Sclerotherapy

Sclerotherapy is a modality of treatment for spider veins that involves injecting a solution called sclerosant into the veins that will eventually cause the veins to close, making them disappear. The majority of patients receiving sclerotherapy will have marked improvement in the visibility of their spider veins. This usually takes 2-5 treatment sessions, depending on each individual's response to the sclerosant. Rarely, some patients may experience little or no improvement; this means that some of the veins may not totally disappear after several treatments. This varies based on each person's genetic makeup and cannot be predicted. There is also no way to predict or cure a person's tendency to form new spider veins; this is typically also genetic trait that is inherited.

Instructions before Sclerotherapy Treatment:

No creams or lotions on your legs the night before or the day of treatment.
Do not shave your legs the day of treatment.
Bring loose fitting shorts to wear during treatment.
Bring a pair of 20-30mm Hg compression hose to put on following treatment. Hose can be purchased at our office the day before or day of treatment.
Shower prior to the treatment, as you will need to wear the hose overnight.
Plan to walk/exercise leg muscles 20 minutes immediately following the treatment.

Instructions after Sclerotherapy Treatment:

The aftercare procedure is critical to the success of your procedure!!
You must apply graduated compression hose (20-30 or 30-40 mm Hg) immediately following the procedure and they must stay on for 24 hours. After the first 24 hours, you may remove them and only wear them during the hours that you are awake (minimum of 12 hours per day) for at least 3 weeks. After 3 weeks, you should wear your compression hose daily (minimum of 8 hours) and as much as possible. Always wear them if you are sitting for more than 2 hours of traveling on a plane, car, etc.
The blood in your legs is moved by walking. Walking causes the muscles in your legs to contract and relax; this squeezes the vein pushing the blood back to your heart. You must walk for 20 minutes immediately after the procedure. You must walk for 20 minutes every day during 1 continuous period of time for a minimum of 1 month.
Avoid prolonged heart exposure such as tanning beds, hot tubs, hot baths/showers, saunas, etc for at least 1 month.
Avoid running or jogging, high impact aerobics, or long periods of sitting or standing for at least 10 days after the procedure. After the initial 10 days, you can resume aggressive exercise in addition to the walking regimen recommended in #2. This will help reduce pain, aching, and tiredness in your legs.
Work on maintaining proper weight. Moderate weight loss may reduce/aching in the legs due to varicose veins and diminish the rate at which spider veins develop.
Avoid wearing high heel shoes. Heels interfere with the normal pumping action that occurs when walking and may lead to cramping and/or aching in your legs.
When you are sitting, move your legs frequently. Flexing the ankles will pump the blood out of your legs like walking. 10 reps every 10 minutes or so is recommended while you are sitting. You can also elevate your legs above the level of your heart for at least 10 minutes 1-3 times per day to help with aching and/or swelling.

There are possible side effects and/or complications to watch for (please call if you have any concerns: 205-561-2370)

Hyperpigmentation: It is normal for the treated veins to become dark immediately after treatment. This usually fades in 3-4 weeks. However, in some rare cases, this can become permanent. This usually occurs with prolonged heat exposure such as sun bathing or tanning bed exposure. Wear sunscreen and protective clothing for 3-4 weeks after the procedure to help avoid this becoming permanent.
Matting: This occurs when a “mat” of redness forms in the treatment area. This is usually due to tiny new veins growing in the treatment area. This typically in week 2 – week 4 range and fades in 4-6 months. It occurs in 18% of patients on estrogen therapy and in 2-4% of all patients.
Trapped blood: Sometimes, the vein will close slowly and a small pocket of blood will become trapped. You will see a dark blue clot. This is not dangerous form of clotting. This can be removed with a small needle puncture within 2-4 weeks after the treatments.
Ulceration: This occurs in <1% of patients. A small blister may form at the injection site, open, and become ulcerated. Should this occur, it usually heals in 8 weeks or so and the scare typically returns to normal skin color.
Allergic reaction: Allergic reaction to sclerosant is extremely rare. However, should such a reaction occur, our office is equipped with medications that can be used in case of an allergic reaction.
Itching: Mild itching and tingling usually occurs along the treated vein for 1-2 days after the procedure. Should this become bothersome, over-the-counter antihistamines can be used to help stop the itch. Examples are: Benadryl or Allegra (H1 blockers); Tagament or Zantac (H2 blockers).
Bruising: Bruising and/or tenderness can occur at the injection sites. Any burning or stinging experienced immediately following injections usually subsides when the hose are applied and walking is resumed. If your skin does bruise, it will usually disappear in 7-10 days. It is okay to take Tylenol for pain if you do not have an allergy to it.
Phlebitis: In less than 0.1% of patients, swelling of the vein occurs with some tenderness and/or pain. This can lead to swelling in the ankles as well. This is not dangerous and usually subsides in a few days.