This information sheet is designed to provide the facts you need to make an informed decision on whether or not to have sclerotherapy. If you have questions or do not understand any potential risks, please ask us.
WHAT IS SCLEROTHERAPY?
Sclerotherapy is a popular method for eliminating varicose veins and superficial telangiectasias (spider veins) in which a solution (sclerosing agent) is injected into the veins. The sclerosing agent irritates the lining of the vein wall, makes it contract, collapse, and eventually disappear.
The vein becomes inflamed, blood can no longer flow through it and ultimately, the body absorbs these non functioning vessels.
DOES SCLEROTHERAPY WORK FOR EVERYONE?
The majority of people who have sclerotherapy will see good improvement. Unfortunately, it is not guaranteed to be effective in every case. Approximately 10% of patients who undergo Sclerotherapy have poor to fair results. (Poor results mean that the veins have not totally disappeared after six treatments.) In very rare cases the condition may worsen after sclerotherapy treatment.
HOW WILL I KNOW IF I AM A CANDIDATE FOR SCLEROTHERAPY?
Before the procedure, you will have an initial consultation with an Interventional Radiologist who will evaluate your eligibility for sclerotherapy. You are not eligible for sclerotherapy if you are pregnant, breastfeeding, or bedridden. You must wait at least three months after delivery before you can be considered for this procedure. You can have sclerotherapy if you take birth control pills.
Patients who cannot walk are not good candidates for vein treatments. Discussions with an IR doctor about existing conditions and recent surgeries help determine an individualized plan of treatment to address specific concerns.
HOW DO YOU PREPARE FOR SCLEROTHERAPY TREATMENT?
Patients must avoid certain medications prior to sclerotherapy. Tetracycline or Minocin, both antibiotics, might cause a staining of the skin if taken 7 to 10 days before sclerotherapy.
Do not take aspirin, ibuprofen (ie. Advil and Motrin) or other anti-inflammatory mediations for 7 DAYS before and after sclerotherapy unless you are taking aspirin for a heart condition Tylenol is permitted. Prednisone also has anti-inflammatory properties and decreases the effectiveness of the sclerosing agent. Herbal medications that increase bleeding such as Gingko Biloba and vitamin Emay cause increased bruising.
HOW MANY TREATMENTS WILL I NEED?
The number of treatments necessary to clear or improve the condition differs with each patient and depends on the extent of the varicose and spider veins. One to six or more treatments may be needed, but the average is three or four. However, there is no guarantee that multiple treatments will clear all veins. While sclerotherapy is a safe and highly effective, more than one treatment is usually required to clear or improve unsightly veins to patient's satisfaction.
Each session is approximately 30-45 min. The fee is based per session, by the amount of scleroscent that is used.
IS SCLEROTHERAPY PAINFUL?
For most people, there is minimal pain in sclerotherapy treatments. Individual injections, however, can cause a slight burning sensation for a few seconds, similar to an insect bite.
The needles we use are the smallest available, similar to the size of a needle used in acupuncture. No pain medication or numbing cream is necessary prior to treatment.
WHAT ARE THE MOST COMMON SIDE EFFECTS ASSOCIATED WITH SCLEROTHERAPY?
Itching: You may experience mild itching along the vein route. This itching normally lasts for 1 to 2 hours but may persist for 1 to 2 days.
Transient Hyperpigmentation: Between 10-30% of patients who undergo sclerotherapy notice a discoloration (light brown streaks or spots) after treatment. Spontaneous clearing within 6-12 months is typical, although this may persist longer than one year.
Sloughing: Sloughing is a small ulceration at the injection site that heals slowly over 1 to 2 months. This occurs in less than 1% of patients who undergo sclerotherapy. A blister may form, open, and become ulcerated. The scars that follow 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 with a history of allergies.
Pain: Some patients may feel moderate to severe pain and some bruising, usually at the injection site. The veins may be tender to the touch after treatment, and an uncomfortable sensation may run along the vein route. This pain is usually temporary and in most cases lasts from 1 to 7 days.
Telangiectatic Matting: This is the development of tiny new blood vessels in the treated area. This phenomenon may occur about 2 to 4 weeks after treatment and usually resolves within 4 to 6 months, although it may sometimes be permanent. Matting occurs in approximately 15 % of all patients.
Ankle Swelling: Ankle swelling 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: This is a very rare complication seen in approximately 1 out of every 1000 patients treated for varicose veins greater than 3 to 4 mm in diameter. The possible dangers of phlebitis include a pulmonary embolus (blood clot), which travels to the lungs, and postphlebitis syndrome, which can result in permanent swelling of the legs.
Bruising: Lasts from one to several weeks. Use of support hose is highly recommended and avoidance of alcohol and anticoagulant medication for 72 hrs prior to each treatment session may minimize effect.
WHAT CAN YOU DO AFTER SCLEROTHERAPY TREATMENT?
You will be able to drive yourself home. You may resume your regular activities and are encouraged to walk 30 minutes a day. Immediately after the procedure, a thigh-high compression stocking is applied to each treated leg.
After the procedure do not take hot baths, sit in a whirlpool or sauna, apply hot compresses or any form of heat to the injected areas. In addition, avoid direct exposure to sunlight (sunbathing, tanning beds,) jogging, high-impact aerobics.
ARE THERE OTHER PROCEDURES TO TREAT VARICOSE VEINS AND TELANGIECTASIAS?
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. In ambulatory phlebectomy, certain types of veins are removed through small surgical incisions. Complications of this procedure are similar to sclerotherapy, with the addition of small surgical scars.
Vein stripping or ligation may be necessary to treat large varicose veins. This procedure is usually performed under some anesthesia. Risks of vein stripping or ligation include permanent nerve paralysis in up to 30% of patients, possible pulmonary emboli, infection, and permanent scarring. Anesthesia has additional associated potential risks of paralysis, brain damage, and death.