Cosmetic Procedures > Sclerotherapy
Leg Vein Treatment with Sclerotherapy
1. What are spider veins and how are they treated?
Spider veins are small red or purple vessels close to the surface of the skin, most commonly on the legs and face. Vessels on the legs are best treated with sclerotherapy. Vessels on the face and some tiny vessels on the legs can be treated with lasers or intense pulsed light. Varicose veins are thick purple or blue veins that can be the source of discomfort. Varicose veins are best treated by a vascular surgeon. Spider and varicose veins are influenced by heredity, pregnancy and hormonal changes, weight, injury and prolonged standing. The regular use of support hose can help prevent new spider and varicose veins from forming.
2. What is sclerotherapy?
Sclerotherapy involves a series of injections into spider veins that causes them to shrink or disappear over time. Most often, we use a very strong salt solution–the same salt solution contained in the blood, only more concentrated. Concentrated salt irritates and damages the small spider veins, but when it enters larger veins, it is diluted to the level that occurs naturally. Alternatively a medical detergent solution that is FDA approved for this purpose may be used. Sclerotherapy has been practiced for decades and is still the best and safest treatment for spider veins on the legs. While laser technology has been moving forward, laser treatment remains less effective than sclerotherapy with a greater risk of side effects, for all but the finest of leg veins. Because spider veins represent a cosmetic problem, insurance does not cover their treatment. Varicose veins are larger and more important medically. Their treatment by a vascular surgeon is generally covered by insurance.
3. What is sclerotherapy like?
During your sclerotherapy treatment, multiple veins will be injected. Fortunately, because spider veins are connected, each vein does not need to be injected individually. With the tiny needle that we use, the pain is minimal, although you may feel some brief stinging, burning or cramping as the saline solution irritates the treated veins.
4. How effective is sclerotherapy?
Although the amount of saline that can be safely injected limits the number of veins that can be treated, one sclerotherapy session can cover many large clusters of veins. On average, sclerotherapy results in 50 to 90% improvement over 4-6 weeks, but it may take up to 6 months to see the full effect of a treatment. Multiple treatments are often necessary for patients with many spider veins. However, a given area may not be retreated before 6 weeks to allow for complete healing. Unfortunately, sclerotherapy cannot prevent the formation of new spider veins.
5. What are the risks?
Temporary reactions can include minor redness, soreness, bruising, itching or hives in the treated area. Darkening of the skin overlying the treated vessels may occur, but generally fades over several months to a year; it is important to avoid sun exposure to minimize this complication. Uncommonly, mats of finer blood vessels can appear in place of a successfully treated spider vein. Phlebitis or clotting of the superficial veins is also an uncommon side effect. Only rarely and generally in the treatment of larger vessels, the concentrated saline can cause local ulceration and scarring of the skin, or a deep vein clot. People with poor circulation, previous leg ulcers, diabetes, or clotting problems and pregnant women are at greater risk for these complications and should not undergo sclerotherapy.
Patient Instructions for Sclerotherapy
- We highly recommend purchasing medical grade support stockings in advance. Wearing support hose after your sclerotherapy increases the effectiveness of the treatment. Moreover, if you get into the habit of wearing them regularly, you can help prevent the formation of new spider veins after your successful treatment. You can mail order Class II stockings from Carolon: 877-MDSOCKS. Other excellent choices are L’Eggs Active, Jobst Sheer, and Sigvaris Delilah, all available in a variety of colors and sizes.
- Do not use aspirin for 10 days prior to the procedure. Do not take ibuprofen (Motrin, Advil) and Vitamin E for 5 days prior to the procedure. These medications will prevent clotting, thereby keeping your vessels from being eliminated. If you have been prescribed one of these medications, ask your doctor before you stop taking it. Tylenol will not affect your sclerotherapy results. However, alcohol is also a blood thinner and should be avoided 2 days prior to the procedure.
- Bring your support hose on the day of the appointment. You may also want to bring shorts to change into, so that you can be as comfortable as possible during the treatment. Please eat an adequate breakfast or lunch, as you may feel lightheaded if your blood sugar is too low. Do not bring children, because they can distract your doctor from the concentration that sclerotherapy warrants.
- For best results, wear medical grade support stockings or ace bandages for one to (preferably) two weeks after treatment, except when lying down. Ace bandages lose their elasticity quickly and would have to be replaced every two days.
- Avoid aspirin, ibuprofen (Motrin, Advil), Vitamin E for one week after treatment. Avoid alcohol for 2 days after treatment.
- Avoid strenuous exercise, such as aerobics, running, jogging, leg weights or other sports, for the first two days after sclerotherapy. Mild exercise, however, (such as walking) is helpful. You should not rest entirely, but go about your daily activities. When you are not moving, elevate your legs as much as possible. Take warm, not hot showers and do not bathe or swim for 2 days.
- For the first two days after treatment, you may experience minor redness, swelling, and tenderness. Please call us if these symptoms increase over time or become significant. You should call immediately if you notice any breakdown of skin, or if a blood vessel becomes increasingly firm and lumpy or painful. Also call us if a leg becomes swollen around the foot and ankle.
- Avoid intense sun exposure for 1-2 months after sclerotherapy, and regularly use sunscreen with SPF 30 and above to minimize the chance of long lasting discoloration.