt water (saline) or anionic surfactant (sotradecol) is slowly injected into the offending vein. The vein wall reacts to the solution and causes the vein to collapse and shut down. After the treatment, some veins almost immediately disappear, but the majority look reddened and swollen. This is followed by a little bruising and sometimes hardening of the vessels. As the vessels are dying, they sometimes appear greenish until all the blood trapped inside the dying vessel resolves. It typically takes anywhere from one to four weeks to see the results of the treatment. The majority of veins collapse after just the first treatment. The surviving veins can be retreated until a satisfactory result is achieved. Sclerotherapy is one of the most popular procedures we perform and it is extremely successful in treating the majority of spider and varicose vein problems our patients present with. A typical spider vein treatment session is relatively quick, lasting anywhere from a few minutes to an hour, depending on the number of veins and the complexity. While lying on an examination table, the veins are injected with a tiny needle using either hypertonic saline or foam sclerotherapy. We mix a local anesthetic into our solution for greater comfort. Dr. Gupta will locate the feeder vessels and inject those first, moving then to the smaller vessels. Some patients will experience some cramping and burning during the procedure. This dissipates very quickly. Typically, for any given area, two to three spider vein treatment sessions are required to achieve the best results.*
Is There Any Pain After Schlerotherapy?
There may be mild to moderate discomfort or tenderness in the treated areas for up to a few hours. Some of the larger vessels treated will continue to be uncomfortable until the vein dissolves. Anti-inflammatory medications as well as herbal homeopathic preparations can be helpful in minimizing these symptoms.*
When is the Best Time of the Year to Have Sclerotherapy?
Sclerotherapy can be performed all year. However, many patients prefer to wear the compression stockings (worn for 48-72 hours post procedure) during the colder winter months. Also, the veins take several weeks to months to fully resolve. The bruising and pigmentation can also take several weeks to resolve, again depending on the size and extent of vessels involved. So to be ready for Summer, we recommend Winter and Spring as ideal treatment months*.
*Before and after results will vary from patient to patient
Is Sclerotherapy Safe?
In expert hands, sclerotherapy is remarkably safe. Serious complications like deep vein clotting or major allergic reactions are rare. Some side effects (like bruising, tenderness, itching, pigmentation, matting, etc) may occur, but are manageable and not very serious in nature. Additionally, besides the legs looking and feeling better, sclerotherapy improves overall blood flow and health of the legs, preventing future problems from vein disease.*
What Are the Side Effects of Sclerotherapy?
Common side effects of spider vein treatment with sclerotherapy are usually temporary and well tolerated. The most common side effects of sclerotherapy include:
Swelling, redness, tenderness and itching (these tend to gradually disappear within hours to days).
Some bruising and retained dark blood clots in the treated veins (some bruising almost always occurs, but gradually fades over a few weeks in most cases).
Brown pigmentation and matting (the appearance of blush like microscopic network of fine red vessels).
A Small skin ulceration that would heal leaving a permanent scar. This should be rare event in experienced hands and is minimized by a meticulous technique and use of the mildest solution that can achieve the desired result.
Allergic reactions to the commonly used sclerotherapy solutions (tends to be very rare).*
Why Does Pigmentation Occur?
Pigmentation develops as a result of the trapped blood within the vessel slowly oxidizing and leaking into the skin. It gradually fades with time. If quicker resolution is important, then this pigmentation can be treated with the Q-switched laser to break the hemoglobin up faster.*
What Can One Do to Treat the Matting that Sometimes Follows Sclerotherapy?
Matting, not a common side effect, may disappear even if untreated. In resistant cases it may be treated with a combination of sclerotherapy and or light based treatments like lasers and IPL (Intense Pulsed Light).*
How should I prepare for Sclerotherapy?
Avoid NSAID medications (such as ibuprofen, Advil, Motrin), vitamin E, or herbal supplements that increase your chances of bruising. Do not apply any lotions to your skin the day of your procedure. We recommend you bring a pair of shorts to wear during the treatment session. If you already own a pair of 15-20 mm Hg compression stockings, please bring them along. If you do not have compression stockings, we stock a variety of sizes and will provide you with a pair. Some patients prefer having two pairs to interchange between showering.*
How Long Should One Wait Between Sclerotherapy Sessions?
In most cases it is recommended to wait about 3 weeks before re-treating a particular area.*
How Long Does it Take for the Spider Veins to Disappear?
Most veins should disappear between 2 weeks and two months, although in select cases the process may take somewhat longer.*
Are There Any Particular Instructions for After Sclerotherapy?
It is recommended to engage in moderate physical activity, wear the prescribed compression stocking, and avoid sun exposure of the area while healing.*
What Sort of Activities One Should or Should Not be Doing After Sclerotherapy?
Moderate physical activities that involve the use of the legs like walking, cycling, hiking, use of the treadmill or elliptical exercise machines are most encouraged. These activities enhance the blood flow to the legs and speed up the circulation. Activities that lead to venous pooling in the legs, on the other hand, should be avoided. These include lifting of heavy weights, belly crunches and any exercise that increase the core pressure of the body, as well as extreme heat environments like hot tubs, sauna, or intense exercise. These tend to dilate the veins and result in venous pooling.*
Why to Wear Compression Stockings After Sclerotherapy
For most vessels other than the tiniest spider veins, the compression stockings are believed to increase the effectiveness and safety of the procedure. Compression stockings keep the treated and injured vessels compressed and help them heal shut, preventing the trapping of blood in them. Trapped blood in these veins may cause unnecessary pain, inflammation and pigmentation, as well as decreased effectiveness of sclerotherapy. In addition, compression pushes the venous blood out of the leg faster, accelerates the blood circulation in the legs and potentially minimizes chances of an unintended secondary clot formation in any of the non-targeted vessels. This, of course, increases the safety and comfort of the procedure.*
How Long do I Wear Compression Stockings After Sclerotherapy?
We recommend wearing the compression stockings for 2-3 days after the procedure. Sleep in them the first night only. After that, put them on first thing in the morning and take them off last thing at night, before sleep. You can also remove them for a quick lukewarm shower, but avoid hot baths or sauna, as these further dilate your veins.*
Is There a Downtime After Sclerotherapy?
No time off work is typically needed.*
When Should One Not Have Sclerotherapy?
Sclerotherapy should be avoided if someone is bedridden, cannot be physically active for whatever reason, or if planning to tan in the weeks following a treatment. A history of allergic reaction to one of the sclerotherapy solutions or history of blood clots in the legs may also make a patient unsuitable for this kind of treatment. Pregnant patients should also wait for 3-6 months before considering sclerotherapy treatments.*
Can You Have Sclerotherapy Before a Vacation Trip?
Vacation trips often involve long periods of immobility in a car or an airplane and therefore are best avoided for at least 5 days after a sclerotherapy treatment session. If travel does occur within two weeks after sclerotherapy, make sure you keep your compression garment on during the trip and try to move as much as possible. Stationary leg exercises are a good idea.*
How Soon Can You Tan After Sclerotherpy?
Since sun exposure of an inflamed area increases the risk of pigmentation, one should avoid tanning until all bruising has disappeared.
Is the Use of Spray Tanners Allowed After Sclerotherapy?
Yes, it’s perfectly fine before and after treatment.
Do the Treated Spider Veins Come Back?
Once treated effectively, the treated veins should not come back. However your body will make new ones over time, at about the same rate as before. Remember, sclerotherapy is not a cure for this condition but an effective treatment that does not take away your body’s predisposition to make new spider and blue veins in the future.*
Why to Treat Spider Veins if New Veins Are Expected in the Future?
If untreated, spider and blue veins always get worse over the years, multiplying, branching out, getting thicker and more unsightly. These veins would then take longer to treat, require more re-treatment sessions, would take longer to heal and with higher chances of side effects like pigmentation.*
How Often Should Leg Spider Veins be Treated in the Future?
Most patients need to have periodic follow up spider vein treatment sessions to maintain optimal results. The frequency varies from a year to several years*.