Sclerotherapy is a popular treatment for small varicose veins. The treatment causes the veins to fade within a few weeks, although occasionally it may take a month or more to see complete results. In more severe instances, several sclerotherapy treatments may be necessary.
The veins in the legs that carry blood back to the heart have valves that allow blood to only flow in one direction. When these valves fail, the veins become enlarged and bulge (varicose), which can lead to a chronic swelling condition called venous insufficiency. Correcting this condition can improve the pain and symptoms of venous insufficiency while also enhancing the cosmetic appearance of the legs.
Sclerotherapy is a procedure dating back to the 1930s to treat both varicose veins and spider veins. The minimally invasive procedure involves injecting a solution (a sclerosant) directly into the vein. Depending on the size of the vein being treated, the sclerosant solution may be either a liquid or a foam.
The sclerosant damages the innermost lining of the vessel (the endothelium), causing the vein to scar and forcing blood to reroute through healthier veins. Then, the scar tissue is eventually reabsorbed by the body.
In addition to cosmetically improving the appearance of varicose veins, sclerotherapy can also improve related symptoms such as:
The procedure can be performed as an outpatient in a clinic and does not require anesthesia. Sclerotherapy is a safe procedure with few complications. The treatment usually takes less than an hour; however, the exact length of the procedure and the number of injections required depends on the number and size of veins being treated.
Side effects that may occur at the site of the injection include:
Raised red areas.
Small skin sores.
Darkened skin in the form of lines or spots.
Multiple tiny red blood vessels.
These side effects usually go away within a few days to several weeks. Nevertheless, some side effects can take months or even years to disappear completely. And, sclerotherapy does not guarantee there will be no visible traces or side effects of varicose or spider veins after the procedure.
Areas Sclerotherapy Can Treat
The most common areas for varicose veins to develop are on the legs and feet. The affected veins may be raised, discolored or swollen, and some are deeper under the skin and can cause discomfort.
Depending on the size of the damaged veins, sclerotherapy can be used to treat varicose and spider veins in the following areas:
Face (frequently the sides of the nose).
Side Effects of Sclerotherapy
There are some mild side effects of sclerotherapy, such as itching, which can last for a couple of days after the procedure. Other side effects following sclerotherapy include:
Larger injected varicose veins may become lumpy and hard for several months before dissolving and fading.
Raised red areas may appear at the injection sites but usually disappear within a few days.
Brown lines or spots on the skin may be seen at the injection sites. In most cases, they disappear within three to six months. In about five percent of cases, they can become permanent.
Bruising may occur around the injection site and last several days or weeks.
New, tiny blood vessels (neovascularization) may develop at the site of the sclerotherapy treatment days or weeks after the procedure. These typically fade within three to twelve months without further treatment.
Who Are Candidates for Sclerotherapy Treatment?
People with venous insufficiency that is poorly controlled with compression stockings and who are not obese are ideal candidates for sclerotherapy. Healthy people who complain of unsightly superficial veins of small diameter (4 mm or less) are also candidates for sclerotherapy.
Doctors recommend women who are pregnant or breastfeeding wait before receiving a sclerotherapy procedure.
What Happens After Sclerotherapy?
After sclerotherapy, the patient is able to get up and walk around soon after the procedure. In fact, walking is encouraged, as is moving your legs to prevent the formation of blood clots. However, the patient must avoid any strenuous (aerobic) activity for two weeks following the procedure. The patient may resume regular daily activities the day following the procedure.
The patient will also be instructed to wear support hosiery to “compress” the treated vessels, usually for about two weeks following the treatment. During this time, the patient should also avoid sun exposure to the treated areas. The inflammation caused by the injections combined with sun exposure can lead to the formation of dark spots on the skin, especially if the patient already has a dark skin tone.
Following the injections, patients may take Tylenol, if needed, to treat any post-treatment discomfort, and patients should avoid the following for 48 hours after the procedure:
Ibuprofen and other anti-inflammatory drugs.
Whirlpools or saunas.
Direct exposure to sunlight.
Showers are allowed; however, the water should be cooler than usual. The injection sites should be washed with a mild soap and tepid water.
What are the Results of Sclerotherapy?
Smaller varicose veins and spider veins respond best to sclerotherapy. Patients can expect to see an improvement in spider veins in about three to six weeks. For larger veins, it may take up to four months to see an improvement. However, multiple treatments may be necessary to eliminate all problem veins. Generally, patients must wait about six weeks before undergoing another sclerotherapy session.
Patients should know that large varicose veins do not respond as well as smaller ones to sclerotherapy. Veins that respond to treatment generally don’t come back, but new veins may appear.
A 2014 study found 83 percent of people who underwent sclerotherapy experienced a decrease in pain related to the varicose veins. Some patients (less than 10 percent) do not respond to the injections at all. In these instances, different solutions or a different method may be necessary to treat the varicose veins. Often, a phlebectomy along with a more comprehensive treatment plan that includes additional procedures, such as endovenous ablation, can resolve varicose veins.
Novus Spine & Pain Center
Novus Spine & Pain Center is in Lakeland, Florida, and treats patients with chronic pain from varicose veins with numerous therapies including sclerotherapy. By using a comprehensive approach and cutting-edge therapies, we work together with patients to restore function and regain an active lifestyle, while minimizing the need for opiates.