Sclerotherapy is a treatment for the removal of spider veins and smaller varicose veins. Veins are injected with a sterile chemical sclerant, which irritates the vessel's lining, making it become inflamed, harden, and eventually fade away completely. Blood circulation is carried out through healthy veins located deeper within the body, so the outward appearance and sometimes pain associated with the problem veins is significantly reduced.
Below, Dr. Bruce Hoyle explains the treatment and who can benefit from it.
What are spider veins?
Spider veins, or telangiectasias, are tiny veins that constantly look dilated. Caused by weak vascular walls and inefficient circulation, spider veins cause no health problems but many people feel they look unappealing. Spider veins can sometimes resemble a spider: a large dark spot with thin veins radiating out of it, or they may appear in other patterns and variations in different places in the body. Frequently occurring in the legs, spider veins can be dark or lighter shades of blue, purple, or red.
How is the procedure performed?
The treatment area will be sterilized, then the doctor will begin injecting the sclerosant into first the larger veins, then smaller ones, monitoring the progress of the chemical throughout the process. For every inch of vein treated, one injection will likely be administered. Since the injection needle is so small, patients often feel little pain and do not need any anesthesia. The injection process typically is complete in just 15 to 30 minutes. A minor stinging or burning sensation is common during and right after the injections are made, but is short lived. After the treatment is finished, a bandage will be applied and most physicians recommend the use of compression or support hose for at least a few days.
What happens after sclerotherapy treatment?
Any discomfort can be easily managed with over the counter pain medications, and is alleviated by the use of compression bandages or hose. Some mild bruising, itching, and swelling at the injection site is normal, but otherwise side effects are uncommon and short in duration.
What are side effects of sclerotherapy?
Because the procedure is minimally-invasive, very few side effects are associated with it. Some minor itching and burning immediately after the treatment is normal and quickly fades. In rare cases, allergic reactions, infection at the injection site, or complications associated with poor injection technique are possible. The potential for side effects can be reduced by choosing an experienced, reputable specialist to administer the procedure.
Where is the procedure done?
Since sclerotherapy is minimally-invasive and almost pain-free, it can be performed at a doctor's office or other outpatient clinic. Anesthesia is not needed and complications are infrequent. Although sclerotherapy is very safe, it is considered to be so only when administered by a professional.
Can sclerotherapy be used to treat large varicose veins?
Because they require more sclerant injected than is safe, large varicose veins are not treated with sclerotherapy. Small to medium sized veins respond best to sclerotherapy procedures. There are many other techniques available for the effective treatment of larger vein problems, which you can discuss with your vascular specialist.
How many sclerotherapy treatments are required?
The number of sessions required depends on the depth, number, and size of the veins being treated. While some patients are happy with the results after just one treatment, others may desire further injections for the optimal effect. These follow up treatments should be spaced at least four weeks apart so that the affects of the previous treatment can be accurately evaluated before injecting more. Patients can determine the amount of treatments they may need and the cost associated with them by discussing their situation with their specialist.
Do I have to limit any activity after the treatment?
It is important to walk regularly to encourage good circulation after you have had sclerotherapy. You should not participate in any strenuous activity for the initial days after your treatment.
Can sclerotherapy be done on the arms or face?
Yes, it is currently considered safe to perform sclerotherapy on the hands, arms, face and other areas previously avoided in this treatment. Talk with your doctor about the options available for treating blemishes and vein problems in these delicate areas.
How long is each sclerotherapy session?
The injection portion of each session takes on average only 15 to 30 minutes to complete, though this can vary depending on the size and extent of the treatment area.
Can anyone undergo sclerotherapy?
Nearly everyone with unsightly spider veins is eligible for treatment, unless they are pregnant or breastfeeding. Also, individuals with skin infections, uncontrolled diabetes, a history of deep vein thrombosis, and those who are taking anticoagulants or corticosteroids should not have sclerotherapy. If you are unsure of your candidacy, consult a specialist for a personal evaluation.
Is there any preparation required before sclerotherapy?
There is no formal regimen for the preparation of sclerotherapy, although doctors will recommend that patients stop taking aspirin and smoking during the few days before the treatment.
What chemicals are used for sclerotherapy?
The most widespread substances used as sclering agents in sclerotherapy are polidocanol (aethoxysklerol), sodium tetradecyl sulfate, and saline solution at 11.7% concentration. Your doctor may recommend other chemicals based on your individual needs.
Does insurance cover sclerotherapy?
Most insurance providers do not cover cosmetic procedures, including sclerotherapy for the treatment of spider veins, because it is not deemed a medially necessary procedure. If the patient is experiencing negative medical side effects such as pain as a result of the dysfunctional vein, the procedure may be covered to an extent. Talk to your insurance carrier for more information.
Who should treat my veins?
Phlebologists, dermatologists, vascular surgeons, interventional radiologists and plastic surgeons are all able to perform sclerotherapy and other vein related procedures. Selecting a specialist with extensive experience and a satisfied client base is the first step to a positive solution to your vein problems.
Disclaimer: This information is intended only as an introduction to this procedure. This information should not be used to determine whether you will have the procedure performed nor does it guarantee results of your elective surgery. Further details regarding surgical standards and procedures should be discussed with your physician.
By VeinDirectory.org Staff
Updated: October 14, 2009
Dr. Sharma has performed major vascular and general surgeries in the Valley since 1995. He is an active staff surgeon at two major hospitals - Banner Thunderbird Samaritan and SunHealthBoswellHospitalCenter, where he currently performs lower extremity bypasses, stent placement surgeries, surgeries of the aorta, AAA, carotid surgery, and other major surgeries related to the peripheral vascular disease.