What is sclerotherapy?
Sclerotherapy is a microinjection procedure to treat spider veins. The procedure involves injection of a sterile solution (called a sclerosing solution) into the small veins using a very fine, thin needle. This solution irritates the vein lining causing it to undergo fibrosis and eventually disappear. Multiple veins can be injected at each session. The sclerosing solution used may be either hypertonic saline or sodium tetradecylsulfate.
What are spider veins?
Spider veins are most common in women in the age groups 30-50. This has been related to the hormone estrogen and pregnancy. Spider veins look like a network pattern in a circular fashion. These light purple veins usually appear in a lattice pattern and are completely harmless.
Where is the procedure done?
It is usually done in the doctor’s clinic. It generally does not require any type of anesthesia. The patient is asked to come to the clinic in loose fitting clothing and the spider veins are identified. With a very fine needle, these spider veins are injected with a chemical that will destroy the vein. There is minimal pain. For those who are unable to tolerate the pain, a topical local anesthetic can be pasted on the skin about 30 minutes before the procedure.
What chemicals are used for sclerotherapy?
The spider veins are destroyed by injecting a small amount of a chemical in the vein. The sclerosant used is called polidochanol – a very safe agent. The chemical irritates the small vein and causes it to undergo fibrosis and eventually disappear.
Can sclerotherapy be used to treat large varicose veins?
Unfortunately, sclerotherapy is generally used for the very small superficial veins next to the skin. Sclerotherapy is not effective for large veins and requires large amounts of the sclerosants with the potential to be absorbed. When large veins are treated with sclerotherapy, a stronger solution and a higher volume is required. Following the treatment for larger veins, compression hose stockings are usually recommended to be worn for at least 2 weeks. It is best to get spider veins treated in the winter months as one can easily wear stockings.
How many sclerotherapy treatments are required?
It varies from individual to individual but typically 2-4 treatments are required for the best results. In patients with milder cases, 1-2 will suffice. The treatments are more when there are more veins or slightly larger veins.
Do I have to limit any activity after the treatment?
Walking is highly recommended soon after the procedure. But any high activity sports should be avoided for the first 2-3 days. You want to avoid aspirin and similar products that thin the blood. Also avoid hot tubs and warm water soaks – you want to keep the vein environment ‘hostile’ so that it won’t ‘re-open’
Does sclerotherapy hurt?
There is a little sting associated with each injection. The burning sensation lasts few seconds. Most individuals tolerate the procedure and do not require any type of anesthesia. The majority of patients claim that the procedure is much less than painful than what they anticipated.
What happens if spider veins are not treated?
Absolutely nothing. Spider veins are small veins which are entirely of a cosmetic nuisance. They do not form blood clots, they do not ache, and they do not cause swollen feet or pain. One may elect to observe them.
Is there any harm in removing spider veins?
Spider veins have no function and removing does no harm. The only reason they are removed is because of their unsightly cosmetic.
Can anyone undergo sclerotherapy?
Almost anyone with unwanted spider veins can be treated, except women who are pregnant or nursing. Other relative contraindications include those with skin infections, uncontrolled diabetes, fever, history of deep vein thrombosis, anticoagulant therapy those patients taking corticosteroids.
Is there any preparation required before sclerotherapy?
No preparation is required before the procedure. It is recommended that one stop smoking and stop taking aspirin a few day before the procedure. Any patient on a blood thinker is not a candidate for sclerotherapy.
What happens after sclerotherapy treatment?
There is some mild pain which can easily be overcome with Tylenol. The injected site will appear bruised and swollen for a few days. Continual wearing of the ace bandaged will relieved the swelling and pain. The bruising usually disappears in 2-3 weeks. One will have no problem with walking. After the first 2 days, most patients can resume their normal activities.
How long is each sclerotherapy session?
Generally, most individuals have multiple spider veins and only up to 15-20 injections can be done at seating. Each treatment session lasts up to 30 minutes. After the treatment, sterile dressings are placed over the injection site and the entire leg is covered with compression stockings for 4 days.
When can the treatment be done?
Sclerotherapy is an elective procedure and can be done whenever the individual wants to have it done. The procedure does not take more than 30-60 mins and can even be done during an office lunch break.
Treatment is done on an outpatient basis during convenient office hours. You can resume most activities shortly after each session.
What are side effects of sclerotherapy?
Besides some stinging pain, sclerotherapy can rarely cause a few side effects. Allergic reactions are rare. A few individual may develop intense itching at the site of injection. If the chemical is injected outside the vein, profound discoloration and pain can occur.
Is there anything I need to do before I come in for a treatment?
It is important to come in for a consultation before your first treatment. You will need to purchase compression stockings before your treatments begin. Do not take aspirin, aspirin products, fish oils, ibuprofen, or large doses of vitamin E (greater than 100 IU/day) for 2 weeks prior to treatment
How much does sclerotherapy cost?
It depends, but usually it costs around $300 for each 20 minute session.