SCLEROTHERAPY

Sclerotherapy is a medical procedure and a proven method of eliminating any diseased and unsightly veins.

Sclerotherapy has been recognized as a very valuable and effective method of therapy for spider and varicose veins. Huge demand for such a procedure has helped the development of new sclerotherapy agents as well as an understanding of venous pathology.

Like any other skill, it requires knowledge, training, experience from performing it physicians and nurses.

They pay huge attention to applying individualized techniques, always having their patients’ health and comfort at their utmost diligence.

 

Why do we suffer from unattractive veins?

There are many possible and very often overlying causes:

  • Genetics (inherited vein weakness from previous, even further, generations)
  • Hormonal changes, very often associated with pregnancy
  • Trauma
  • Easy bruising
  • Occupational factors

 

What are the benefits of sclerotherapy?

The procedure:

  • Eliminates unsightly veins
  • Eliminates diseased veins giving relief to sore, heavy, discolored legs
  • Does not require hospitalization
  • It is very affordable and in some cases covered by medical insurances
  • Activities after sclerotherapy can be resumed immediately
  • It is short, simple, and effective

 

Who is a candidate for sclerotherapy?

Prior to sclerotherapy everybody should have an initial consultation with a vascular medicine specialist.

The specialist will be able to determine the extent of a vein problem and the best treatment modality to be used.

The eligibility for sclerotherapy will be decided on an individual basis.

Contraindications for sclerotherapy include:

  • Pregnancy
  • Allergic sensitivity to sclerosant agent
  • Infection
  • Deep Vein Thrombosis (DVT) – if somebody has had a blood clot in the past, sclerotherapy is possible after diligent consideration
  • Severe arterial disease

What is sclerotherapy and how is it done?

Sclerotherapy is considered a safe procedure.

It involves an injection of a special medication, through a very thin needle, to an affected vein. The medication, also called sclerosant, irritates and dissolves the inner wall of the vein. The wall disintegrates releasing clotting agents and collapses. The vein disappears over time.

The procedure does not require an anesthetic if done by a skilled specialist.

Sclerotherapy takes approximately 20 – 30 minutes. Patients rest comfortably on the examination table and are fully awake.

Most often, patients require more than one sclerotherapy sessions.

Institute for Vein Health uses only FDA approved sclerosant agents and only from FDA approved manufacturers.

 

What to do before sclerotherapy?

Prior your treatment:

  • Avoid certain medications for 48-72 hours before your procedure; Aspirin (unless it is prescribed by your doctor), anti-inflammatory agents (naproxen, ibuprofen), fish oil
  • Talk about all medicines (also over-the-counter drugs, herbs, dietary supplements) with your vascular specialist.
  • Do not apply lotion to the legs
  • Bring your compression stockings
  • Wear comfortable clothing

For your comfort, the Institute for Vein Health can provide you with any compression garment.

 

What are the side effects of sclerotherapy?

Side effects are rare.

  • Itching, which can last even 2-3 days after the procedure
  • Raised, red areas at the injection site
  • Bruising that can last several day or weeks

 

Other side effects:

  • Brown lines or spots (hyperpigmentation) can appear at the treated vein site, they should resolve within four to six months
  • Some veins (larger size veins) can become hard and lumpy, they will require several months to disappear
  • Neovascularization (matting) is the development of new veins in response to the treatment. Like the body saying, “Trying to close some veins on me? Let me show you what I can do!”. Tiny veins are formed. The treatment of choice is “tincture of time” as they disappear by themselves.
  • Inflammation (phlebitis) with hardness, soreness, and redness of the treated vein. Requires compression and often over-the-counter anti-inflammatories.
  • Skin ulcer formation at the injection site. It may heal slowly forming a scar.
  • Allergic reaction to sclerosant agent can be localized (hives) or generalized
  • Blood clot formation, very rare with present day medications but listed in the literature
  • Short time dizziness and/or blurry vision

Sclerotherapy is a safe procedure and the listed side effects have been reported in the vascular literature as infrequent.

 

What happens after the procedure?

Compression stocking or socks are applied immediately after sclerotherapy. Patients should keep them on during the first night after procedure and then wear them daily for the next seven days. The compression has been proven to markedly diminish possible side effects.

Patients can drive themselves home and resume daily activities.

Walking is encouraged.

Activities to avoid for at least 48 hours after treatment:

  • Hot baths
  • Hot compresses
  • Direct exposure to sunlight
  • Aspirin (unless recommended by a doctor), anti-inflammatory drugs
  • Saunas, hot tubs, whirlpools

 

How effective is sclerotherapy?

It is unreasonable to agree with a claim that sclerotherapy does not work.

I have never encountered even one patient who would have not benefitted from that very simple procedure. Multiple studies have shown that each sclerotherapy session eliminates as many as 50%-60% of treated veins. Although less than 10% of patients have very minimal response to treatment, majority of them are happy with the achieved results.

Treated veins will never reappear. However, new veins may appear in the future and will require further sclerotherapy.

 

Does insurance pay for sclerotherapy?

Medical insurances pay only for medically necessary sclerotherapy and only if their plans have the treatment listed as a covered benefit.

Insurances do not pay for cosmetic sclerotherapy.

Nevertheless, it is for the vein specialist to determine if a required sclerotherapy may meet the criteria for insurance reimbursement. What may seem as a cosmetic problem on the surface still can have a deeper, sometimes dangerous source underneath the skin.

Always discuss all your concerns with a doctor to establish the nature of your problem and medical necessity for treatment.