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Medical Treatments

Sclerotherapy

Sclerotherapy is most often used for smaller varicose veins and spider veins. This procedure can eliminate the pain and discomfort of varicose veins and prevent complications, such as ulcers or vein bleeding. It may also be used simply to improve appearance.

With sclerotherapy, doctors inject a liquid chemical directly into a varicose vein to close it off. The chemical irritates and scars the inside of the vein, making it collapse. Over the course of six months, the vein disappears.

You may need several treatments to close off a vein entirely. Typically, treatments are done every 4 to 6 weeks.

Foam sclerotherapy is a variation in which a foaming agent is mixed into the injection. The foaming agent moves blood out of the vein so that the chemical can come into better contact with the vein wall.  

During sclerotherapy treatments, you may feel small needle pricks as your doctor injects the veins. You can also experience temporary muscle cramping from normal saline sclerotherapy injections. Afterward, you’ll need to wear medical-grade support stockings for a few weeks.

Some temporary reactions may occur, including slight leg or foot swelling, mild bruising or soreness, itching, or redness. Rarely, sclerotherapy can cause development of small clusters of red blood vessels, brown pigmentation, and skin ulcerations around the treated veins.

Laser and light therapy 

Laser and pulse light therapy can heat blood vessels to shrink them.

Laser therapy applies light energy from a laser onto a varicose vein to make it shrink and fade away. For veins to be treated successfully, several sessions may be required, usually at six week intervals.

Laser therapy is most effective for small varicose veins and spider veins, but lasers are also used in a different procedure called “endovenous ablation therapy” to treat larger varicose veins. Doctors may also use laser therapy as an additional treatment after sclerotherapy, endovenous therapy, or surgery for larger varicose veins.

Another treatment option, Photoderm or intense pulsed light therapy (IPL), uses high-intensity pulsed light to shrink certain sizes of varicose veins and small spider veins. IPL differs from laser therapy, which uses a single emitted wavelength, by emitting a spectrum of light. Photoderm or IPL may help when sclerotherapy or laser therapy doesn't work.