Sclerotherapy is a well-proven procedure in use since the 1930’s used to eliminate varicose veins and spider veins with an injection of a solution (generally a salt solution) injected directly into the vein which 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. Spider veins respond in three to six weeks and larger veins respond in three to four months. Veins will not reappear if they respond to the treatment, but new veins may appear at the same rate as before and they can be also treated with injections.
A good candidate for sclerotherapy is not pregnant or bedridden and if he/she had a blood clot in the past, 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.
Also, veins that are potentially usable for future surgical bypass procedures (saphenous vein – a large vein in the leg) will generally not be considered for sclerotherapy, unless they are already deemed unusable.
Before the procedure, the patient must avoid certain medications (aspirin, ibuprofen, anti-inflammatory medications) but he/she will receive instructions from a doctor. Also, no lotion should be applied to the legs before the procedure.
The procedure can be performed in the doctor's office by a dermatologist or a surgeon. During the procedure, the salt solution is injected through a very fine needle directly into the vein. The number of veins injected in one session depends on the size, location of the veins and general medical condition of the patient.
The patient can experience mild discomfort and cramping for one to two minutes, especially when larger veins are injected. The procedure itself takes approximately 15 to 30 minutes.
After the procedure, the patient can drive and resume his/her regular daily activities – walking is encouraged. The patient will be instructed to wear support hosiery to "compress" the treated vessels and for at least 48 hours to avoid aspirin, ibuprofen or other anti-inflammatory medications, hot baths and compress, whirlpools or saunas but showers are permitted but with cooler water than usual.
The patient can experience after sclerotherapy certain milder side effects, such as:
- Itching (one or two days after the procedure),
- Red areas at the injection site (disappear within a few days)
- Bruising around the injection side (disappear several days or weeks)
Also, these side effects can appear:
- Lumps and hardness of larger veins (several months to dissolve and fade),
- Brown lines or spots (disappear within three to six months),
- Neovascularization (the development of new, tiny blood vessels – they fade within three to twelve months)