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Schlerotherapy is a microinjection procedure that needs no pain medication or surgery. Abnormal veins are treated by injecting a solution called a sclerosant, sealing the vein off from the rest of the vein network in your leg, allowing the body to naturally redirect the blood flow to the healthy veins. An injection of solution into the vein that causes the vein walls to swell, stick together, and seal shut. This stops the flow of blood and the vein turns into scar tissue. In a few weeks, the vein should fade. The same vein may need to be treated more than once.
Veins have one-way valves composed of two leaflets that close together when filled with blood. The closed valve prevents blood from flowing back into the leg. If these valves become damaged and fail to function properly (become incompetent) blood can become static in the leg. If the valve is not closing properly blood falls back down and causes pressure sideways. Resulting in varicose veins.
Sclerotherapy is a common treatment for small and medium size spider veins, and is preferred over laser for eliminating spider veins. Unlike a laser, the sclerosing solution additionally closes the "feeder veins" under the skin that are causing the spider veins to form, thereby making a recurrence of the spider veins in the treated area less likely. With this procedure, veins can be eliminated at an early stage, helping to prevent further complications.
You may need anywhere from one to several sclerotherapy sessions depending on the type and number of veins being treated.
Studies have shown that many of the injected veins may be eliminated with each session of sclerotherapy. Although this procedure works for most patients, there are no guarantees for success.
Prior to sclerotherapy, you will have an initial consultation with the physician or schlerotherapist.
You can not have treatment if you are pregnant or nursing. You can have sclerotherapy if you take birth control pills. If you have had a blood clot in the past, your eligibility will be decided on an individual basis, and will depend on your overall health.
Generally, normal activities may be resumed after sclerotherapy. Support hose must be worn for several days to assist in the resolution of the veins. This procedure, performed in the doctor's office, usually causes only minimal discomfort, and walking is very important and necessary to aid in the elimination of the veins.
Bruising and pigmentation may occur after sclerotherapy. Bruising typically disappears within 1-2 weeks. Although pigmentation almost always fades, although it can last for several months.
Injecting the unwanted veins with a sclerosing solution causes the target vein to immediately shrink, and then dissolve over a period of weeks as the body naturally absorbs the treated vein.
Multiple injections of dilute sclerosant are injected into the abnormal surface veins of the involved leg. The patient's leg is then compressed with either stockings or bandages that they wear usually for two weeks after treatment. Patients are also encouraged to walk regularly during that time. It is common practice for the patient to require at least two treatment sessions separated by several weeks to significantly improve the appearance of their leg veins.
Sclerotherapy can also be performed using microfoam sclerosants under ultrasound guidance to treat larger varicose veins, including the great and small saphenous veins.[13] After a map of the patient's varicose veins is created using ultrasound, these veins are injected whilst real-time monitoring of the injections is undertaken, also using ultrasound. The sclerosant can be observed entering the vein, and further injections performed so that all the abnormal veins are treated. Follow-up ultrasound scans are used to confirm closure of the treated veins, and any residual varicose veins can be identified and treated.
Sclerotherapy is fully FDA approved in the USA.
Sclerotherapy has been used in the treatment of varicose veins for over 150 years. Like varicose vein surgery, sclerotherapy techniques have evolved during that time. Modern techniques including ultrasonographic guidance and foam sclerotherapy are the latest developments in this evolution.
What Happens After Sclerotherapy
After sclerotherapy you will be able to drive yourself home and resume your regular daily activities. You will be instructed to wear support hosiery to "compress" the treated vessels. If you have compression hosiery from previous treatments, you are encouraged to bring them with you to be certain they still have adequate compression. Department store support stockings will not be adequate if a heavy compression stocking is needed. Your doctor's office can recommend where to purchase heavy compression stockings.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.
Following the injections, avoid aspirin, ibuprofen, or other anti-inflammatory drugs 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
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