Sclerotherapy effectively treats varicose and spider veins. It’s often considered the treatment of choice for small varicose veins.
Sclerotherapy involves injecting a solution directly into the vein. The sclerotherapy solution causes the vein to scar, forcing blood to reroute through healthier veins. The collapsed vein is reabsorbed into local tissue and eventually fades.
After sclerotherapy, treated veins tend to fade within a few weeks, although occasionally it may take a month or more to see the full results. In some instances, several sclerotherapy treatments may be needed.
Why do Sclerotherapy?
- Cosmetic purposes – to improve the appearance of varicose and spider veins
- Aching, swelling, burning & night cramps
After Sclerotherapy there maybe temporary side effects which may occur at the site of the injection. These 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. Some side effects can take months or even years to disappear completely.
Other complications are less common but may require treatment. These include:
- Inflammation – This is usually mild but may cause swelling, warmth and discomfort around the injection site. Your doctor may suggest an over-the-counter pain reliever such as aspirin or ibuprofen to reduce the inflammation.
- Blood clot – A lump of clotted blood may form in a treated vein that may require drainage. Rarely, a blood clot may travel to a deeper vein in your leg (deep vein thrombosis).
How you prepare
Before the procedure, your doctor performs:
- Medical history
- Physical examination
- Evaluate the involved veins
- Check for any underlying blood vessel disease
Medical history may include:
- Recent illnesses or existing medical conditions, such as a heart condition or a past history of blood clots
- Medications or supplements you take, especially aspirin, ibuprofen, naproxen, blood thinners, iron supplements or herbal supplements
- Previous treatment for varicose veins and the results of the treatment
If you take aspirin, ibuprofen, naproxen sodium or blood thinners, your doctor may instruct you on how to stop taking the medication for a certain amount of time before the procedure, to reduce the chances of bleeding.
Depending on which veins are involved, your doctor may request ultrasound imaging on the veins in your legs. Ultrasound is a painless procedure that uses sound waves to produce images of structures inside the body.
The day before
Before the procedure, avoid shaving or applying any lotion to your legs. (Don’t shave or use lotion after the procedure until the injection site is healed either.) Wear loose, comfortable clothing to your appointment. You might even consider wearing a pair of shorts so that your legs are exposed.
What you can expect
Sclerotherapy is typically done in your doctor’s office and doesn’t require anesthesia. It generally takes less than an hour to complete.
During the procedure
- You’ll lie on your back with your legs slightly elevated. After cleansing the area to be treated with alcohol, your doctor will use a fine needle to slowly insert a solution into the appropriate vein.
- The solution, usually in liquid form, works by irritating the lining of the vein, causing it to swell shut and block the flow of blood. Some solutions contain a local anesthetic called lidocaine.
Eventually, the vein will become scar tissue and disappear. Sometimes a foam version of the solution may be used, particularly when a larger vein is involved. Foam tends to cover more surface area than liquid.
Some people experience minor stinging or cramps when the needle is inserted into the vein. If you have a lot of pain, tell your doctor. Pain may occur if the solution leaks from the vein into surrounding tissue.
Once the needle is withdrawn, your doctor applies compression and massages the area to keep blood out of the injected vessel and disperse the solution. A compression pad may be taped onto the injection site to keep the area compressed while your doctor moves on to the next vein.
The number of injections depends on the number and size of veins being treated.
Your doctor will likely schedule a follow-up visit about a month after the procedure to check the procedure’s success and decide whether further sessions are needed. Generally, you need to wait about six weeks before undergoing another sclerotherapy session.
If you’re pregnant or breast-feeding, doctors recommend waiting to have sclerotherapy done.