What are the long-term risks associated with sclerotherapy?

I read an article that stated that sclerotherapy used to treat spider veins could lead to valve incompetence in healthy veins as the sclerosant can leave the treated area and disperse throughout the venous system, thereby damaging healthy valves. Is this really possible? What are the long-term risks associated with sclerotherapy?

Answers from doctors (9)


The Vascular Institute at Teton Radiology

Published on May 30, 2013

Long-term adverse events from sclerotherapy are extremely rare. A French study followed 1,605 patients and after 60 months, the rate of adverse events from sclerotherapy was 0.4%. Foam sclerotherapy had a slightly higher rate at 1.1%. The agent used was Asclera (polidocanol). Sclerotherapy for spider veins treatment isn't perfect though. We do see some patients who develop dark areas (bronzing). This usually goes away over months. Matting (red patches of fine capillaries) may occur. Sometimes it resolves on its own, other times it does not. The worst thing we see are skin ulcerations or small areas of skin necrosis that develop at the site of injection. This typically heals on its own from the inside out, but a few patients have required wound care visits to help with the healing. However, none of these are long-term problems.

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Answered by The Vascular Institute at Teton Radiology

Long-term adverse events from sclerotherapy are extremely rare. A French study followed 1,605 patients and after 60 months, the rate of adverse events from sclerotherapy was 0.4%. Foam sclerotherapy had a slightly higher rate at 1.1%. The agent used was Asclera (polidocanol). Sclerotherapy for spider veins treatment isn't perfect though. We do see some patients who develop dark areas (bronzing). This usually goes away over months. Matting (red patches of fine capillaries) may occur. Sometimes it resolves on its own, other times it does not. The worst thing we see are skin ulcerations or small areas of skin necrosis that develop at the site of injection. This typically heals on its own from the inside out, but a few patients have required wound care visits to help with the healing. However, none of these are long-term problems.

Published on Jul 11, 2012


Americas Vein Centers - Southborough

Published on May 30, 2013

When sclerotherapy is performed, sclerosant concentrations dilute; therefore, there should be no damage to large veins. Although it is theoretically possible, such occurrences often do not happen if the procedure is performed correctly and by an experienced surgeon. Long-term results are good to excellent.

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Answered by Americas Vein Centers - Southborough

When sclerotherapy is performed, sclerosant concentrations dilute; therefore, there should be no damage to large veins. Although it is theoretically possible, such occurrences often do not happen if the procedure is performed correctly and by an experienced surgeon. Long-term results are good to excellent.

Published on Jul 11, 2012


Vein Center of Orange County

Published on May 30, 2013

There are no long-term risks with sclerotherapy. There is so much redundancy in the superficial venous system that your concern is unwarranted. The sclerosing agent works for only a short distance once injected and is inactivated beyond that point.

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Answered by Vein Center of Orange County

There are no long-term risks with sclerotherapy. There is so much redundancy in the superficial venous system that your concern is unwarranted. The sclerosing agent works for only a short distance once injected and is inactivated beyond that point.

Published on Jul 11, 2012


Intermountain Vein Center

Published on May 29, 2013

There is always a risk with any procedure in the venous system, but with sclerotherapy, the amount that is put into the body is controlled (usually no more than 20cc) so that by the time it would be in the deep system it would be too dilute to cause any damage. There is a reason why there is a limit to the amount that can be used during treatment. The sclerosing agent is strong enough to treat the bad veins, but dilute enough by the time it circulates around the body. The risk with spider vein treatment is lower than normal sclerotherapy treatments. There are really no long-term effects to sclerotherapy, even if there are short-term complications that arise over a period of a few months.

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Answered by Intermountain Vein Center

There is always a risk with any procedure in the venous system, but with sclerotherapy, the amount that is put into the body is controlled (usually no more than 20cc) so that by the time it would be in the deep system it would be too dilute to cause any damage. There is a reason why there is a limit to the amount that can be used during treatment. The sclerosing agent is strong enough to treat the bad veins, but dilute enough by the time it circulates around the body. The risk with spider vein treatment is lower than normal sclerotherapy treatments. There are really no long-term effects to sclerotherapy, even if there are short-term complications that arise over a period of a few months.

Published on Jul 11, 2012


Vein Specialties of St. Louis

Published on May 29, 2013

Great question. Sclerotherapy has been performed safely for very many years. In fact, there is evidence the ancient Greeks injected veins. If the person performing the procedure is well trained and experienced, there is very little risk involved. We check all our patients with ultrasound prior to beginning treatments and use a transilluminating light that shows the flow of the sclerosants during injection. The very small amounts which go into the general circulation are so diluted and quickly eliminated by the body that problems are not caused. Again, choose an experienced and well trained sclerotherapist in order to lower your risk of complications.

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Answered by Vein Specialties of St. Louis

Great question. Sclerotherapy has been performed safely for very many years. In fact, there is evidence the ancient Greeks injected veins. If the person performing the procedure is well trained and experienced, there is very little risk involved. We check all our patients with ultrasound prior to beginning treatments and use a transilluminating light that shows the flow of the sclerosants during injection. The very small amounts which go into the general circulation are so diluted and quickly eliminated by the body that problems are not caused. Again, choose an experienced and well trained sclerotherapist in order to lower your risk of complications.

Published on Jul 11, 2012


Vanish Vein and Laser Center

Published on May 29, 2013

Any procedure carries risk, but sclerotherapy when done by an experienced injector carries minimal side effects, and, usually very good results. There is always a chance of the solution spreading to larger normal veins and affecting the valves. This incidence is low. In almost 30 years of doing sclerotherapy in thousands of patients I have seen this only once, and associated DVT with injecting spider veins only once.

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Answered by Vanish Vein and Laser Center

Any procedure carries risk, but sclerotherapy when done by an experienced injector carries minimal side effects, and, usually very good results. There is always a chance of the solution spreading to larger normal veins and affecting the valves. This incidence is low. In almost 30 years of doing sclerotherapy in thousands of patients I have seen this only once, and associated DVT with injecting spider veins only once.

Published on Jul 11, 2012


Bay Vein Associates

Published on May 28, 2013

In theory, what you mention could happen, but in practice it's not something that is really considered since the amount of sclerosant used is very minute. The mere presence of spider veins often mean there is an upstream incompetence already present. If someone were to inadvertently inject too much sclerosant, then yes, the sclerosant could end up somewhere undesirable and cause damage. You may benefit from an evaluation and ultrasound study to check for an underlying venous reflux problem that may be leading to your spider veins.

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Answered by Bay Vein Associates

In theory, what you mention could happen, but in practice it's not something that is really considered since the amount of sclerosant used is very minute. The mere presence of spider veins often mean there is an upstream incompetence already present. If someone were to inadvertently inject too much sclerosant, then yes, the sclerosant could end up somewhere undesirable and cause damage. You may benefit from an evaluation and ultrasound study to check for an underlying venous reflux problem that may be leading to your spider veins.

Published on Jul 11, 2012


Arizona Vein Specialists

Published on May 28, 2013

As a rule, sclerotherapy success depends on the expertise of the administering doctor. Proper technique requires that the treating physician not overdo the amount of pressure or sclerosant injected. The sclerosing agent should dilute enough so that the important valves are not affected by the time the solution reaches them. Of course, your doctor will not just be treating spider veins alone, but also the feeder veins in the reticular dermis that are the real cause. This helps prevent recurrence.

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Answered by Arizona Vein Specialists

As a rule, sclerotherapy success depends on the expertise of the administering doctor. Proper technique requires that the treating physician not overdo the amount of pressure or sclerosant injected. The sclerosing agent should dilute enough so that the important valves are not affected by the time the solution reaches them. Of course, your doctor will not just be treating spider veins alone, but also the feeder veins in the reticular dermis that are the real cause. This helps prevent recurrence.

Published on Jul 11, 2012


Bella MD Laser Vein and Aesthetic Center

Published on May 28, 2013

If the sclerosing agent is given in proper small doses, there should be no long-term consequences.

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Answered by Bella MD Laser Vein and Aesthetic Center

If the sclerosing agent is given in proper small doses, there should be no long-term consequences.

Published on Jul 11, 2012


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