Sclerotherapy might be a little hard to pronounce (it’s sclair-o-ther-uh-pee) but it’s a very useful technique for treating varicose and spider veins. The treatment has a lot of advantages for both patients and doctors, and is very effective, with minimal side effects or complications. Here are the basics on sclerotherapy, courtesy of Dr. Louis DeJoseph and Premier Image Cosmetic and Laser Surgery.
To understand sclerotherapy, it’s best if you have some idea of how the vascular system works. Arteries rely on the pressure of each heartbeat to move blood through the blood vessels. The veins, however, need an assist from muscle contractions in the legs to pump blood back to the heart. Veins also need to prevent blood from flowing backward in the pause between heartbeats, so flaps of tissue called valves drop into place, sealing the vein. Over time, however, these valves may become less effective or even fail completely; as a result, blood pools in the veins, making them distended and tortuous. These distended veins are what we call varicose veins. While you may not have any symptoms, the appearance of your legs can make you feel uncomfortable in shorts or bathing attire. You may also develop very small, fine varicose veins – spider veins – in places like the face.
What Is Sclerotherapy?
Sclerotherapy acts on the principle that when a vein is subjected to an irritant, it swells, collapses and scars closed. In fact, “sclero” means scar. Doctors use a solution or foam that irritates the inner wall of the vein. Salt solutions are usually quite effective for this purpose. The solution or foam is slowly injected into the vein with a very fine needle. Once the veins collapse, they may be held in that position with a compression bandage or special elastic stockings. The vein forms scar tissue all along its length. Eventually, the collapsed vein is absorbed into the surrounding tissue. Sclerotherapy can be used on either spider veins or varicose veins (although some deep varicose veins may require a different treatment). It’s particularly effective with spider veins, which are often too small to treat any other way.
Why Have Sclerotherapy?
The success rate of sclerotherapy is generally high, with 50 to 80 percent of treated veins responding to the temperament. In many cases, one treatment is sufficient for each vein. A small percentage of people (about 10 percent) don’t respond to sclerotherapy. A minimally invasive procedure, sclerotherapy can be performed in a doctor’s office or clinic. It does not require anesthesia. The treatment is quick – 15 to 30 minutes in many cases – although it depends on how many veins are treated at one time. Most people can immediately resume their normal activities, with the possible exception of strenuous exercise. Unlike more invasive procedures, sclerotherapy scars are inside the veins and thus not visible externally. Side effects are typically limited to bruising and swelling, and both are minor in most cases. It does take about three to six weeks for spider veins to disappear, while larger varicose veins take three to six months. Be aware, however, that sometimes varicose veins do reoccur after sclerotherapy treatment and sclerotherapy cannot prevent new varicose veins from forming. The treatment can be repeated if necessary.
The first step in treating varicose veins is an assessment of your condition. This allows the doctor to determine how severe the problem is, collect your medical history and discuss a treatment plan (sometimes other options are a better choice than sclerotherapy). For sclerotherapy on the legs, you will lie on an exam table with your legs elevated; for spider veins, your position depends on the location of the veins. The doctor or nurse will carefully cleanse your skin to prevent infection. Although the procedure is not generally painful, you may notice a burning or stinging sensation when the solution is injected. Once the needle is removed, the doctor will massage the area and apply compression bandages and/or stockings. You’ll need to wear the stockings for about two weeks after the procedure. Avoid sun exposure on the treated areas for several weeks; otherwise it may cause the skin to darken.
Are You A Candidate?
Almost anyone can be a candidate for sclerotherapy; the primary issue is how large and deep the varicose veins are and where they are located. The typical age range is between 30 and 60. Chronic conditions like diabetes and heart disease won’t keep you from having the procedure in most cases. If you take birth control pills you can still have sclerotherapy, but if you take anticoagulants (blood thinners), your doctor may recommend against the procedure or suggest you stop them for a while prior to sclerotherapy (don’t stop them without a doctor’s approva1!). Women who are pregnant should wait until after the baby is delivered and most doctors recommend against sclerotherapy for the first three months of breastfeeding. If you have a history of blood clots, you and your doctor will need to discuss whether sclerotherapy is right for you.
How long will the procedure last?
In most cases, the sclerotherapy procedure itself takes about 15 to 30 minutes. It will be longer if you are having multiple veins injected and you should allow time for office preparation and a short recovery.
What can I expect after the procedure?
Most people go home immediately after the procedure and can resume their normal activities within a day or so. Strenuous exercise is usual not advisable for a week or two.
Are there risks?
Sclerotherapy risks are minimal. Bruising and swelling are the most common side effects but are usually minimal. Occasionally there is irritation at the injection site and there is a very small chance of infection.
How soon can I return to work?
How soon you return to work depends on what kind of job you do. If you perform heavy labor or spend long hours on your feet, you may need to take a few days off. This decision is made on the basis of the patient’s general condition and the number of veins that are injected. For spider veins, there usually isn’t any down time.
Sclerotherapy is a good choice for treating many varicose veins and is consider the gold standard in treating spider veins. This treatment may or may not be covered by insurance; the determination is made on a case-by-case basis. If you have questions about this procedure, please feel free to contact us by calling (770) 457-6303 or filling out the contact form on this page. We can provide you with information or schedule an appointment.