sclerotherapy

Sclerotherapy is a minimally invasive in-office vein treatment used to alleviate small varicose veins and spider veins — the tiny purple and red veins on the surface of the skin.

What is sclerotherapy?

Sclerotherapy is a minimally invasive in-office vein treatment used to alleviate small varicose veins and spider veins—the tiny purple and red veins on the surface of the skin. Using a micro-needle, a solution is injected into the vein, which causes the vein to collapse and close. Over time, the body absorbs the treated vein and it disappears. Sclerotherapy is the gold standard of treatment for small varicose veins and spider veins because it is so effective, causes little or no pain and requires no downtime or recovery time.

What are Spider Veins and Varicose Veins?

Spider veins are a cluster of small blood vessels that appear on the surface of the skin. Spider veins have "branches" that tend to look like a spider web. They can be red, blue or purple in color and are most often found on the legs and face. In most cases, spider veins are strictly a cosmetic concern and are not painful. Varicose veins tend to be blue or purple in color and occur in a variety of sizes, from relatively small, thin lines to large, twisting and bulging ropes. Varicose veins are most often present on the legs. They can be painful and, in some cases, are an indication of underlying vein disease.

What Causes Spider Veins and Varicose Veins?

Injury to the leg is an obvious culprit for the development of spider veins and small varicose veins on the legs. Beyond injury or trauma to the legs, spider and varicose veins develop when the one-way valves in the vein stop functioning properly and allow blood to seep downward and pool in the vein. The pooled blood and increased pressure inside the vein can cause the vein to enlarge or bulge.

Who Gets Spider Veins and Varicose Veins?

There seems to be a genetic factor in the development of spider and varicose veins, as these types of vein problems tend to run in families. Older individuals tend to get these vein conditions more often than younger people. Further, women tend to get spider and varicose veins more frequently than men, perhaps due to hormone changes during pregnancy and menopause. Hormone-based birth control, as well as hormone replacement therapy, can exacerbate spider and varicose veins.

Why Treat Spider Veins and Varicose Veins?

For most patients, spider veins and small varicose veins are nothing more than skin blemishes and do not pose a serious health risk. Of our patients that seek treatment for these benign skin lesions, most do so for cosmetic reasons. The small purple and red veins can make people feel self-conscious about the appearance of their legs. Treating these veins with sclerotherapy is an effective and relatively painless way to eliminate these unattractive blemishes. In addition, treating spider veins can improve the following leg symptoms:

  • Aching
  • Swelling
  • Leg cramps
  • Burning

Why Choose Sclerotherapy to Treat Spider Veins and Varicose Veins?

Sclerotherapy is one of the most minimally invasive treatments used to alleviate small varicose and spider veins. Doctors and patients alike tout the benefits of sclerotherapy:

  • Non-surgical
  • No need for anesthesia
  • No stitches
  • Performed in the comfort of our office
  • Treatment is quick—patients are in and out of the office in about an hour
  • No recovery period
  • Immediate return to normal activities
  • Few, if any, side effects
  • Effective treatment option for patients with other underlying health conditions

How Does Sclerotherapy Work?

The special solution used during sclerotherapy is called a sclerosant. When the sclerosant is injected into the diseased vein, it causes a chemical injury to the lining of the vein, prompting it to contract and ultimately scar itself closed. It may take several treatments to achieve full results for densely matted or larger veins. Usually two to four sessions will accomplish great outcomes for even the most challenging veins. Patients often comment that they saw a video online that showed the spider veins instantly disappearing with the injection of medicine. This “disappearance” is the medicine washing out the blood contained in the small, dilated capillary vein. In minutes, blood typically refills the vein. The actual elimination of the treated vein can take weeks to months, with gradual improvement throughout that time frame.

What is Sclerotherapy Treatment Like?

Upon arrival at Atlantic Vein Institute, our staff will help you get comfortable, with your legs elevated. Your provider will review the treatment plan with you and answer any questions you may have before the procedure begins. The treatment area is cleaned and then a tiny needle is inserted into the compromised vein and the sclerosant is injected. You may feel a slight pinch as the needle enters the skin and a mild stinging sensation as the sclerosant begins to work inside of the vein. After the needle is withdrawn, your provider may massage the area to distribute the sclerosant throughout the vein. Finally, compression stockings or compression wrap may be applied to the treatment area. The entire process takes less than 30 minutes, depending on the number of veins receiving sclerotherapy.

What Should I Expect After Sclerotherapy?

Immediately after your sclerotherapy procedure, you can drive yourself home. You can return to work and your normal activities the same day. For the first 24-72 hours following treatment, avoid hot showers, saunas, heating pads, sun exposure and certain medications as advised by your provider. Walking is encouraged from the start; however, refrain from more intense exercise for 24-72 hours. A compression stocking or compression bandage should be worn for 24-72 hours following sclerotherapy to promote circulation while minimizing swelling and bruising.

Some of the treated veins may feel hard or tender after treatment. Rarely do our patients experience or report any post treatment issues, however treatment side effects can include skin discoloration, small blisters, raised bumps, bruising or the presence of several tiny red blood vessels. The extent of the side effects depends on the patient and the number of veins treated. However, most patients are very pleased and surprised by the ease of the treatment and recovery.

Although the likelihood of more significant risks is rare, complications such as formation of a blood clot, inflammation at the treatment site or an allergic reaction to the sclerosant occurs in well under 1% of treatments. If you experience any concerning side effects, or if you have questions following your treatment, please call our office or your provider directly.

How Effective is Sclerotherapy?

According to research, an overwhelming majority—90 percent—of patients respond positively to sclerotherapy. It is estimated that 50 to 80 percent of the spider veins treated with sclerotherapy are eliminated with each treatment. Patience is key. The resolution of these tiny veins is not immediate. It may take three to six weeks for the treated veins to begin to diminish. Your doctor will monitor your progress following your first sclerotherapy procedure and may recommend additional treatments to achieve complete resolution of your spider and varicose veins.

Will My Spider Veins Come Back After Sclerotherapy?

Technically, no. The veins that are successfully treated are destroyed. However, a patient with spider veins or small varicose veins often has a genetic tendency toward developing these conditions. As a result, more veins can form in the future. Our approach is to thoroughly eliminate spider veins of all sizes—particularly the smallest developing spider veins—so that the reappearance of new veins takes a long time. Some of our patients come in annually for a touch-up treatment.

Am I a Good Candidate for Sclerotherapy?

You will have a consultation before treatment to determine if sclerotherapy is the best option for your vein concerns. In our experience, most sclerotherapy patients are between the ages of 30 and 65. Even if a patient has an underlying health condition, they may be eligible for sclerotherapy because it is minimally-invasive and doesn’t require anesthesia. Sclerotherapy may be the right treatment for you if you:

  • Have small varicose or spider veins
  • Are not currently pregnant
  • Have not had blood clot issues (this can be considered on a case-by-case basis)
  • Are mobile and not bedridden
  • Are willing to carefully follow pre- and post-treatment care instructions