Sclerotherapy

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Overview

Sclerotherapy is a procedure in which a solution is injected into blood vessels to make them shrink, performed to treat blood vessel malformations such as varicose or spider veins. The treated veins usually fade in a few weeks but sometimes it takes a month for the results to show up. The related symptoms such as aching, swelling, or bruising could also be improved. Depending on the severity of the condition, several treatment sessions may be needed. While the result of the sclerotherapy is permanent and the treated veins fade away, it does not prevent the development of new varicose or spider veins over time.

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Andrzej Krajewski

Dr. Andrzej Krajewski

Aesthetic Plastic Surgeon
null Poland
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Tomasz Hamera

Dr. Tomasz Hamera

Aesthetic Plastic Surgeon
null Poland
23 years of experience
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Ali Sakinsel

Dr. Ali Sakinsel

Aesthetic Plastic Surgeon
Istanbul, Turkey
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Salih Onur Basat

Dr. Salih Onur Basat

Aesthetic Plastic Surgeon
Istanbul, Turkey
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Everything About Sclerotherapy

Published on | Last updated on 6 June 2023

By Medical Content TeamMedically Reviewed by Dr. Thierry Cahuzac

Fact-checked

Sclerotherapy is a minimally invasive medical procedure used to treat varicose veins and spider veins. During sclerotherapy, a sclerosing solution is injected directly into the affected veins, causing them to shrink, collapse, and eventually fade from view. The solution irritates the lining of the blood vessel, leading to the formation of scar tissue that closes off the vein. Over time, the body naturally absorbs the treated vein, redirecting blood flow to healthier veins.

Sclerotherapy is commonly performed on the legs to improve the appearance of spider veins and small varicose veins. It is a relatively quick procedure that can be done in a healthcare provider's office without the need for anesthesia. Patients may experience mild discomfort or a sensation of cramping during the injections, but the procedure is generally well-tolerated.

Sclerotherapy is considered a safe and effective treatment for visible veins, with minimal downtime and few side effects. Multiple sclerotherapy sessions may be needed to achieve the desired results, depending on the severity and extent of the vein issues.

Varicose veins and spider veins are common vascular conditions that affect the appearance of the veins, often on the legs. 

Varicose veins

Varicose veins are enlarged, twisted, and bulging veins that usually appear blue or dark purple in color. They can occur when the valves in the veins do not function properly, causing blood to pool and the veins to stretch and become visible. Varicose veins may cause symptoms such as aching, heaviness, swelling, and discomfort in the legs, especially after prolonged standing or sitting. Risk factors for varicose veins include family history, age, obesity, pregnancy, and occupations that require long periods of standing.

Spider veins

Spider veins, also known as thread veins or telangiectasias, are smaller, red, blue, or purple veins that appear close to the skin's surface. They often resemble a spider web or tree branch pattern and are typically found on the legs and face. Spider veins are caused by the dilation of small blood vessels near the skin's surface and are not usually associated with underlying health issues. Risk factors for spider veins include genetics, hormonal changes, sun exposure, and injuries.

Both varicose veins and spider veins are common cosmetic concerns that can be treated for aesthetic reasons or to alleviate associated symptoms. Treatment options include sclerotherapy, laser therapy, vein stripping, and lifestyle modifications to improve circulation and reduce vein visibility.

Sclerotherapy may be a suitable treatment option for individuals who have varicose veins or spider veins and are looking to improve the cosmetic appearance of their legs or hands. It is commonly recommended for individuals who experience symptoms associated with varicose veins, such as pain, swelling, aching, and discomfort. Sclerotherapy may be right for individuals who:

  • Have varicose veins or spider veins: Sclerotherapy is most commonly used to treat visible varicose veins and spider veins on the legs, thighs, calves, or hands, but it can also be used for other areas such as the face and chest. 
  • Desire cosmetic improvement: Individuals seeking to improve the cosmetic appearance of their legs or hands by reducing the visibility of varicose veins or spider veins may benefit from sclerotherapy.
  • Experience symptoms: Those who experience symptoms related to varicose veins, such as pain, swelling, heaviness, cramping, or itching, may find relief through sclerotherapy.
  • Have a healthy vascular system: Candidates for sclerotherapy should have a generally healthy vascular system and be free from underlying conditions that may interfere with the healing process.
  • Are not pregnant: Sclerotherapy is typically not recommended for pregnant women, as hormonal changes and increased blood volume during pregnancy may affect treatment outcomes.
  • Are committed to aftercare: Following post-treatment instructions, wearing compression stockings as recommended, and attending follow-up appointments are essential for optimal results after sclerotherapy.

It is important to consult with a qualified healthcare provider, such as a dermatologist or vein specialist, to determine if sclerotherapy is the right treatment option for your specific vein concerns. A thorough evaluation, including a physical examination and possibly imaging tests, can help assess your candidacy for sclerotherapy and ensure that the treatment is safe and effective for your individual needs.

Before undergoing sclerotherapy for varicose veins or spider veins, here are some common steps and expectations to consider:

  • Consultation: You will typically have an initial consultation with a healthcare provider, such as a dermatologist or vein specialist, to discuss your vein concerns, medical history, symptoms, and treatment goals. During this consultation, the provider will evaluate your veins and determine if you are a suitable candidate for sclerotherapy.
  • Preparation: Your healthcare provider may provide specific instructions to prepare for the procedure, which may include avoiding certain medications, such as blood thinners, and wearing loose, comfortable clothing on the day of the treatment.
  • Medical history: Be prepared to provide a detailed medical history, including any current medications, allergies, previous vein treatments, and existing health conditions, to ensure the safety and effectiveness of the procedure.
  • Skin assessment: Your provider will examine your veins to assess the size, location, and extent of the varicose veins or spider veins that will be treated. They may also mark the veins to be targeted during the procedure.
  • Expectations: Your healthcare provider will discuss the expected outcomes of sclerotherapy, potential risks and complications, the number of sessions needed for optimal results, and post-treatment care instructions.
  • Consent: Before the procedure, you will likely be asked to sign a consent form indicating that you understand the treatment plan, risks, benefits, and potential outcomes of sclerotherapy.
  • Compression stockings: You may be advised to wear compression stockings before and after the procedure to help promote blood flow and support the healing process.
  • Follow-up: Depending on the extent of your vein issues, multiple sclerotherapy sessions may be recommended. Your provider will schedule follow-up appointments to monitor your progress, assess the results, and determine if additional treatments are necessary.

By following these pre-procedure steps and guidelines, you can help ensure a successful sclerotherapy treatment experience and optimize the outcomes of your varicose vein or spider vein treatment. It is essential to communicate openly with your healthcare provider, ask any questions you may have, and adhere to the recommended pre-treatment protocols for a smooth and effective sclerotherapy procedure.

During a sclerotherapy procedure for varicose veins or spider veins, here is what you can typically expect:

  • Preparation: You will be asked to lie down on a treatment table, and the area to be treated will be cleaned and sterilized. You may be provided with protective eyewear.
  • Injection of sclerosing solution: Your healthcare provider will use a fine needle to inject a sclerosing solution directly into the affected veins. The solution irritates the vein walls, causing them to collapse and stick together.
  • Sensation: You may feel a mild burning or stinging sensation at the injection site as the sclerosing solution is injected. Some patients report experiencing slight discomfort or cramping during the procedure.
  • Multiple injections: Depending on the number and size of the veins being treated, multiple injections may be necessary to target all visible veins effectively.
  • Compression: After each injection, gentle pressure or compression may be applied to the treated area to help disperse the sclerosing solution and promote vein closure.
  • Post-treatment care: Once the procedure is complete, you may be instructed to wear compression stockings to apply pressure to the treated veins and aid in healing. Your provider may also recommend walking and staying active to improve circulation.
  • Duration: The duration of a sclerotherapy session can vary depending on the number of veins being treated. In general, the procedure can be completed within 30 minutes to an hour.
  • Follow-up: Your healthcare provider will schedule follow-up appointments to monitor your progress, assess the treated veins, and determine if additional sessions are needed for optimal results.

By understanding what to expect during a sclerotherapy procedure, you can prepare yourself for the treatment process and ensure a smooth and successful experience. It is important to follow your healthcare provider's instructions, attend follow-up appointments, and communicate any concerns or questions you may have throughout the treatment and recovery period.

After undergoing a sclerotherapy procedure for varicose veins or spider veins, here is what you can typically expect in terms of post-procedure care and recovery:

  • Compression stockings: Your healthcare provider may recommend wearing compression stockings or bandages for a period of time following the procedure. Compression helps promote blood flow, reduce swelling, and support the healing process.
  • Activity restrictions: You may be advised to avoid strenuous exercise, heavy lifting, and prolonged standing for a few days after sclerotherapy. Walking and light activities are generally encouraged to improve circulation.
  • Avoiding sun exposure: Direct sun exposure should be avoided on the treated areas for a few weeks post-procedure to prevent hyperpigmentation or skin discoloration.
  • Hydration: Staying well-hydrated by drinking plenty of water can help flush out the sclerosing solution and promote healing.
  • Monitoring side effects: It is normal to experience some minor side effects after sclerotherapy, such as bruising, redness, swelling, or tenderness at the injection sites. These symptoms usually resolve on their own within a few days to weeks.
  • Follow-up appointments: Your healthcare provider will schedule follow-up appointments to monitor your progress, assess the treated veins, and determine if additional sessions are needed for optimal results.
  • Results: Over time, the treated veins will gradually fade and be reabsorbed by the body. Multiple sclerotherapy sessions may be required to achieve the desired cosmetic outcomes, depending on the extent of the vein issues. The full results of sclerotherapy may take several weeks to months to become apparent as the body absorbs the treated veins. It is important to be patient and follow your provider's recommendations for optimal outcomes.

By following these post-procedure guidelines and staying in communication with your healthcare provider, you can help ensure a smooth recovery process and maximize the benefits of sclerotherapy for your varicose veins or spider veins. If you have any concerns or questions during the recovery period, do not hesitate to reach out to your healthcare provider for guidance and support.

Sclerotherapy is generally considered a safe and effective treatment for varicose veins and spider veins. However, like any medical procedure, there are potential risks and side effects associated with sclerotherapy. Some of these include:

  • Bruising: It is common to experience bruising at the injection sites after sclerotherapy. This usually resolves on its own within a few days to weeks.
  • Swelling: Mild swelling in the treated area is normal and typically subsides over time. Compression stockings may help reduce swelling.
  • Discoloration: Temporary skin discoloration or hyperpigmentation may occur at the injection sites. This usually fades over time but can be more persistent in some cases.
  • Pain or discomfort: Some individuals may experience mild pain, stinging, or discomfort during or after the procedure. Pain relievers or anti-inflammatory medications can help manage these symptoms.
  • Inflammation: Inflammation of the treated veins may occur, leading to redness, warmth, and tenderness in the area. This is usually temporary and resolves on its own.
  • Allergic reactions: While rare, allergic reactions to the sclerosing solution used in the procedure can occur. Symptoms may include itching, hives, or more severe reactions such as anaphylaxis.
  • Blood clots: In some cases, blood clots (thrombophlebitis) may develop in the treated veins. This can cause pain, redness, and swelling in the affected area.
  • Skin ulcers: Rarely, sclerotherapy can lead to skin ulceration at the injection site. Proper technique and post-procedure care can help minimize this risk.
  • Matting: Occasionally, new, tiny blood vessels may appear near the treated area, a phenomenon known as telangiectatic matting. These vessels may resolve on their own or require additional treatment.
  • Infection: While uncommon, there is a risk of infection at the injection sites. It is essential to keep the treated areas clean and follow proper aftercare instructions to reduce this risk.
  • Recurrence: In some cases, treated veins may reappear or new veins may develop over time, requiring additional sclerotherapy sessions or alternative treatments.

It is important to discuss the potential risks and side effects of sclerotherapy with your healthcare provider before undergoing the procedure. By following pre-procedure guidelines, choosing a qualified provider, and adhering to post-treatment care instructions, you can help minimize risks and achieve successful outcomes with sclerotherapy for varicose veins and spider veins.

The cost of sclerotherapy for varicose veins or spider veins can vary depending on various factors such as the extent of treatment needed, the number of sessions required, the geographic location of the treatment facility, and the expertise of the healthcare provider performing the procedure. On average, a single sclerotherapy session can cost anywhere from $200 to $500 or more.

Insurance coverage for sclerotherapy may vary depending on your insurance provider, the specific type of veins being treated, and whether the procedure is deemed medically necessary. In general, insurance companies are more likely to cover sclerotherapy for varicose veins that cause symptoms such as pain, swelling, or skin changes, rather than for cosmetic reasons alone.

Before undergoing sclerotherapy, it is recommended to contact your insurance provider to inquire about coverage details, including any pre-authorization requirements, copayments, deductibles, and out-of-pocket expenses. Your healthcare provider's office can also assist in verifying insurance coverage and providing information on potential costs associated with the procedure.

If insurance does not cover the full cost of sclerotherapy or if you are seeking treatment for cosmetic reasons, it is important to discuss payment options and any available financing plans with your healthcare provider. Some clinics may offer package deals for multiple treatment sessions or discounts for paying upfront.

How long does a session of sclerotherapy last?

A session of sclerotherapy typically lasts between 30 minutes to an hour, depending on the number of veins being treated and the complexity of the case.

How long do sclerotherapy results last?

Sclerotherapy is considered a permanent treatment for varicose veins and spider veins in the sense that the injected solution causes the treated veins to collapse, close off, and eventually be reabsorbed by the body. Once the veins have been successfully treated with sclerotherapy, they typically do not reappear in the same location. However, it is important to note that new veins may develop over time due to various factors such as genetics, lifestyle, and underlying venous issues. 

Does the sclerotherapy procedure hurt?

Sclerotherapy is generally well-tolerated, with most patients experiencing minimal discomfort. Some may feel a mild stinging or cramping sensation during the injections, but the pain is usually mild and temporary.

How many sessions of sclerotherapy do I need for spider veins?

The number of sclerotherapy sessions needed for spider veins varies depending on the size, number, and location of the veins. Typically, multiple sessions spaced several weeks apart are required for optimal results.

Is sclerotherapy or laser therapy more effective for spider veins?

Both sclerotherapy and laser therapy are effective treatments for spider veins, with the choice often depending on individual factors such as vein size, location, and patient preference. Sclerotherapy is commonly preferred for larger veins, while laser therapy may be suitable for smaller, superficial veins. Consulting with a healthcare provider can help determine the most appropriate treatment option for your specific case.