Please read through this information carefully. If you have any questions please do not hesitate to ask. Keep this information to review the before and after treatment instructions before each sclerotherapy treatment session.
WHAT IS SCLEROTHERAPY?
Sclerotherapy is an injection treatment used to eliminate small to medium size varicose veins and “spider” veins. “Spider” veins are superficial telangiectasias, tiny vessels that are red, blue or purple in color. The majority of these veins present as a cosmetic problem.
HOW DOES SCLEROTHERAPY WORK?
A very small needle is used to inject a sclerosing solution into a varicose or “spider” vein. Different strengths of the solutions are used based on the size of the vessel. Once injected the cells that line the vein wall (endothelium) will become irritated, inflamed and damaged.
External compression is applied using cotton balls, tape and support hose. The compression causes the vein walls to seal together and the vein no longer can transport blood. Your body will then break down and absorb the damaged vein. When healing is complete the vein is no longer visible. The process is very similar to how your body heals a bad bruise.
“Spider” veins do not have any useful function and eliminating them will not affect your circulation. Reducing or eliminating varicose veins can improve your circulation and symptoms of heaviness, aching and fatigue.
HOW MANY TREATMENTS ARE NEEDED?
The number of treatments needed varies from patient to patient depending on the type, size and quantity of veins to be treated. Varicose veins and “spider” veins may require multiple injection sessions. Subsequent treatments are usually scheduled every four to six weeks to allow time for the body to respond to the treatment.
It is important to realize that the best results require patience. It takes time for your body to respond to the injections. It is important to follow the post-treatment instructions to optimize your results. Your body will continue to heal and “fade” injection sites for months after treatment. After your initial screening exam your clinician will give you an estimate as to the number of treatments that may be required. This is based on the clinician assessment, your history and expectations.
You may end up needing fewer or more treatments than the clinician estimated. It is important to discuss your expected outcomes with your clinical provider.
WHAT TO EXPECT:
Photographs will be taken before treatment is initiated. This helps to monitor your progress. Your legs will look worse before they look better.
Most people will notice a dramatic improvement approximately four weeks after their initial treatment. Maximal improvement often takes several months and several treatments.
There is no guarantee sclerotherapy will be effective in every case. Some veins and areas will need to be retreated.
Recurrence of the same vein treated rarely occurs with proper injection technique and compliance with post treatment instructions.
New varicose veins or “spider” veins may form requiring subsequent treatment.
Periodic re-evaluations are encouraged so that any new veins that develop can be injected before they become too large or too numerous.
COMMON SIDE EFFECTS:
ITCHING: you may experience itching around the area injected. If this occurs, it is usually mild and lasts for one to two days.
HYPERPIGMENTATION: a light brown discoloration of the skin may develop along the vein in the area injected. Approximately 20-30% of patients treated note the discoloration, which is lighter and less obvious than the vein being treated. The hyper pigmentation usually fades in a couple weeks, but may take several months to a year to totally resolve. There is a one-percent incidence of hyper pigmentation continuing after one year. Exposure to sunlight may also cause hyper pigmentation. Try to avoid sun exposure for 6 weeks following a treatment. It is highly recommended that a sun block of at least 45 spf be used. A small amount of blood may become trapped and hardened in the vein when injecting varicose veins or some “spider” vein complexes. This may feel like a knot or cord and it may look dark blue or bruised. This is a common occurrence. You may need to return before your next treatment so this area can be drained to remove the trapped blood. This will reduce the hyper pigmentation that can occur. The chance of this occurring can be decreased with proper compression of the vein and use of compression hose after your treatment.
TELANGIECTATIC MATTING: the formation of new, fine “spider” veins in the area injected occurs in approximately 10% of patients injected. The exact reason for this occurring is unknown. If untreated, thematting usually resolves in three to twelve months, but very rarely it can be permanent. If the matting does not fade it can be re-injected or treated with a laser/light source.
PAIN: it is common to have some tenderness at the injection site. Injection of the sclerosing agent can be uncomfortable, but is usually well tolerated by most patients. The discomfort is temporary, lasting one to at most seven days. Acetaminophen (Tylenol) can be used if needed, according to product directions.
BRUISING: may occur at the injection site. Bruising may be minimized by avoiding Aspirin and Ibuprofen products for ten days before and after each treatment session.
RARE SIDE EFFECTS:
ULCERATION AT INJECTION SITE: very rarely a small ulcer will occur at the site where the vein is injected. An ulcer can take four to six weeks to completely heal. A small scar may result.
ALLERGIC REACTION: there is a very rare incidence of an allergic reaction to the solution injected. You will be observed for such reaction and will be treated appropriately should it occur. Please inform us of any allergic history.
PULMONARY EMBOLUS/DEEP VEIN THROMBOSIS: a blood clot to the lungs/a blood clot in the deep vein. In the medical literature there is an extraordinarily low incidence of this complication.
ALTERNATIVES TO SCLEROTHERAPY:
You may choose no therapy. The existing varicose and “spider” veins may progress and new veins may form. You should be re-evaluated periodically to monitor your condition for changes. You may choose to wear compression support hose (if this is an appropriate treatment for your problem). Compression hose promote venous blood return to the heart. If support hose are worn faithfully, symptoms such as aching, heaviness and tiredness are often alleviated. They also may help prevent the progression and formation of varicose and “spider veins”. Endovenous thermal ablation may be appropriate to treat some patients with larger varicose veins. Laser/light source therapy may be an option if you have “spider” veins. Your doctor will discuss these alternative choices with you.