Varicose veins and spider veins are manifestation of inefficient circulation with a result of unsightly blue enlarged discolored veins and unappealing esthetic look mostly of the lower legs.
Sclerotherapy is a medical cosmetic procedure where a medicine is injected into the affected vein to cause closure and improvement of the esthetic area affected. Sclerotherapy is used for varicose veins as well as for spider small veins. Enlarged blue veins are called varicose veins. Spider veins are single or multiple fine small veins that also look unsightly.
The chemical or medicine injected traditionally has been a high concentrated saline or salty solution however recent medication have been introduced by the medical community to improve results and lessen the discomfort of the treatment. The medicine works by causing the walls of the veins to close and seal the affected vein.
One of the medications used nowadays for sclerotherapy has an anesthetic effect and proves to be friendlier and better tolerated by the patients.
The sclerotherapy procedure is usually carried out in the medical office setting and requires no anesthesia and takes a few minutes to an hour depending on the extent and numbers of veins to be injected.
ARE YOU A GOOD CANDIDATE?
Patients presenting for sclerotherapy have noted enlarged blue veins or clusters of fine veins called telangiectasias or spider veins. These changes occur most commonly over the lower legs, either upper or lower parts or both. Pain and itching in the leg may be present.
Family history of similar veins weakness is present in some cases. The doctor will examine you and determine if you are a good candidate. The doctor who specializes in venous treatment will evaluate you and may ask for tests including an ultrasound to evaluate the efficiency of the major veins and its valves.
No treatment is done during the pregnancy as the veins may enlarge more and safety of the medicine is not established.
Patients on blood thinners as aspirin may not be treated as the risk of bleeding is increased.
Some specific veins may not be treated at the discretion of your doctor.
HOW IS THE SCLEROTHERAPY PERFORMED?
Sclerotherapy is usually an office procedure. The doctor will cleanse the skin to be treated, identify visually the vein or veins to inject, and will use a small needle to introduce the medicine into the affected vein. The injection will contain a high concentrated saline solution or other medication of the doctor’s choice. Polidocanol is one the new medicine designed for sclerotherapy. Medical foam has also been used for sclerotherapy to close the veins.
A gauze is usually applied with a light pressure on the injection site and the process is repeated again for other veins affected.
Some veins may be too enlarged and appear as bulging ropy structures, these may fail or not be ideal for sclerotherapy. Ask your doctor during the consultation if you have similar situation .The doctor may advise you to wear compression hoses after the procedure and refrain from activities for few days to few weeks.
WHAT TO EXPECT POST SCLEROTHERAPY?
Redness, itching, some discomfort is expected following the injection. A minimal swelling is at times expected, however a large swelling with pain may be a sign of a clot or adverse effect and needs your doctor input. Bruising may occur at the site of injection and it is temporary. Pain and discomfort is usually minimal and subside after one to two days. Lumpy veins may hurt on touch and a follow up visit is recommended with your doctor for an exam and assurance.
The doctor may wrap your leg in compression hose and restrict exercises for few days.
Driving home and walking is allowed and patients should be able to do it without much discomfort.
Office work and stairs are allowed with no major activity involved.
The doctor may want you to follow up for a checkup or repeat treatments in about 6 weeks or sooner.
The treated veins nay disappear and may leave a brown mark or pigmentation along its prior course. This hyper pigmentation will usually clear in few months in majority of cases.
Recurrence of blue varicose veins or new fine (spider) veins may occur after treatment and can be temporary or permanent.
WHAT ARE THE COMPLICATIONS OF SCLEROTHERAPY?
Sclerotherapy can cause irritation and inflammatory reactions in the affected vein. It can also cause a blood clot with adverse reactions of the clot, although this is rare.
Ulceration can occur at the site of injection or other sites if an arterial supply is being compromised to the skin area with resultant of skin being deprived of its blood nutrition. A specialist in venous treatment would advice you prior to this treatment if you are at risk.
Irritation or inflammation of the vein can happen but they are temporary and respond to conservative management. Recurrence of similar veins at the same place or different place of the injection can occur and may need further treatment.