• Sclerotherapy Frequently Asked Questions

    What Is Sclerotherapy?

    Sclerotherapy is a method for elimination of varicose veins and superficial telangiectasias (spider veins). Using this method, a solution is injected into the veins, which causes the veins to collapse and disappear. There are a variety of solutions that can be used depending on the type of vessels being treated.

    Does Sclerotherapy Always Work?

    The majority of people who have sclerotherapy performed will be cleared, or at least see improvement, of the leg veins treated. However, there is no guarantee that sclerotherapy will be effective in every case. Approximately 20 percent of patients who undergo sclerotherapy have poor to fair results, ("poor results" mean that the veins have not totally disappeared after six treatments).

    How Many Treatments Will I Need?

    The number of treatments needed to clear or improve the condition differs from patient to patient and depends on the extent of varicose and spider veins present. One to six or more treatments may be needed (the average is three to four). Individual veins usually require one to three treatments.

    What Are the Most Common Side Effects?

    • Itching-Depending upon the type of solution used, you may experience mild itching along the vein routes. This itching normally lasts one to two hours, but may persist for a day or so.
    • Transient Hyperpigmentation-Approximately 10 percent of patients who undergo sclerotherapy notice a discoloration of light brown streaks after treatment. In almost every patient, the veins become darker immediately after the procedure. In rare instances, this darkening of the vein may persist for 4 to 12 months.
    • Sloughing-Sloughing occurs in less than 1 percent of the patients who receive sclerotherapy. Sloughing consists of a small ulceration at the injection site, which heals slowly over one to two months. A blister may form, open, and become ulcerated. The scar that follows should return to a normal color. This usually represents injection into or near a small artery and is not preventable.
    • Allergic Reactions-Very rarely, a patient may have an allergic reaction to the sclerosing agent used. The risk of an allergic reaction is greater in patients who have a history of allergies.
    • Pain-A few patients may experience moderate to severe pain and some bruising, usually at the site of the injection. The veins may be tender to the touch after treatment, and an uncomfortable sensation may run along the vein routes. This pain is usually temporary, in most cases lasting one to seven days.
    • Telangiectatic Mating-This refers to the development of new tiny blood vessels in the area where a vessel was treated. This temporary phenomenon occurs two to four weeks after treatment and usually resolves within four to six months. It occurs in up to 18 percent of women on estrogen therapy and in 2 to 4 percent of all patients.
    • Ankle Swelling-Swelling of the ankle may occur after treatment of blood vessels in the foot or ankle. It usually resolves in a few days and is lessened by wearing the prescribed support stockings.
    • Phlebitis-Phlebitis is a very rare complication, seen approximately in 1 out of every 1,000 patients treated for varicose veins greater than 3 to 4 nun in diameter. The possible dangers of phlebitis include the possibility of a pulmonary embolus (a blood clot to the lungs), and post-phlebitis syndrome, in which the blood clot is not carried out of the legs, resulting in permanent swelling of the legs. 

    What Are the Possible Complications If I Do Not Have Sclerotherapy Performed?

    In cases of large varicose veins (greater than 3 to 4 mm in diameter), spontaneous phlebitis and/or thrombosis may occur with the associated risk of possible pulmonary emboli. Additionally, large skin ulcerations may develop in the ankle region of patients with long-standing varicose veins with underlying venous insufficiency.

    Are There Other Types of Procedures to Treat Varicose Veins and Telangiectatic? What Are the Side Effects?

    Because varicose and telangiectatic leg veins are not life-threatening conditions, treatment is not mandatory in every patient. Some patients may get adequate relief of symptoms from wearing graduated support stockings. Ambulatory phlebectomy is a procedure where certain types of veins can be removed through small surgical incisions. The complications of this procedure are similar to sclerotherapy with the addition of small surgical scars, which naturally occur with this procedure.

    Vein stripping and /or ligation may also be utilized to treat large varicose veins. This may require a hospital stay and is performed while the patient is under general anesthesia. Risks of vein stripping and/or ligation include permanent nerve paralysis in up to 30 percent of patients, possible pulmonary emboli, infection, and permanent scarring. General anesthesia has some associated serious risks.

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