Rocky Mountain Internal Medicine

Of all available cosmetic treatments, Sclerotherapy is most commonly used for both spider veins and varicose veins. It involves injecting a solution into the vein that cause the lining of the vein walls to swell, stick together, and eventually seal shut. The flow of blood is stopped and the vein turns into scar tissue. In a few weeks, the vein should fade. Although the same vein may need to be injected with the solution more than once, sclerotherapy is very effective if done correctly. Sclerotherapy does not require anesthesia, and it can be performed in the doctor's office.

You'll be instructed not to apply any type of moisturizer, sun block or oil to your legs on the day of your procedure. You may want to bring shorts to wear during the injections, as well as your physician-prescribed support hose, and slacks to wear home.

When scheduling your procedure, keep in mind that your legs may be bruised or slightly discolored form some weeks afterward. You probably won't be comfortable wearing shorts, a swimsuit, or a mini skirt until your have cleared up a bit.

Sclerotherapy normally takes fifteen minutes to one hour, depending on the number and length of the spider veins. A series of treatments at bi-weekly or monthly intervals may be required.

A typical sclerotherapy session is relatively quick, lasting only about 15 minutes. After changing into shorts, your legs may be photographed for your medical records. You will be asked to lie down on the examination table and the skin over your spider veins will be cleaned with an antiseptic solution. Using one hand to stretch the skin taut, your doctor or nurse will begin injecting the sclerosing agent into the affected veins. Bright, indirect light and magnification help ensure that the process is completed with maximum precision.

Approximately one injections is administered for every inch of spider vein (anywhere from 5 to 40 injections per treatment session). A cotton ball and compression tape is applied to each area of the leg as it is finished.

As the procedure continues, you will feel small needle sticks and possibly a mild burning sensation. However, the needle used is so thin and the sclerosing solution is so mild that pain is usually mild.

In addition to the compression tape applied during the procedure, tight-fitting support hose may be prescribed to guard against blood clots and to promote healing. The tape an cotton balls can be removed after 48 hours. However, you may be instructed to wear the support hose for 72 hours or more.

It's not uncommon to experience some cramping in the leg for the first day or two after the injections. This temporary problem usually doesn't require medication.

You should be aware that your treated veins will look worse before they being to look better. When the compression dressings are removed, you will notice bruising and reddish areas at the injection sites. The bruises will diminish within one month. In many cases, there may be some residual brownish pigmentation which may take up to a year to completely fade.

Itching
Depending on the type of solution used, you may experience mild itching along the vein route. This itching normally lasts 1 to 2 hours but may persist for up to a day or so.
Transient Hyper-pigmentation
Approximately 10% of patients who undergo sclerotherapy notice discoloration (light brown streaks) after treatment. In almost every patient the veins become darker immediately after the procedure. In rare instances this darkening of the vein persists fro 4 to 12 months.
Sloughing
Sloughing occurs in less than 1% of all patients who receive sclerotherapy. Sloughing consists of a small ulceration at the injection site that heals slowly over 1 to 2 months. A blister may form, open, and become ulcerated. The scar that follows should return to a normal color.
Allergic Reactions
Very rarely a patient may have an allergic reaction to the sclerosing agent used. The risk of an allergic reaction is greater in patients who have a history of allergies.