Sclerotherapy involves the injection of one of several different types of solutions, known as sclerosants, directly into a diseased vein with a fine needle. Usually, this technique is performed to improve the cosmetic appearance of legs or hands.
The most common indication for this therapy is to treat small 1-3mm veins called “spider veins” that develop on the legs and occasionally hands. While there is a genetic predisposition for the appearance of these small veins, multiple pregnancies, hormonal replacement and obesity also have been linked to their appearance. Sclerotherapy injections are also occasionally used to close typical sized varicose veins in the leg.
We ask patients who are interested in this procedure to visit our offices for a consultation. We will evaluate your condition and determine if the spider veins could be caused by a more significant problem of the deeper veins. Occasionally, an ultrasound exam of these deeper veins is indicated.
The technique we and many other vein specialists use is simple and performed in the office. We position our patients in a comfortable semi-upright position. After cleansing the leg, we use special lighting and magnification to visualize the target veins. Next, we create a solution of sclerosant and use very small needles to perform the actual injections (27-30 gauge needle).
The number of injections is limited by only injecting a safe maximal amount of sclerosant per sitting. Discomfort is minimal. We then either wrap your leg in a pressure dressing or more commonly, place you in medical grade compression stockings which you can purchase in our office at wholesale prices. These stockings or wraps need to be worn for 24 hours continuously, then during the day for at least 1 week. Compression, longer than a week has also been recommended by some experts. Repeat sessions are sometimes needed but usually not recommended sooner than two weeks.
Complications are rare. Sloughing of the overlying skin, or increased pigmentation at the site can occur. Both complications resolve but can take months to do so. Maximal benefit is usually apparent in approximately 8-12 weeks.