Smaller varicose veins and spider veins are very well treated
with sclerotherapy. This technique allows us to inject a small
amount of solution directly into the veins causing them to become
irritated and eventually absorbed or turned to scar by the body.
Spider veins typically fade completely while smaller varicose
veins may disappear leaving a small palpable scar-like sensation
deeper in the tissue.
We use a very tiny needle which makes the injection almost painless.
The solution injected displaces the blood in the vein transiently
allowing a contact with the small vein wall. This incites the
irritation which eventually leads to resolution of the vein. It
is very common for the vein to appear darker and more visible
immediately after the injection session. Over a period of several
weeks the intensity of the coloration fades as does the vein itself.
Foam sclerotherapy has led to a significant advance in our ability
to treat larger varicose veins and we are able to replace surgical
vein removal with foam sclerotherapy on a number of occasions.
The foam allows the injected solution to remain in contact with
the vein wall for a prolonged period of time leading to a more
successful result.
Potential side effects
1) Hyperpigmentation, which is a
usually temporary darkened discoloration over the injected vein,
usually resolves but can take a number of months for resolution.
Fortunately some of the newer agents are less likely to cause
this problem.
2) Trapped blood can occur in the larger injected veins as areas
of the veins close down. This is not a serious problem and is
easily treated by simply aspirating the blood in the office with
a small needle. If the trapped blood is evacuated within 2-3 weeks
after injection, the chance of developing hyperpigmentation is
much less.
3) Matting occurs very rarely but may be seen after injection
if a patient finds very fine new pink vessels at the site of the
sclerotherapy. This matting usually resolves on its own in a few
months, but on occasion, a dermal laser may be effective in leading
to complete resolution.
Aftercare:
Patients who have larger veins treated with sclerotherapy should
wear support hose up to a week after injection to reduce the risk
of hyperpigmentation and trapped blood. We encourage regular activity
and specifically do not advise bed rest after sclerotherapy.
