What is Sclerotherapy?

Sclerotherapy is a minimally invasive procedure using chemical irritants to close unwanted veins. Sclerotherapy is the treatment of choice treatment for small varicose and spider veins that may or may not be symptomatic and a source of significant distress.

You may have noticed tiny red and blue spidery looking veins or varicose veins that bulge and look twisted.

Sclerotherapy causes these small veins to collapse, forcing blood to go into a healthy vein. The collapsed vein is eventually absorbed after some time.

This simple procedure is done here in our office.

Who needs it?

Sclerotherapy is done for the following patients:

  • Symptomatic relief of venous symptoms in the leg including:
    • Burning
    • Aching
    • Swelling
    • Night cramps
  • For cosmetic purposes in the following patients:
    • Hereditary venous insufficiency
    • Advancing age
    • Who stand or sit for a prolonged amount of time
    • Overweight
    • After pregnancy

How does it occur?

In healthy veins, blood is pumped from the legs up to the heart. Blood is pumped upwards due to a series of valves within the veins directing blood flow from the superficial veins to the deep veins leading back to the heart. Contraction of the calf muscles also aid in pumping the blood flow back up to the heart.

When the valves within the veins are damaged or not working properly, blood flows backwards resulting in a pooling of blood in the legs. Pooling of blood in the legs increases the pressure in the veins leading to venous hypertension. This increase in pressure can cause mild symptoms of leg heaviness and aching or in chronic cases may progress to severe symptoms. The most important aspect is locating the origin of reflux. Many providers perform sclerotherapy without treating the underlying insufficiency which does not treat the true problem.

First, we treat the origin of reflux completely with venous ablation to reduce the high pressure within the greater saphenous, lesser saphenous, and perforating veins. Sclerotherapy is done once the origin and high venous pressure has been corrected. This is usually done 1 month after venous ablation.

Why is it done?

Sclerotherapy is done to eradicate long standing efforts of venous insufficiency. The primary purpose of treatment in venous disease is to restore normal direction of blood flow in the veins towards the heart.

The venous system in the body is made up of a network of veins interacting between superficial and deep veins. The removal of the superficial veins does not affect the drainage of blood from the leg due to alternate pathways.

This is a definitive treatment for visible, painful, and disfiguring veins. Sclerotherapy has a fast healing time, little pain, and a great cosmetic result.

As with any therapy, new varicose or spider veins may develop over time.

Before the procedure:

This procedure is done here in our clinic. Arrive at the clinic 15 minutes before the time of your scheduled appointment.

You may eat and drink before and after the procedure. This procedure is not effecting by eating.

This procedure does not require any alteration in medications, so take your morning medications as prescribed.

Avoid the use of body lotion before and after the procedure.

If you have a compression bandage or stocking from a previous procedure, make sure to bring it with you.

Arrange for someone to drive you home after the procedure. You may not be permitted to drive immediately after the procedure.

During the procedure:

The procedure lasts between 15 – 30 minutes.

The procedure will be carried out in our clinic in our procedure room. During the procedure you will lay on a table positioned on your back. Under sterile precautions, a fine needle is inserted into the effected vein. The sclerosing agent will directly be injected into the vein.

You might feel a slight burning or stinging sensation.

Many veins may be injected depending on the size and location of the veins, although some veins may need to be injected more than once in a separate session.

Once the procedure is completed the entire legs is cleansed with an antiseptic agent.

After the procedure:

Following the procedure, a compression bandage will be wrapped around the entire length of the leg and should be worn for 1-2 days.

A compression bandage is important because it helps prevent bruising and tenderness as well as reduces the risk of blood clot formation and dislodgment.

A compression stocking is required to be worn for 1- 3 weeks.

You are encouraged to walk for at least 30 minutes a day after the procedure to prevent deep vein thrombosis.

Avoid heavy or strenuous exercise for a few days. Avoid prolonged sitting or standing.

Elevate your legs as instructed to reduce swelling.

After 2 weeks of the procedure, a follow up is required to confirm whether all sites have been treated, whether more sessions are required, and whether the procedure was successful.

What are the possible risks and complications?

Sclerotherapy is generally a safe procedure, but with any surgical procedure it carries a risk. If they occur, they are usually minor and temporary.

Complications include:

  • Bruising
  • Pain
  • Swelling
  • Infection
  • Blood clot formation
  • Skin pigmentation
  • Nerve irritation or damage

What are the benefits?

The benefits of sclerotherapy include:

  • Relief of symptoms
  • Outpatient procedure
  • Well tolerated procedure
  • High success rate
  • Less invasive, less pain, tenderness, and few complications compared to surgical venous procedures
  • Does not require anesthesia
  • No sutures required
  • Quick healing time
  • Good cosmetic results