What is sclerotherapy?
Sclerotherapy is the treatment of reticular veins (small varicose veins) and spider veins (telangiectasias) of the legs. Reticular veins are typically 1-3 mm in diameter, and spider veins are 1 mm in diameter or smaller. During a sclerotherapy treatment, a solution is injected with a very fine needle into each affected vein. The solution causes irritation of the vessel wall lining, collapsing the vein and leading to its absorption by the body and eventual disappearance.
What solutions are used during sclerotherapy?
Only FDA-approved solutions are used at Carlsbad and Vista Dermatology: glycerin and Asclera (polidocanol). Both solutions are effective and much safer than other sclerosing agents used in cosmetic dermatology.
Glycerin is a sugar solution that is used to treat spider veins of small diameter. It has a very low incidence of side effects as hyperpigmentation (brown spots), ulceration, and formation of new vessels (telangiectatic matting) are unlikely to occur with this sclerosing agent.
Asclera (polidocanol) is FDA-approved for the treatment of spider veins and small varicose veins called reticular veins. Asclera can be used as a foam solution to effectively treat reticular veins. Like glycerin, Asclera is very safe and the incidence of side effects is quite low.
What is the sclerotherapy treatment like?
Sclerotherapy treatments are done in-office and typically take 30-60 minutes to complete, depending on the number of veins being treated. Prior to each treatment, photos will be taken and the skin cleansed with alcohol. The procedure is performed with the patient lying down and the entire affected leg is treated from thigh to ankle, with larger veins usually being injected first. Sometimes a special light is used to help illuminate the veins for more effective placement of the sclerosing solution.
How many sclerotherapy sessions will I need?
Multiple sclerotherapy treatments are often required to achieve desired results. The number of sessions needed is determined by the severity of venous disease and on each patient’s individual response. Most patients will need 3-6 sessions. As sclerotherapy treatment does not remove the underlying tendency of patients with spider veins and varicose veins to develop new, abnormal veins, touch-up treatments may be required periodically.
How do I care for my legs after sclerotherapy treatment?
It is recommended that patients wear compression hose immediately following sclerotherapy treatment for 1 week. This has been shown to decrease the incidence of side effects and promote more effective clearance of spider veins and varicose veins. Patients are encouraged to walk immediately following treatment and every day thereafter to promote healing.
When do my veins improve and how long does sclerotherapy last?
The results from sclerotherapy take approximately 4-6 weeks to occur. Sclerotherapy should be performed as a series of treatments to achieve desired results. It can sometimes take up to 6 treatments to achieve optimal results. Once a vein is treated it will not recur, but it is possible that new veins may develop over time, particularly common in patients with underlying deep venous disease. Thus, touch-up treatments may be required with time.
What are the possible side effects associated with sclerotherapy?
Sclerotherapy is a well-tolerated procedure. However, like any cosmetic treatment, there are possible side effects. Most side effects are mild in nature and resolve within a few weeks to months. The most common side effects include itching, bruising, transient hyperpigmentation, new vessel formation, and temporary pain and swelling in the treatment area.
Is sclerotherapy treatment contraindicated for any individuals?
Yes. Patients with known allergies to any of the sclerosing solutions should not be treated with sclerotherapy. Additionally, individuals with active vein and/or blood clotting disorders should not undergo sclerotherapy treatment.
All photos provided by: Asclera; Merz Aesthetics Company
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