- What Is It?
- Does It Hurt?
- Varicose Veins
- Follow-up Care
Facts you should know about sclerotherapy
- During the sclerotherapy procedure, a health care professional injects chemicals into smaller veins, which damage the inner lining and produce a clot. As the clot is reabsorbed, the vessel is permanently obliterated.
- The choice of the chemical sclerosing agent and its physical form depend on the size of the vessel to be treated.
- Treatment of the correct vessels can improve the symptoms of venous insufficiency.
- Small superficial vessels are often destroyed for cosmetic reasons.
What is sclerotherapy?
Sclerotherapy is a medical procedure whereby a chemical, the sclerosant, is injected into a vein to entirely obliterate it. The sclerosant damages the innermost lining of the vessel (the endothelium), resulting in a clot that blocks the blood circulation in the vein beyond. Veins carry unoxygenated blood from the peripheral tissues back to the heart. Since the venous blood pressure in the veins is low, the blood is pumped by forward by contractions of the heart. To prevent back-flow, most veins have valves that only allow blood only to flow in the direction of the heart. When these valves become incompetent, veins become enlarged and bulging (varicose). Smaller veins that feed these varicose veins can also become enlarged and appear as red or blue spider veins in the skin. Varicose veins can lead to a chronic swelling condition of the leg called venous insufficiency. Venous insufficiency predisposes a person to leg swelling, blood clots, and skin ulceration. Even more frequently, damaged veins are manifested as unsightly spider veins. The destruction of these types of veins can be desirable both medically and cosmetically.
Is sclerotherapy safe?
All medical procedures have risks that should be considered carefully prior to embarking on a particular treatment. Since sclerotherapy is frequently used to treat cosmetic problems, untoward and dangerous side effects ought to be fully explained to the patient.
Does sclerotherapy hurt?
Because this procedure requires injections through the skin, it is not a painless procedure. Some chemicals that are injected (sclerosants) are more likely to cause pain than others. If the sclerosant is deposited outside the vein inadvertently, this is often more painful.
Is sclerotherapy an effective treatment for varicose veins and spider veins?
Sclerotherapy is an effective technique to obliterate or collapse veins. Other techniques include surgical removal of the offending vein, endovenous laser destruction (fiberoptic-transmitted laser light) and, for very small vessels, percutaneous laser light or intense pulsed-light exposure are also effective.
Who is a good candidate for sclerotherapy?
Those with venous insufficiency who have disease that is poorly controlled with compression stockings and who are not obese are ideal candidates for sclerotherapy. To determine if sclerotherapy obliteration is likely to be of benefit, the site of the defective vein is identified as well as the venous drainage pattern. Healthy people who complain of unsightly superficial veins of small caliber (4 mm or less) are also candidates for sclerotherapy.
How do people prepare for the sclerotherapy procedure?
Patients are screened using special ultrasound techniques to determine the site of venous disease prior to treatment. In situations where there is only a small area of spider veins, this is rarely done.
How does a doctor administer sclerotherapy injections?
There are now two FDA-approved sclerosants available, sodium tetradecyl sulfate (a detergent) and polidocanol (Asclera). For small veins, hypertonic saline is occasionally used. Depending on the size of the vein to be treated, the sclerosant may be administered as foam. A needle of the appropriate caliber is inserted into the vessel to be treated, and the chemical is injected.
What is the recovery time for sclerotherapy?
This is an outpatient procedure and the patient leaves the office on the same day of treatment.
What aftercare is needed following a sclerotherapy procedure?
Patients should wear compression dressings for one to three weeks after treatment. A follow-up visit within two weeks to enable the evacuation of blood clots in larger veins can improve the prognosis and the appearance.
What are the benefits of sclerotherapy?
For patients with venous insufficiency, treatment can be beneficial by improving venous blood flow and limiting chronic swelling. For those with cosmetic complaints, their appearance can be improved.
What are risks, side effects, and complications of sclerotherapy?
Sclerotherapy risks, side effects, and complications include hyperpigmentation, temporary swelling, capillary dilation (telangiectatic matting), pain from the injection, localized hives, tape compression blister, tape compression folliculitis, and recurrence, vasovagal reflex, localized hair growth (hirsutism), skin death (cutaneous necrosis), allergic reaction, superficial thrombophlebitis, arterial injection, pulmonary embolism, deep vein thrombosis, nerve damage, and migraine headaches.
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Goldman, Mitchel P. "My Sclerotherapy Technique for Telangiectasia and Reticular Veins." Dermatol Surg 36 (2010): 1040-1045.
Weiss, Margaret A., et al. "Consensus for Sclerotherapy." Dermatol Surg 40 (2014): 1309-1318.
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Allergy (Allergies)An allergy refers to a misguided reaction by our immune system in response to bodily contact with certain foreign substances. When these allergens come in contact with the body, it causes the immune system to develop an allergic reaction in people who are allergic to it. It is estimated that 50 million North Americans are affected by allergic conditions. The parts of the body that are prone to react to allergies include the eyes, nose, lungs, skin, and stomach. Common allergic disorders include hay fever, asthma, allergic eyes, allergic eczema, hives, and allergic shock.
BirthmarkA birthmark is any abnormal mark, spot, or bump that is present in or around the time of birth on the skin of an infant. Types of birthmarks include cafe au lait marks, Mongolian spots, strawberry marks, and others. Depending on the birthmark type, birthmarks can be removed by scalpel surgery, lasers, and rarely radiation.
Blood Clots (in the Leg)Blood clots can form in the heart, legs, arteries, veins, bladder, urinary tract, and uterus. Risk factors include high blood pressure and cholesterol, diabetes, smoking, and family history. Symptoms and treatment depend on the location of the clot.
Deep Vein Thrombosis (DVT, Blood Clot in the Legs)Deep vein thrombosis (DVT) is a blood clot in the deep veins, and can be caused by broken bones, trauma to a limb, immobility, medications, smoking, cancer, genetic predisposition, and cancer. Symptoms and signs of a deep vein thrombosis in a leg are swelling, tenderness, redness, warmth, and pain. Treatments for DVT include medications and surgery.
FolliculitisFolliculitis is a skin condition that causes small red bumps to form around the hair follicles. Skin bacteria such as Staphylococcus and Pseudomonas may infect the follicles. Treatment involves over-the-counter bacterial washes, topical antibiotics, and/or topical steroids.
Hives (Urticaria)Hives, also called urticaria, is a raised, itchy area of skin. Most often the cause of hives is unknown. Sometimes it is a sign of an allergic reaction to food or medications, but the cause of the allergy (the allergen) is unknown. Dermatographism and swelling (angioedema) may accompany hives. Treatment to get rid of hives and alleviate symptoms typically includes antihistamines.
Itching (Pruritus)Itching can be a common problem. Itches can be localized or generalized. There are many causes of itching including infection (jock itch, vaginal itch), disease (hyperthyroidism, liver or kidney), reactions to drugs, and skin infestations (pubic or body lice). Treatment for itching varies depending on the cause of the itch.
Pulmonary Embolism (Blood Clot in the Lung)A pulmonary embolism (PE) occurs when a piece of a blood clot from deep vein thrombosis (DVT) breaks off and travels to an artery in the lung where it blocks the artery and damages the lung. The most common symptoms of a pulmonary embolism are shortness of breath, chest pain, and a rapid heart rate. Causes of pulmonary embolism include prolonged immobilization, certain medications, smoking, cancer, pregnancy, and surgery. Pulmonary embolism can cause death if not treated promptly.
ScarsScar formation is a natural part of the healing process after injury. The depth and size of the wound incision and the location of the injury impact the scar's characteristics, but your age, heredity and even sex or ethnicity will affect how your skin reacts.
Varicose Veins SlideshowLearn the causes of spider veins and varicose veins and how to prevent them. Explore which treatments get rid of spider and varicose veins and view before-and-after vein treatment images.
Spider Veins PictureSpider Veins. Spider veins twist and turn and look like a spider’s web or tree branch. They are usually red, purple, or blue and easily visible through the skin. They are most often found on the legs and face.
UltrasoundUltrasound (and ultrasonography) is imaging of the body used in the medical diagnosis and screening of diseases and conditions such as:
- heart valve irregularities,
- carotid artery disease,
- heart disease,
- kidney stones,
- liver disease,
- diseases of the female reproductive, and
- diseases of the male reproductive organs.
Varicose VeinsA varicose vein is a dilated (widened) tortuous (twisting) vein, usually involving a superficial vein in the leg, often associated with incompetency of the valves in the vein. These visible and bulging veins are often associated with symptoms such as tired, heavy, or aching limbs. Spider veins are a group of widened veins that can be seen through the surface of the skin.
Why Do You Need Sclerotherapy?Sclerotherapy is a procedure in which a solution called “sclerosing agent” is injected into the veins for treatment of small vessel varicose disease (varicose veins). Sclerotherapy is typically performed on the legs for conditions such as telangiectasis, venulectasias, and reticular ectasias, all of which are different kinds of varicosites.