Sclerotherapy

Sclerotherapy is a procedure used to treat blood vessel malformations and also malformation of the lymphatic system. Sclerotherapy is non–invasive procedure, requiring only one injection.  The treatment involves a doctor injecting medicine into your blood vessels or lymph vessels that causes them to shrink. It is used to treat varicose veins or so-called spider veins. It is used for children and young adults with vascular or lymphatic malformation.  USES OF SCLEROTHERAPY

• Cosmetic reasons. Sclerotherapy improves the appearance of varicose and spider veins.
• To treat varicose veins (also known as chronic venous insufficiency), and related disorders such as weakened vein valves, swellings, rashes, painful veins.
• Treats malformed lymph vessels
• Treatment of  hemorrhoids, and associated symptoms
• Treatment of hydroceles. This is an unhealthy development of fluid in a body cavity. Hydroceles are common in the testicles.
• Sclerotherapy should be considered when the skin legs or feet are patchy or dry, and when your legs are sore or feel heavy.
• It can be useful in reducing aching and night cramps.

RISK OF SCLEROTHERAPY Sclerotherapy is a safe procedure. It is less invasive and less risky than surgery. It does not require anesthesia.  Sclerotherapy results in typically two categories of side effects viz the temporary side effects that usually go away within a few days to several weeks and treatable side effect that is less common. Some side effects can take months or even years to disappear.  Temporary side effects They may occur on the side of the injection. They include;

• Bruising
• Small skin sours 
• Skin reddening
• Skin darkening in form of lines or spots
• Multiple tiny red blood vessels

Side effects that may require treatment.  They are less common, they include: 

• Inflammation. 

Usually mild, but may cause swelling, warmth, sometimes pain, and discomfort around the injection site. Your doctor may recommend an over-counter-pain pain reliever like aspirin or ibuprofen (Advil, Motrin IB, others) to relieve the inflammation. 

• Air Bubbles. 

Tiny air bubbles from the needle can get into the bloodstream, causing changes in vision, headache, and nausea.

• Blood Clot. 

Rarely blood clots can form in the treated vein. The clots may travel to areas of the body and becomes life-threatening if left untreated.  A blood clot is an embolus. Seek immediate medical care if you experience difficulty in breathing, chest pain, dizziness, or cough up blood.

• Allergic Reaction. 

This may be as a result of the solution used for treatment, this is not common. PREPARING FOR SCLEROTHERAPY Before the procedure, your doctor will perform a physical exam and gather your medical history. Physical Examination;

• Your doctor examines the involved veins
• The doctor checks for any underlying blood vessel disorder

Medical History; Your doctor will ask about any:

• Recent health disorder or existing medical condition, (a heart condition or a history of blood clots).
• Allergies
• Previous treatment for varicose veins and its results
• Medication or supplements you take especially aspirin, ibuprofen(Advil, Motrin IB, others), naproxen sodium (Aleve, Anaprox Ds), blood thinners, iron supplements, or herbal supplements.

Your doctor may give instructions on how to stop taking these medications for some time before the procedure, to prevent chances of bleeding. ULTRASOUND; Your doctor may request ultrasound imaging on the veins in your legs. The Day Before The Procedure;

• Don’t or apply any lotion to your legs. (Even after the procedure, avoid sharing or applying lotion until the injection site is healed).
• Wear loose, comfortable clothing to your appointment
• You may wear a pair of shorts, so that your legs may be exposed.

THE SCLEROTHERAPY PROCEDURE

• Done in the doctor’s room
• Requires no anesthesia
• Duration is 30 – 60 minutes
• Performed by a physician
• You may return home the same day
• Possible to resume normal activities the same day.

During the Procedure:

• You will lie on your back with your legs slightly raised
• The treated area will be cleansed with alcohol and insert a small needle into the vein
• Your doctor will inject an irritative solution into your vein. (You may feel a burning or tingling sensation or nothing at all).
• After the injection, the doctor will massage the area to prevent blood from re-entering the vein.
• You‘ll wear a pad or compression stockings in the area.

After one vein, the doctor moves to the next vein. The number of injections depends on the number and size of veins being treated.  The solution is usually liquid or foam. The foam tends to cover more surface area than liquid. The solution works by irritating the lining of the vein, causing it to swell, shut and block the flow of blood.

After the Procedure:

• You’ll be able to get up and walk around after the procedure (walking and moving your legs prevents the fountain of blood clots, therefore of great importance to avoid complications).
• You’ll be asked to wear compression stockings or bandages (usually on the treated vein.
• You may likely return home and may resume your normal activities the same day.
• It is recommended that someone should drive you home after the procedure
• Your doctor may advise you to avoid strenuous exercises for 2 weeks after the procedure
• You should also avoid sun exposure to the treated areas. Sun exposure can lead to dark spots on your skin.

RECOVERY

• For the treatment of small varicose veins or spider veins, expect to see results in 3 – 6 weeks.
• Larger veins may require 3 – 4 months.

However, multiple treatments may be needed to achieve the needed results. Generally, veins that respond to treatment will not come back, but new veins may emerge.

• Your doctor will schedule a follow-up visit about one month after the procedure to evaluate the success of the procedure and if you need more sessions.
• Generally, there must be a six-week interval before undergoing another sclerotherapy session.

SUCCESS RATE OF SCLEROTHERAPY There have been several studies reporting the results of sclerotherapy in small series of patients. The majority of these show clinical success rates of 80 – 90 percent for the resolution of injected vessels. However, about 10 percent of patients report no improvement in their condition.  

FAQ

Can sclerotherapy make veins or cause more spider veins to form?

Sclerotherapy does NOT worsen existing veins or cause more spider veins to form.

• What happens if you don’t wear compression stockings after sclerotherapy?

This usually occurs 2 -4 weeks after treatment and may take several months to resolve. Politics: Lack of compression increases the chances that the blood might accumulate in a partially collapsed vein and form a blood clot. This can lead to swelling, inflammation, and pain requiring further medical treatment.

• Which is better sclerotherapy or laser?

As laser therapy is more painful, it takes much longer to treat spider veins and therefore fewer veins may be treated in a single session, as compared with the use of sclerotherapy. This means that sclerotherapy can provide optimal results for spider vein removal with less time and treatment sessions.

• How much does sclerotherapy cost?

The average cost of spider vein treatment (sclerotherapy) is $343 and the average cost of laser treatment for leg veins is $443, according to 2019 statistics from the American Society of Plastic Surgeons.

• How many times can you have sclerotherapy?

This varies depending on the size of the veins and the extent of spider vein spreads. Most clients take 2 -4 treatment sessions to get near-complete results. While complete elimination of the veins is not guaranteed, most clients will see significant improvement in the weeks after the first treatment.