Sclerotherapy is a treatment used for spider veins or varicose veins of the legs. Sclerotherapy has been used for the treatment of varicose veins for over 150 years. It was first attempted in 1682, but was abandoned due to high rates of side effects with the drugs used at that time. Surgical stripping then became the treatment of choice.
Advances were made and eventually safer and more effective sclerosants were developed. Of particular importance was the development of sodium tetradecyl sulfate (Sotradecol or STS) in 1946, which is one of the most widely used sclerosant used to this day.
Learn about sclerotherapy vein treatment and other med spa services by calling Genesis Plastic Surgery & Medical Spa at 405-340-9949 today. Dr. Panchal welcomes patients throughout the Oklahoma City area to our offices in Edmond, Norman and Lawton.
How Does Sclerotherapy Work?
Sclerotherapy is the “gold standard” and is preferred over laser treatments for eliminating spider veins (telangiectasia) or small varicose veins. Injecting the unwanted veins with a sclerosing solution causes the targeted vein to shrink and then dissolve over a period of weeks as the body naturally absorbs the treated vein.
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 less likely.
Who Is a Good Candidate for Sclerotherapy?
Anyone who has spider veins, and possibly even small varicose veins, is a possible candidate for sclerotherapy, whether they have one vessel or numerous. For varicose veins, tests can be run to help determine if good results could be achieved with sclerotherapy or if they would be a better surgical candidate.
What Is the Difference between Spider Veins and Varicose Veins?
Spider veins are small, thin veins that lie close to the surface of the skin. They may appear in a simple linear pattern or sometimes look like a starburst. Although spider veins are connected to the larger venous system, they are not an essential part of it. Many factors can contribute to the development of spider veins including heredity, pregnancy, weight gain, or occupations or activities that require prolonged sitting or standing.
Varicose veins are larger, usually more than a quarter inch in diameter, darker in color and tend to bulge from the surface of the skin. Varicose veins are more likely to cause pain and can be related to more serious vein disorders. Sclerotherapy can be used to treat varicose veins, but often require surgical intervention.
What Is the Treatment Like?
The treatment involves a series of tiny injections and covers the entire surface of the legs from hip to toe. This can take anywhere from an hour and a half to two hours depending on how many vessels need to be treated. Compression hosiery is then placed on the area immediately post-treatment. Most patients tolerate the treatment very well. Shorts and the compression hosiery are available at our office.
What Kind of Solutions Are Used?
Sodium tetradecyl sulfate (Sotradecol or STS) and/or hypertonic saline
What Kind of Side Effects Occur?
Tiny, purple spots of bruising are usually seen at the injection sites. This usually resolves in about one week and is the most common side-effect. Hyperpigmentation, or a brown streak, along the course of the vein can sometimes be seen. This is not a common finding and usually only occurs in one or two places. They look like a small bruise and resolve within a few months. Telangiectatic matting is the formation of tiny, red vessels and is treated with follow-up sclerotherapy treatments. It also is not a common finding.
Extremely rare side effects can include allergic reactions, skin ulcerations, thrombophlebitis, and thromboembolism. We have not experienced any of these reactions in o ur eight years of experience.
What Can I Expect after Treatment?
Compression hosiery is applied in the office post-treatment and must be worn for 3 days to 2 weeks. They must be slept in the first night. Discomfort after treatment is rare, but there may be a slight tingling sensation for the first several hours. The spider veins will usually look worse before they look better due to the inflammation caused from the sclerosant. The vessels will fade very gradually and will be lighter after each treatment.
How Many Treatments Are Needed?
Most patients will require between 3 and 6 treatments. Treatments are spaced between 5 and 6 weeks apart. All the vessels are treated at each session and will lighten gradually each time.
Are There Any Activity Restrictions after Treatment?
Exercise must be avoided for 48 hours post-treatment. Excessive heat such as hot baths, hot tubs and saunas should be avoided for a week post-treatment. Walking is actually encouraged, especially immediately after the treatment is completed.
What Kind of Results Can I Expect?
Usually around 80-90% reduction can be expected. There will still be some faint veins that can be detected after treatment, but there should be a dramatic improvement. Sclerotherapy does not prevent the future formation of new vessels and follow-up treatments are nearly always required.