Skin Conditions: Sclerotherapy

Sclerotherapy, a well-proven medical procedure that has been in use since the 1930s, is used to eliminate varicose veins and spider veins. During the procedure a solution (generally a salt solution) is injected 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.

How Will I Know if I am a Candidate for Sclerotherapy?

Prior to the procedure, you will have an initial consultation with a dermatologist or vascular medicine specialist who will determine if sclerotherapy is right for you.

Sclerotherapy is not recommended in the following circumstances.

• If you are pregnant or 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 (for example, 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, unless they are already deemed unusable.

How Is Sclerotherapy Done?

In most cases, the salt solution is injected through a very fine needle directly into the vein. At this point, you may experience mild discomfort and cramping for one to two minutes, especially when larger veins are injected.

Sclerotherapy is performed in the doctor's office by a dermatologist or a surgeon and the procedure itself takes approximately 15 to 30 minutes. The number of veins injected in one session varies, and depends on the size and location of the veins, as well as your general medical condition.

What You Need To Do Before the Procedure

Prior to vein injection, you should avoid certain medications. Talk to your doctor about all medicines (including over-the-counter drugs, herbs and dietary supplements) you are taking before the procedure. Some doctors recommend avoiding aspirin, ibuprofen (for example, Advil, Motrin and Nuprin) or other anti-inflammatory medications for 48-72 hours before sclerotherapy.

If you need to take an antibiotic before sclerotherapy, contact your doctor.

No lotion should be applied to the legs before the procedure (tape will not stick) and it is best to wear shorts to the procedure.

What Side Effects Are Associated With Sclerotherapy?

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.

Other side effects include:

• Larger veins that have been injected may become lumpy and hard and may require several months to dissolve and fade.
• Brown lines or spots may appear at the vein site. In most cases, they disappear within three to six months.
• New, tiny blood vessels may occur at the site of sclerotherapy treatment. These tiny veins can appear days or weeks after the procedure, but should fade within three to twelve months without further treatment.