Sclerotherapy is a well-proven procedure and has been in use since the 1930s.
It involves an injection of a solution (generally a salt solution) directly into small varicose veins and spider veins. The solution irritates the lining of the blood vessel, causing it to swell and stick together, and the blood to clot. Over time, the vessels will turn into scar tissue and fade from view.
Research shows that up to 50%-80% of injected veins by experienced physicians may be eliminated with each session of sclerotherapy. However, it should be noted that less than 10% of the people who have sclerotherapy do not respond to the injections at all. In these cases, alternative solutions can be tried.
Generically, response time for spider veins is three to six weeks, and three to four months for larger veins. If the veins respond to the procedure, they will not reappear. However, new veins can later surface at the same place and additional injections may be needed.
Pregnant or are bedridden patients are not eligible for the procedure. For patients with a history of blood clots, their eligibility will be decided on by the medical doctor.
The Procedure
Anti-inflammatory medications such as aspirin and ibuprofen (i.e. Advil, Motrin and Nuprin) should not be taken 48-72 hours before sclerotherapy. Also, Tetracycline, an antibiotic, should not be taken 7-10 days prior. No lotion should be applied to the legs before the procedure.
A salt solution is injected through a very fine needle directly into the vein. Patients may experience mild discomfort and cramping for one to two minutes, especially when larger veins are injected. The size and location of the veins, and the general medical condition of the patient will determine the number of injections in one session. The procedure itself takes approximately 15 to 30 minutes.
Possible mild side effects can include itching, raised red areas, minor allergic reaction, and bruising at the injection site. These should disappear within a few days. Other side effects for larger veins might include the feeling of hard lumps (may require several months to dissolve and fade), brown lines or spots at the vein site. (they should disappear within three to six months), and neovascularization, or the temporary development of new, tiny blood vessels (may appear days or weeks after the procedure, but should fade within three to twelvemonths without further treatment).
Should inflammation within five inches of the groin, a sudden onset of a swollen leg, or formation of small ulcers at the injection site occur, contact the physician immediately.
After the treatment, the patient will need to wear compression stockings and avoid aspirin, ibuprofen or other anti-inflammatory medications for at least 48 hours. Tylenol may be used if needed. Patients should also avoid, for 48 hours, applying hot baths or compresses, whirlpools or saunas, and direct sunlight to the injected areas.
Patients will be able to drive themselves home and resume their regular daily activities. Walking is encouraged. Showers are permitted, but the water should be cooler than usual. The injection sites may be washed with a mild soap and tepid water.
