I have thin skin that bruises easily, and I have brown stains from previous sclerotherapy treatments that I did over 7 years ago.
Consider an evaluation from a vein specialist who you can trust. Ultrasound scan should be part of the evaluation as well. A vein doctor can help you decide the correct treatment or combination of treatments to achieve the best results. Vein specialist can also recommend or refer you for treatment for your hyper-pigmented areas.
Published on Jul 11, 2012
Veins in the ankles and feet can be successfully treated with sclerotherapy. These veins may require more treatments because they are under more pressure than the veins in your upper thighs. Some patients are more prone to staining. There are certain sclerosants that cause less staining. If you do have these veins treated, check and see what was used last time and give your physician that information. Taking Arnica before treatment to avoid bruising, wearing compression hose for 2 weeks after treatment, and evacuating any trapped blood earlier rather than later can all limit staining.
Published on Jul 11, 2012
The first thing you should consider doing is having an ultrasound to check
for underlying venous insufficiency. Spider veins in the ankle areas are a
pretty good sign you might have a problem in the superficial set of veins
under the skin and fat. Polidocanol injections rarely result in
pigmentation and this has only been approved for use in the USA for the past
2.5 years so it was probably either sotradecoal sulfate or hypertonic saline
that was used for your previous injections. Foaming may also result in more
pigmentation so liquid sclerotherapy is recommended.
Published on Jul 11, 2012
It is very likely that you have other veins higher up in the legs that feed those veins. It would be a good idea to have another ultrasound to determine if those bigger veins higher up in the legs are refluxing and causing problems.
Published on Jul 11, 2012
Laser, Vein Wave, Vein Gogh, and sclerotherapy with a different agent might all work. You need to see a vein specialist to discuss this.
Published on Jul 11, 2012
It is possible that your previous treatments were using saline (super concentrated saline solution). This has a higher incidence of staining. Also if you have larger very blue veins in the ankle area there may be some staining from the iron in the blood.
Newer approved solutions Asclera and Sotradecol have a lower incidence of staining, Aslcera perhaps a little less. It is important that your practitioner is experienced especially in doing ankles. However, staining is one of the most common side effects of sclerotherapy but less so in experienced hands.
Published on Jul 11, 2012
Sclerotherapy is probably still the best treatment for the veins on your heels and ankles. The discoloration or brown staining you are referring to is, in all likelihood, hyperpigmentation from the sclerosing agent used previously - probably Sodium Tetradecyl Sulfate (Sotradecol). This particular sclerosing agent can have a hyperpigmentation effect and is especially high risk for hyperpigmentation with sun exposure after treatment.
My suggestion would be to see a provider who uses glycerin as the sclerosing agent. Glycerin carries virtually no hyperpigmentation risk and is well tolerated. Also, you may want to ask you dermatologist or vein specialist about Hydroquinone topical cream to help remove the dark or stained areas on your heels and ankles. Only your provider can determine if hydroquinone is appropriate for you.
Published on Jul 11, 2012
If the veins are large microphlebectomies may be possible. If the veins are small sclerotherapy is the procedure of choice. I would recommend that you go to someone with sclerotherapy experience and that you ask them about using either glycerine or polidocanol which both have low incidences of staining.
Published on Jul 11, 2012
Both laser and sclero will usually result in some brown staining.
Published on Jul 11, 2012
You may have undetected saphenous vein insufficiency. Have an ultrasound/vein mapping by a vein specialist first.
Published on Jul 11, 2012