Sclerotherapy for Veins

Sclerotherapy is a medical procedure used to eliminate “reticular veins” and “spider veins.” Sclerotherapy involves an injection of a solution (such as sodium chloride, a salt solution, or sotradecol, a detergent) directly into the vein. The solution irritates the lining of the blood vessel, causing it to swell and stick together, and the blood to clot. Over time, the vessel turns into scar tissue that fades from view. Sclerotherapy is a well-proven procedure and has been in use since the 1930s.

How will I know if I am a candidate for sclerotherapy?

Prior to the procedure, you will have an initial consultation with a Registered Nurse specialist who will advise you on your eligibility for sclerotherapy. You are not eligible if you are pregnant or are bedridden. If you have had a blood clot in the past, your eligibility will be decided on an individual basis and will depend on the overall health of the area needing treatment as well as the reason for the clot. Veins that are potentially usable for future surgical bypass procedures (i.e., use of the saphenous vein, a large vein in the leg used for coronary artery bypass graft surgery) will generally not be considered for sclerotherapy.

How is sclerotherapy done?

In most cases, the sclerosing solution is injected through a very fine needle directly into the vein.

At this point, you may experience mild discomfort and cramping for 1 to 2 minutes, especially when larger veins are injected. The procedure itself takes approximately 4 minutes. You should plan to wear shorts during the injection. The number of veins injected in one session varies, and depends on the size and location of the veins, as well as the general medical condition of the patient.

What do you need to do before the procedure?

Prior to vein injection, you should avoid certain medications. Tetracycline, an antibiotic, may possibly cause a staining of the skin if taken seven to 10 days before or after sclerotherapy. If you need to take an antibiotic before sclerotherapy, contact your physician. No lotion should be applied to the legs before the procedure. Some physicians recommend avoiding aspirin, ibuprofen (i.e., ®Advil and ®Naproxen) or other anti-inflammatory medications for 48-72 hours before sclerotherapy to minimize bruising. Tylenol, however, should not affect this procedure.

Could sclerotherapy cause any side effects?

You may experience certain side effects after sclerotherapy. There are milder effects, such as itching, which can last for one or two days after the procedure. Also, you may experience raised, red areas at the injection site. These should disappear within a few days. Bruising may also occur around the injection side and can last several days or weeks.

What happens after the treatment?

Walking for approximately 90 minutes is encouraged. You will be instructed to wear tape and cotton balls until the next morning post-treatment. Following the injections, avoid aspirin, ibuprofen or other anti-inflammatory medications for at least 48 hours. Tylenol may be used if needed.

Also, you should avoid the following for 48 hours after treatment:

• Hot baths
• Hot compresses
• Whirlpools or saunas
• Direct exposure to sunlight
• How effective is sclerotherapy?

Studies have shown that as many as 50 percent to 80 percent of injected veins may be eliminated following a series of sclerotherapy sessions. Less than 10 percent of the people who have sclerotherapy do not respond to the injections at all. In these instances, different solutions can be tried. Although this procedure works for most patients, there are no guarantees for success.

In general, spider veins respond in three to six weeks, and larger veins respond in three to four months. If the veins respond to the treatment, they will not reappear. However, new veins may appear at the same rate as before. If needed, you may return for injections.