Sclerotherapy

Overview

Sclerotherapy is a medical procedure primarily used to treat varicose veins and spider veins, often seen on the legs. In this process, a healthcare provider uses a needle to inject a specialized solution directly into the problematic vein. This solution causes irritation along the vein’s lining, leading it to expand, stick together, and eventually develop scar tissue. Consequently, the vein is sealed off, resulting in enhanced appearance and sensation.

Following sclerotherapy, the veins that have been treated typically begin to diminish within a few weeks, although complete disappearance may not occur immediately. It may take a month or longer to see the full results. Certain veins may require multiple sclerotherapy sessions for optimal treatment.

Reasons for undergoing the procedure

Sclerotherapy could be suitable for individuals dealing with varicose veins or spider veins, but it’s not universally applicable. Prior to undergoing the procedure, you’ll have a consultation with a vascular specialist who will assess your eligibility for sclerotherapy. You may not qualify for sclerotherapy if you:

• Have a blood clot (superficial vein thrombosis) or deep vein thrombosis that is currently active.
• Are expecting a child. It will take you at least three months following delivery to receive sclerotherapy.
• Nursing (breastfeeding) a baby.
• Unable to move from bed.

Sclerotherapy remains a viable option even for individuals using birth control pills. However, eligibility for sclerotherapy after a previous blood clot hinges on the clot’s cause and severity. Generally, certain veins critical for potential future surgical bypass procedures, like the saphenous vein for coronary artery bypass graft surgery, are not typically treated unless they are already deemed unusable.

Discussing the potential success of sclerotherapy with your healthcare provider is recommended, especially for those with high expectations, as outcomes may not meet every individual’s desired results. Understanding the expected outcomes helps in managing expectations. It’s essential to note that results are not instantaneous; immediate transformation into flawless legs should not be anticipated upon leaving the provider’s office.

Risks

Sclerotherapy typically requires more time than surgery for varicose veins or spider veins and may also entail certain side effects.

Potential side effects of sclerotherapy include:

• Injection site redness should subside in a few days; larger injected veins may become lumpy or hard for several months.
• Within three to six months, brown lines or spots on your skin where the injection was made normally disappear. On the other hand, they may be permanent in around 5% of cases.
• Bruising at the injection site may persist for a few days or weeks.
• The treated area may grow tiny blood vessels. After your sclerotherapy, they might show up for a few days or weeks, but they should go away in a few months. In most cases, they don’t require further care.
• Although they are rarely severe, allergic reactions to the substance being injected may occur at the moment of the injection. Swelling and itching are among the symptoms.

Rarely, other side effects may occur following sclerotherapy. If you experience any of these uncommon side effects, it’s important to contact your doctor immediately:

• Swelling or inflammation that is five inches or less from your groin.
• A sudden swelling ofyour leg.
• The development of tiny sores at the injection site.
• Red streaks, particularly in the groin region.

Before the procedure

Prior to your sclerotherapy treatment, it’s important to adhere to certain medication guidelines. Here’s what you should know:

• Avoid antibiotics like tetracycline or minocycline for seven to 10 days before and after sclerotherapy to prevent skin staining. Consult your doctor for alternative antibiotics or safe discontinuation guidelines. Inform your provider if you require antibiotics before invasive procedures.
• Refrain from taking aspirin, ibuprofen, or other anti-inflammatory medications 48 hours before and after sclerotherapy. These medications may interfere with the effectiveness of the sclerosing agent or increase bleeding. Acetaminophen is generally safe to take. Seek specific instructions from your doctor before discontinuing any medication.
• Prednisone can reduce the effectiveness of the sclerosing agent. Consult the doctor who prescribed your prednisone to determine if it’s safe to stop taking it for 48 hours before your sclerotherapy treatment.

Additional instructions to follow before your procedure include:

• Refrain from applying lotion to your legs both before and after sclerotherapy.
• Remember to bring a pair of shorts to wear during your procedure.
• If you possess compression hosiery (support stockings) from prior treatments, bring them along to ensure they provide adequate support post-procedure, as your doctor may need to assess their suitability.

During the procedure

Sclerotherapy will be conducted by your doctor within their office setting. They might utilize ultrasound technology to assist in identifying the targeted vein for treatment.

The procedure typically lasts between 30 to 45 minutes. You will be positioned either on your back or stomach, depending on the location of the vein being treated.

Multiple chemicals are available for use in sclerotherapy, giving your provider a range of options to choose from. They will determine the appropriate chemical and its concentration based on the size of the vein under treatment.

Before commencing the procedure, your doctor may administer a test injection and observe for any adverse reactions.

The steps involved in the procedure include:

• Cleanse the treatment area.
• Stretch the skin around the injection site outward. An assistant may lend a hand in this process while your provider prepares to insert the needle into your skin.
• Use tiny needles to inject a liquid or foam solution straight into your blood vessel. The needle will pinch your skin, and you can experience a slight burning sensation as well. A slight discomfort during the injection process is possible. During the injection, you can experience cramping in larger veins for a minute or two.

The size, location, and general health of your veins will determine how many veins your doctor treats in a single session.

After the procedure

Following your treatment, your doctor may request you to remain lying down for approximately 15 minutes to monitor for any adverse reactions to the injected material.

You will be able to drive yourself home afterward and resume your normal activities, particularly walking.

It’s advisable to wear support hosiery or compression wraps for three to seven days to compress the treated vessels. Note that support stockings bought from a department store may not suffice if your doctor prescribes a heavy compression stocking.

For the 48 hours following your procedure, adhere to these guidelines:

• Steer clear of ibuprofen, aspirin, and other anti-inflammatory drugs. If acetaminophen is necessary for your pain, you can take it.
• Avoid using saunas, whirlpools, and hot tubs. Showering is OK, but the water should be colder than normal.
• Use lukewarm water and mild soap to wash the injection sites.
• Avoid using any kind of heat, including hot compresses, on the treated areas.
• Steer clear of direct sunlight (including tanning beds and the sun tanning).

If you have any concerns or questions following your procedure, don’t hesitate to reach out to your provider.

Outcome

The effects of sclerotherapy on small varicose veins or spider veins usually become noticeable within 3 to 6 weeks, while larger veins may take 3 to 4 months to display results. Multiple treatments are often necessary to achieve desired outcomes.

Veins that respond to treatment generally do not reappear, but there’s a chance of new veins emerging over time.

Recovery from sclerotherapy is typically quick. After the procedure, you can drive yourself home and resume your regular activities. Your doctor may advise walking as beneficial for your recovery, so receiving such a recommendation is common.